| A spinal disc herniation, commonly called a "slipped | | | | Cervical disc herniations occur in the neck, most |
| disc", is a medical condition affecting the spine, in | | | | often between the sixth and seventh cervical |
| which a tear in the outer, fibrous ring (annulus | | | | vertebral bodies. Symptoms can affect the back of |
| fibrosus) of an intervertebral disc allows the soft, | | | | the skull, the neck, shoulder girdle, scapula, shoulder, |
| central portion (nucleus pulposus) to bulge out. | | | | arm, and hand. The nerves of the cervical plexus and |
| It is normally a further development of a previously | | | | brachial plexus can be affected. |
| existing disc protrusion, a condition in which the | | | | Thoracic disc herniation |
| outermost layers of the annulus fibrosus are still | | | | Thoracic discs are very stable and herniations in this |
| intact, but can bulge when the disc is under pressure. | | | | region are quite rare. Herniation of the uppermost |
| Terminology | | | | thoracic discs can mimic cervical disc herniations, while |
| Some of the terms commonly used to describe the | | | | herniation of the other discs can mimic lumbar |
| condition include herniated disc, prolapsed disc, | | | | herniations. |
| ruptured disc, and the misleading expression "slipped | | | | Lumbar disc herniation |
| disc." Other terms that are closely related include disc | | | | Lumbar disc herniations occur in the lower back, most |
| protrusion, bulging disc, pinched nerve, sciatica, disc | | | | often between the fourth and fifth lumbar vertebral |
| disease, disc degeneration, degenerative disc disease, | | | | bodies or between the fifth and the sacrum. |
| and black disc. | | | | Symptoms can affect the lower back, buttocks, |
| The popular term "slipped disc" is quite misleading, as | | | | thigh, and may radiate into the foot and/or toe. The |
| an intervertebral disc, being tightly sandwiched | | | | sciatic nerve is the most commonly affected nerve, |
| between two vertebrae, cannot actually "slip," "slide," | | | | causing symptoms of sciatica. The femoral nerve can |
| or even get "out of place." The disc is actually grown | | | | also be affected. Can cause the patient to |
| together with the adjacent vertebrae and can be | | | | experience a numb, tingling feeling throughout one or |
| squeezed, stretched, and twisted, all in small degrees. | | | | both legs and even feet. |
| It can also be torn, ripped, herniated, and | | | | Causes |
| degenerated, but it cannot "slip." | | | | Causes of a disc herniation can include general wear |
| The spelling "disc" is based on the Latin root discus. | | | | and tear on the disc over time, repetitive |
| Most English language publications use the spelling | | | | movements, stress on the disc that occurs while |
| "disc" more often than "disk." Nomina Anatomica | | | | twisting and lifting, or other injuries. |
| designates the structures as "disci intervertebrales" | | | | Symptoms |
| [plural form] and Terminologia Anatomica as "discus | | | | While the chief complaint for spinal disc herniation is |
| intervertebralis/Intervertebral disc," | | | | low back pain, symptoms of a herniated disc can |
| Regional distribution | | | | vary depending on the location of the herniation and |
| Frequency | | | | the types of soft tissue that become involved. They |
| Disc herniation can occur in any disc in the spine, but | | | | can range from little or no pain if the disc is the only |
| the two most common forms are the cervical disc | | | | tissue injured to severe and unrelenting neck or back |
| herniation and the lumbar disc herniation. The latter is | | | | pain that will radiate into the regions served by an |
| the most common, causing lower back pain (lumbago) | | | | affected nerve root when it is irritated or impinged |
| and often leg pain as well, in which case it is | | | | by the herniated material. Other symptoms may |
| commonly referred to as sciatica. | | | | include sensory changes such as numbness, tingling, |
| Lumbar disc herniation occurs 15 times more often | | | | muscular weakness or paralysis, and affection of |
| than cervical (neck) disc herniation, and it is one of | | | | reflexes. Unlike a pulsating pain or pain that comes |
| the most common causes of lower back pain. The | | | | and goes, which can be caused by muscle spasm, |
| cervical discs are affected 8% of the time and the | | | | pain from a herniated disc is usually continuous. |
| upper-to-mid-back (thoracic) discs only 1 - 2% of the | | | | It is possible to have a herniated disc without any |
| time.[5] | | | | pain or noticeable symptoms, depending on its |
| The following locations have no discs and are | | | | location. If the extruded nucleus pulposus material |
| therefore exempt from the risk of disc herniation: | | | | doesn't press on soft tissues or nerves, it may not |
| the upper two cervical intervertebral spaces, the | | | | cause any symptoms. It has been estimated that as |
| sacrum, and the coccyx. | | | | many as 50% of the population have focal herniated |
| Most disc herniations occur when a person is in their | | | | discs in their cervical region that do not cause |
| thirties or forties when the nucleus pulposus is still a | | | | noticeable symptoms. |
| gelatin-like substance. With age the nucleus pulposus | | | | Typically, symptoms are experienced only on one |
| changes ("dries out") and the risk of herniation is | | | | side of the body. If the prolapse is very large and |
| greatly reduced. At the same time osteoarthritic | | | | presses on the spinal cord or the cauda equina in the |
| degeneration makes its inroads. | | | | lumbar region, affection of both sides of the body |
| Cervical disc herniation | | | | may occur, often with serious consequences. |