1. The Anatomy of a
Herniated Disc

2. Understanding how a herniated disc develops requires a
basic understanding of the intervertebral disc itself. A disc
is made up of two components: the annulus fibrosus and
the nucleus pulposus. The annulus fibrosus is the wall of
tough fibrocartilage (made of concentric layers called
lamellae) that contains the nucleus pulposus, which is the
disc’s gelatinous center. The nucleus pulposus is primarily
made of water, protein, and collagen. Together, the
annulus fibrosus and the nucleus pulposus provide a
highly pressurized, shock-absorbent cushion that
separates and connects adjacent vertebrae while lending
flexibility to the spine.

3. How an Intervertebral Disc
Degenerates
An intervertebral disc, just like any other part of the body, is prone to degeneration. The
intervertebral discs in the lower back (lumbar spine) and neck (cervical spine) are especially prone
to deterioration because they are tasked with supporting the weight of the upper body and
head, respectively, and also facilitating the spine’s many movements. Over time, the nucleus
pulposus can lose water and collagen while the annulus fibrosus loses elasticity. The nucleus
pulposus may press against the weakened disc wall and cause it to bulge out to one side (a bulging
disc), or a tear may develop in the annulus fibrosus (a herniated disc).
There are a variety of underlying causes of disc degeneration, a few of which are:
• Age
• Genetics
• Injuries
• Poor posture
• Smoking
• Repetitive stress

4. Herniated Disc Symptoms
In some cases, a herniated disc remains completely asymptomatic.
However, if the nucleus pulposus leaks through the rupture in the
disc’s wall, it can either irritate nerve endings in
the wall or spread into the spinal canal and press
on a nearby spinal nerve root or the spinal cord.
When this happens, the following symptoms
may develop in the neck, back,
and/or extremities:
• Shooting pain
• Tingling
• Numbness
• Muscle weakness

5. Getting a Professional Diagnosis
If you think you may be suffering from a herniated disc, it
is extremely important to get a professional diagnosis
from a medical professional before starting any kind of
treatment plan. You can start by scheduling a consultation
with your primary care physician, who will likely conduct
a physical examination, ask you about your
symptoms, and review your medical history. He or she
may also order medical imaging tests like an X-
ray, MRI, or CT scan. If your physician is unable to confirm
a diagnosis at this point, you may be referred to a spine
specialist for further testing.

6. Herniated Disc Treatment
In the event that a herniated disc diagnosis is confirmed by your primary care physician or a spine
specialist, the initial approach to treatment will most likely be nonsurgical, or conservative, in
nature. Common treatments for a herniated disc in the neck or back include pain medication like
analgesics or non-steroidal anti-inflammatory drugs, physical therapy, hot/cold
compresses, gentle stretching, or low-impact exercise. More targeted pain management
techniques are sometimes necessary, such as corticosteroid injections, ultrasound
therapy, prolotherapy, or transcutaneous electrical nerve stimulation (TENS). Some patients also
choose to explore different forms of complementary and alternative medicine for the treatment
of a herniated disc, including yoga, massage, acupuncture, and herbal supplements.
However, before integrating any types of alternative therapies into your prescribed regimen of
treatments, be sure talk with your doctor.
Surgery for a herniated disc is generally only necessary in rare cases when weeks or months of
conservative treatments have proven ineffective. Several different types of surgery are available
to relieve neural compression associated with a ruptured disc, including open spine surgeries and
minimally invasive surgeries, but not all patients will be candidates for all types of treatment.
Before consenting to elective surgery of any kind, be sure that you have tried a wide range of
conservative treatments and gotten multiple opinions from various spine surgeons.