Spinal disc herniation is a medical condition affecting the spine in which a tear in the outer, fibrous ring (anulus fibrosus) of an intervertebral disc (discus intervertebralis) allows the soft, central portion (nucleus pulposus) to bulge out beyond the damaged outer rings. Disc herniation is usually due to age-related degeneration of the anulus fibrosus, although trauma, lifting injuries, or straining have been implicated. Tears are almost always postero-lateral in nature owing to the presence of the posterior longitudinal ligament in the spinal canal. This tear in the disc ring may result in the release of inflammatory chemical mediators, which may directly cause severe pain, even in the absence of nerve root compression.
Disc herniations are normally a further development of a previously existing disc "protrusion", a condition in which the outermost layers of the anulus fibrosus are still intact, but can bulge when the disc is under pressure. In contrast to a herniation, none of the nucleus pulposus escapes beyond the outer layers. Most minor herniations heal within several weeks. Anti-inflammatory treatments for pain associated with disc herniation, protrusion, bulge, or disc tear are generally effective. Severe herniations may not heal of their own accord and may require surgical intervention. The condition is widely referred to as a slipped disc, but this term is not medically accurate as the spinal discs are firmly attached between the vertebrae and cannot "slip".
Lumbar Herniated Disc Symptoms
General symptoms typically include one or a combination of the following:
Leg pain (sciatica), which may occur with or without lower back pain. Typically the leg pain is worse than the lower back pain.
Numbness, weakness and/or tingling in the leg
Lower back pain and/or pain in the buttock
Loss of bladder or bowel control (rare), which may be an indication of a serious medical condition called cauda equina syndrome.
This patient education animation illustrates the internal anatomy of a prolapsed and herniated disc.
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