A common source of back or neck pain is a herniated disk. Sometimes called a "slipped" or "ruptured" disk, this condition most often occurs in the lower back, as well as the smaller disks in the neck.
Although a herniated disk can sometimes be very painful, most people feel much better with just a few months of simple, nonsurgical treatments.
Disks are soft, rubbery pads found between the hard bones (vertebrae) that make up the spinal column. The disks between the vertebrae allow the back to flex or bend. Disks also act as shock absorbers.
Disks in the lumbar spine (low back) are composed of a thick outer ring of cartilage (annulus) and an inner gel-like substance (nucleus). In the cervical spine (neck), the disks are similar but smaller in size.
A disk herniates or ruptures when part of the center nucleus pushes through the outer edge of the disk and back toward the spinal canal. This puts pressure on the nerves. Spinal nerves are very sensitive to even slight amounts of pressure, which can result in pain, numbness, or weakness in one or both legs.
In children and young adults, disks have high water content. As people age, the water content in the disks decreases and the disks become less flexible. The disks begin to shrink and the spaces between the vertebrae get narrower. Conditions that can weaken the disk include:
Excessive body weight that places added stress on the disks (in the lower back)
Sudden pressure (which may be slight)
Repetitive strenuous activities
Low back pain affects many people. Pain alone is not enough to recognize a herniated disk. See your doctor if back pain results from a fall or a blow to your back. The most common symptom of a herniated disk is sciatica—a sharp, often shooting pain that extends from the buttocks down the back of one leg. It is caused by pressure on the spinal nerve. Other symptoms include:
Weakness in the leg and/or foot
Tingling (a "pins-and-needles" sensation) or numbness in the leg and/or foot
Trouble walking, loss of balance, or weakness in the hands or legs
Loss of bladder or bowel control (This is rare and may indicate a more serious problem called cauda equina syndrome. This condition is caused by the spinal nerve roots being compressed. It requires immediate medical attention.)
As with pain in the lower back, neck pain is also common. When pressure is placed on a nerve in the neck, it causes pain in the muscles between your neck and shoulder (trapezius muscles). The pain may shoot down the arm. Other symptoms include:
Weakness in one arm
Tingling (a "pins-and-needles" sensation) or numbness in one arm
Burning pain in the shoulders, neck, or arm
To determine whether you have a herniated disk, your doctor will ask you for a complete medical history and conduct a physical examination.
A physical examination will help determine which nerve roots are affected.
To help confirm a diagnosis of herniated disk, your doctor may recommend a magnetic resonance imaging (MRI) scan. This test can create clear images of soft tissues like intervertebral disks.