Why does a herniated disc cause severe pain

Your spine is made of 24 moveable bones called vertebrae. The lumbar lower back section of the spine bears most of the weight of the body. There are 5 lumbar vertebrae numbered L1 to L5. The vertebrae are separated by cushiony discs, which act as shock absorbers preventing the vertebrae from rubbing together. The outer ring of the disc is called the annulus. It has fibrous bands that attach between the bodies of each vertebra.

Each disc has a gel-filled center called the nucleus. At each disc level, a pair of spinal nerves exit from the spinal cord and branch out to your body. Your spinal cord and the spinal nerves act as a "telephone," allowing messages, or impulses, to travel back and forth between your brain and body to relay sensation and control movement see Anatomy of the Spine. A herniated disc occurs when the gel-like center of your disc ruptures out through a tear in the tough disc wall annulus Fig.

The gel material is irritating to your spinal nerves, causing something like a chemical irritation. The pain is a result of spinal nerve inflammation and swelling caused by the pressure of the herniated disc.

Over time, the herniation tends to shrink and you may experience partial or complete pain relief. Different terms may be used to describe a herniated disc. A bulging disc protrusion occurs when the disc annulus remains intact, but forms an outpouching that can press against the nerves. A true herniated disc also called a ruptured or slipped disc occurs when the disc annulus cracks or ruptures, allowing the gel-filled center to squeeze out.

Sometimes the herniation is so severe that a free fragment occurs, meaning a piece has broken completely free from the disc and is in the spinal canal.

Most herniated discs occur in the lumbar spine, where spinal nerves exit between the lumbar vertebrae, and then join together again to form the sciatic nerve, which runs down your leg. Symptoms of a herniated disc vary greatly depending on the location of the herniation and your own response to pain.

If you have a herniated lumbar disc, you may feel pain that radiates from your low back area, down one or both legs, and sometimes into your feet called sciatica. You may feel a pain like an electric shock that is severe whether you stand, walk, or sit.

Activity such as bending, lifting, twisting, and sitting may increase the pain. Lying flat on your back with knees bent may be the most comfortable because it relieves the downward pressure on the disc. Sometimes the pain is accompanied by numbness and tingling in your leg or foot. You may experience cramping or muscle spasms in your back or leg. In addition to pain, you may have leg muscle weakness, or knee or ankle reflex loss.

In severe cases, you may experience foot drop your foot flops when you walk or loss of bowel or bladder control. If you experience extreme leg weakness or difficulty controlling bladder or bowel function, you should seek medical help immediately.

Discs can bulge or herniate because of injury and improper lifting or can occur spontaneously. Aging plays an important role. As you get older, your discs dry out and become harder.

The tough fibrous outer wall of the disc may weaken. The gel-like nucleus may bulge or rupture through a tear in the disc wall, causing pain when it touches a nerve.

Genetics, smoking, and a number of occupational and recreational activities may lead to early disc degeneration. Herniated discs are most common in people in their 30s and 40s, although middle aged and older people are slightly more at risk if they're involved in strenuous physical activity. Sharing this diary with Dr. Your symptoms may also change in frequency and intensity as your disc heals. Many people notice a change in symptoms during therapy, with symptoms sometimes temporarily worsening before they finally get better.

Herniated discs often resolve with nonsurgical treatments like:. To learn how Dr. Spinal fusion is a safe, effective treatment for many types of back pain, but some patients worry it might have an impact on their mobility.

Disc problems can cause plenty of pain — in your spine and your arms and legs, too. Without the right treatment, a damaged disc can cause permanent nerve damage. Most people think that spinal curvature problems only affect teens, but they can affect adults, too. The prolapsed disk may also put pressure on nerves and cause pain through compression. The cause of a leaking disk is usually gradual wear and overuse as a result of repeated movement over time. Spinal disks lose some of their water content as a person ages.

This reduction in fluid makes the disks less supple and more prone to splitting. It is not always possible to recall the exact point when a disk problem begins, but it often occurs when lifting objects without bending at the knee or after twisting while lifting a heavy item. Herniated disks can occur at any age, but they are most common for men between the ages of 20 and 50 years.

If the herniated disk is in the lower back, the pain often affects the buttocks, thighs, calves, and, possibly, the feet. This is often referred to as sciatica because the pain travels along the path of the sciatic nerve. If the problem occurs in the neck, the shoulders and arms normally experience the pain.

Quick movements or sneezing might induce shooting pains. This can cause permanent weakness, paralysis, loss of bowel and bladder control, and sexual dysfunction.

An X-ray can help rule out other conditions with similar symptoms. Other types of imaging can provide more detail as to the location of the herniated disk, such as:.

Although it can sometimes be extremely painful, a herniated disk has many promising treatment options. Polyneuropathy is damage to multiple nerves outside of the brain and central nervous system. This can cause pain, discomfort, and mobility…. Peripheral neuropathy is most common among people with diabetes, causing impairment in the peripheral nervous system Find out here about other medical….

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