A herniated disc, commonly known as a slipped disc, occurs when the soft inner core of an intervertebral disc protrudes through a tear in the outer layer. This condition is a frequent source of back pain and can be attributed to factors such as aging, strain, injury, or the natural degeneration of disc material. When a herniated disc occurs, it can lead to pain, often described as a burning or stinging sensation that may radiate into the lower extremities. In severe cases, it can result in weakness or changes in sensation. At times, the pressure from a herniated disc can affect nerves or the spinal cord, giving rise to symptoms such as nerve compression or myelopathy.

Key Points:

• Herniated discs can be painful, but they often resolve within a few weeks.
• Some individuals with herniated discs may not experience pain.
• Herniated discs can be detected on MRI scans in individuals without symptoms.
• Initial treatment often involves conservative measures, with surgery considered when there is significant nerve compression.
• Surgery is typically a last resort, as it doesn’t always provide predictable outcomes and can leave patients with lingering pain and neurological issues.
• Physical therapy is a crucial component of recovery, with better results for those who maintain an active and healthy lifestyle.

Types of Herniations:

• Posterolateral Disc Herniation: Typically protrudes into the vertebral canal and can compress nerves as they pass the level of the disc.
• Central (Posterior) Herniation: Less common and may compress the spinal cord or lead to Cauda Equina Syndrome.
• Lateral Disc Herniation: Often involves nerve root compression above the level of the herniation.

Stages of Herniation:

• Bulging: The disc extends beyond the adjacent vertebral endplates.
• Protrusion: The inner nucleus impinges on the outer annulus fibrosus, with the posterior longitudinal ligament remaining intact.
• Extrusion: Nucleus material emerges through the annular fibers, while the posterior longitudinal ligament remains intact.
• Sequestration: Nucleus material emerges through the annular fibers, and the posterior longitudinal ligament is disrupted, with some material protruding into the epidural space.