Overview
What is a herniated disk? A Mayo Clinic expert explains
Learn more from Mohamad Bydon, M.D.
A herniated disk refers to a problem with one of the rubbery cushions, called disks, that sit between the bones that stack to make the spine. These bones are called vertebrae.
A spinal disk has a soft, jellylike center called a nucleus. The nucleus is encased in a tougher, rubbery exterior, known as the annulus. A herniated disk occurs when some of the nucleus pushes out through a tear in the annulus. A herniated disk is sometimes called a slipped disk or a ruptured disk.
A herniated disk, which can occur in any part of the spine, most often occurs in the lower back. Depending on where the herniated disk is, it can result in pain, numbness or weakness in an arm or a leg.
Many people have no symptoms from a herniated disk. For people who do have symptoms, the symptoms tend to improve over time. Surgery is usually not needed to relieve the problem.
Symptoms
Most herniated disks occur in the lower back, but they also can occur in the neck. Symptoms depend on where the disk is sitting and whether the disk is pressing on a nerve. Herniated disks often affect one side of the body.
- Arm or leg pain. If your herniated disk is in your lower back, you’ll typically feel pain in your lower back, buttocks, thigh and calf. You might have pain in part of your foot as well.
For a herniated disk in your neck, you’ll typically feel the most pain in your shoulder and arm. This pain might shoot into your arm or leg when you cough, sneeze or move into certain positions. Pain is often described as sharp or burning.
- Numbness or tingling. People who have herniated disks often have radiating numbness or tingling in the body part served by the affected nerves.
- Weakness. Muscles served by the affected nerves tend to weaken. This can cause you to stumble or affect your ability to lift or hold items.
You can have a herniated disk without symptoms. You might not know you have it unless it shows up on a spinal image.
When to see a doctor
Seek medical care if your neck or back pain travels down your arm or leg, or if you also have numbness, tingling or weakness.
Causes
Disk herniation is most often the result of a gradual, aging-related wear and tear called disk degeneration. As people age, the disks become less flexible and more prone to tearing or rupturing with even a minor strain or twist.
Most people can’t pinpoint the cause of their herniated disk. Sometimes, using the back muscles instead of the leg and thigh muscles to lift heavy objects can lead to a herniated disk. Twisting and turning while lifting also can cause a herniated disk. Rarely, a traumatic event such as a fall or a blow to the back is the cause.
Risk factors
Factors that can increase the risk of a herniated disk include:
- Weight. Excess body weight causes extra stress on the disks in the lower back.
- Occupation. People with physically demanding jobs have a greater risk of back problems. Repetitive lifting, pulling, pushing, bending sideways and twisting also can increase the risk of a herniated disk.
- Genetics. Some people inherit a predisposition to developing a herniated disk.
- Smoking. It’s thought that smoking lessens the oxygen supply to disks, causing them to break down more quickly.
- Frequent driving. Being seated for long periods combined with the vibration from a motor vehicle engine can put pressure on the spine.
- Being sedentary. Regular exercise can help prevent a herniated disk.
Complications
Just above your waist, your spinal cord ends. What continues through the spinal canal is a group of long nerve roots that resembles a horse’s tail, called the cauda equina.
Rarely, disk herniation can compress the entire spinal canal, including all the nerves of the cauda equina. In rare instances, emergency surgery might be needed to avoid permanent weakness or paralysis.
Seek emergency medical attention if you have:
- Worsening symptoms. Pain, numbness or weakness can increase to the point that they hamper your daily activities.
- Bladder or bowel dysfunction. Cauda equina syndrome can cause incontinence or trouble urinating even with a full bladder.
- Saddle anesthesia. This progressive loss of sensation affects the areas that would touch a saddle — the inner thighs, the backs of the legs and the area around the rectum.
Prevention
To help prevent a herniated disk, do the following:
- Exercise. Strengthening the trunk muscles stabilizes and supports the spine.
- Maintain good posture. This reduces pressure on your spine and disks. Keep your back straight and aligned, particularly when sitting for long periods. Lift heavy objects properly, making your legs — not your back — do most of the work.
- Maintain a healthy weight. Excess weight puts more pressure on the spine and disks, making them more susceptible to herniation.
- Quit smoking. Avoid the use of any tobacco products.
Safe exercises for a herniated disk
Gentle exercises, stretches, and activities can all help relieve the pain of a herniated disk. Neck, back, and hamstring stretches may improve flexibility and prevent a herniated disk from recurring.
People with a herniated disk do not usually need surgery. Doctors often recommend physical therapy to treat the symptoms of a herniated disk.
Any disk in the spine can become herniated, including the neck, but it most commonly occurs in the lower back. Different exercises can help depending on where the herniated disk is.
This article will look at some exercises that can relieve pain, speed recovery, and help prevent a herniated disk from recurring.
Neck pain is common after a slipped disk. Pressure on the nerves in the neck can cause pain in the neck and shoulder muscles. It may also cause shooting painTrusted Source down the arm.
The following exercise can help ease neck pain caused by a slipped disk in the upper spine or neck.
Neck stretches
To relieve pain and pressure from a herniated disk near the neck, people can try the following exercise:
- Sit upright in a chair and move the chin toward the chest, then back against the headrest, stretching the neck.
- Move the left ear toward the left shoulder, then the right ear toward the right shoulder.
- Repeat this pattern several times.
For a gentle, seated stretch along the hamstring:
- Sit in a chair with one foot on the floor and the other extended out straight, with the heel on the floor.
- Straighten the back and lean forward over the extended leg until there is a stretch along the back of the upper thigh.
- Hold this position for 15–30 seconds.
- Switch legs and repeat several times.
Towel hamstring stretch
For another hamstring stretch, try the following:
- Lie flat on a yoga mat with one leg lifted into the air.
- Wrap a towel around the foot of the leg in the air.
- Holding the towel, pull the leg toward the body.
- Hold for 15–30 seconds.
- Switch legs and repeat several times.
Back flexion exercises stretch the spine and back muscles. Speak to a doctor before performing these exercises after a back injury. To perform a back flexion stretch:
- Lie on the back and hold both knees toward the chest.
- At the same time, move the head forward until there is a comfortable stretch across the mid and low back.
- Hold the stretch for 15-30 seconds.
- Repeat several times.
Knee to chest stretch
The knee-to-chest stretch will work the muscles on each side of the body separately for a gentler stretch. Try the following:
- Lie on the back with the knees bent and both heels on the floor.
- Place both hands behind one knee and pull it toward the chest.
- Hold the stretch for 15-20 seconds.
- Switch legs and repeat several times.
Piriformis muscle stretch
The piriformis muscle is a small muscle located deep in the buttocks. To stretch this muscle:
- Lie on the back with the knees bent and both heels on the floor.
- Cross one leg over the other, resting the ankle on the bent knee.
- Gently pull the crossed knee toward the chest until there is a stretch in the buttock.
- Hold the stretch for 15-30 seconds.
- Repeat on both sides.
Exercises and physiotherapy are often important parts of recovery from a herniated disk. A doctor usually recommends a few rest days after experiencing a herniated disk.
Doing gentle activities and exercises will strengthen the muscles that support the spine and reduce pressure on the spinal column. They will also promote flexibility in the spine and may help reduce the risk of a herniated disk recurring.
A doctor may suggest starting small and slowly building up the activity level. They will discuss specific exercises a person should and should not perform during recovery.
Gentle activities that can help with a herniated disk include:
- yoga
- swimming
- walking
- cycling
Perform all exercises slowly and flexibly, especially when bending or lifting. Exercises should not hurt. If a person feels pain, they should stop exercising and speak with their doctor.
Below, we discuss exercises that can help treat a herniated disk pain in the neck and back.
People might wish to avoid high-impact activities like jogging or martial arts. These can jar the spine.
Starting small and building up to more intense exercise is the safest way to reduce symptoms. Starting exercises and stretches early can also help improve a person’s outcome.
A person should speak to a doctor about the best exercise regimen for their needs.
Doing gentle exercises and stretches can help ease the pain and pressure of a herniated or slipped disk. Strengthening the back and hamstring muscles can ease pressure on the spinal column to prevent pain and recurrence.
Always speak to a doctor before doing exercises to ensure they will not damage the back or cause further pain. A doctor can recommend the best exercises for each individual depending on the location of the herniated disk.
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