Herniated Disc: Symptoms, Causes, Risk Factors, and Treatment Options

A herniated disc (herniated nucleus pulposus) occurs when the gel-like center of an intervertebral disc ruptures through the annulus fibrosus, potentially compressing spinal nerves or the cord.

Common Symptoms

• Radicular pain: Sharp, shooting pain along nerve distribution (sciatica: L5/S1 → leg; C6/C7 → arm).
• Numbness/tingling in dermatomal pattern.
• Weakness in myotomal muscles (foot drop, grip weakness).
• Axial pain: Local back/neck pain.
• Red flags (cauda equina): Saddle anesthesia, bowel/bladder dysfunction, bilateral leg weakness — emergency surgery.

Risk Factors

• Age 30–50 (disc degeneration peaks).
• Male sex (slightly higher).
• Obesity (increased axial load).
• Smoking (impairs disc nutrition).
• Heavy lifting, twisting, vibration exposure.
• Genetics (collagen variants).

Diagnosis

• Clinical exam (neurological, straight leg raise).
• MRI (gold standard for soft tissue).
• CT myelogram if MRI contraindicated.

Treatment

• Conservative (first-line): NSAIDs, activity modification (not bed rest), PT (McKenzie, core stabilization), epidural steroid injections.
• Surgery (microdiscectomy): Indicated for progressive deficit, cauda equina, or refractory pain >6–12 weeks. Success rate ~85–90%.

Prevention

• Core strengthening, proper lifting technique, weight control, smoking cessation, ergonomic workspace.