A herniated disc is a spinal problem that troubles many people. What causes a herniated disc? What treatments are available? This article will start by introducing the disc, explain common pain locations and examination methods, and provide treatment options to help your disc feel good as new!

1. Where are the intervertebral discs? Why does a herniated disc occur?

(1) Understanding the intervertebral disc

The intervertebral disc is a soft tissue structure located between the vertebrae of the human spine, distributed between the cervical, thoracic, and lumbar regions. It is mainly composed of a tough outer annulus fibrosus and a soft, elastic nucleus pulposus. The nucleus pulposus is semi-fluid and rich in water and gelatinous substances, effectively absorbing and dispersing pressure from the spine, giving the disc elasticity and flexibility and allowing the spine to bend, twist, and move in multiple directions while preventing direct friction or impact between vertebrae that could cause damage.

(Image source: freepik)

(2) What is a herniated disc? Where does it commonly occur?

When a disc changes shape, shifts position, or ruptures structurally, it may compress the surrounding spinal cord and nerves, causing pain and neurological symptoms. This condition is called a herniated disc. Simply put, it is like a mattress spring breaking, where the protruding part presses against your body and makes you uncomfortable and unable to sleep well.

Herniated discs most commonly occur in the lumbar and cervical spine. Specifically, about 90% of herniated discs occur between the fourth (L4) and fifth (L5) lumbar vertebrae in the lower back, and between the fifth lumbar vertebra and the first sacral vertebra (S1).

In addition, cervical herniated discs are also common, but thoracic herniated discs are less common. This is because the lumbar region has the greatest mobility and bears greater pressure, making it more prone to disc degeneration and herniation.

Likelihood of common herniated disc locations: lumbar > cervical > thoracic

2. What are the symptoms of a herniated disc?

(1) Cervical herniated disc

• Neck stiffness and pain

• Headache

• Pain, soreness, or numbness in the shoulders, upper back, or upper arms

• Numbness, tingling, or weakness in the upper limbs

(2) Thoracic herniated disc

• Back pain

• Numbness or weakness in the upper limbs

• Band-like pain in the chest and abdomen, similar to the pain from shingles

(3) Lumbar herniated disc (most common)

• Back pain, a dull ache or severe pain in the lower back

• Sciatica, causing radiating pain in the buttocks, back of the thigh, calf, and even the sole of the foot

• Numbness or tingling in the legs or feet

• Muscle weakness; in severe cases, you may not be able to lift your foot

In addition, when symptoms are severe, there may be decreased muscle strength, abnormal reflexes, and postural changes. In particular, severe lumbar disc herniation may affect bladder or bowel function and cause loss of bladder or bowel control.

Different protruding areas compress different nerve roots, so symptoms vary, but the main manifestations are pain, numbness, and functional impairment.

3. Why do people get herniated discs? Here are the 3 major causes!

(1) Physiological factors

• Age-related degeneration of the disc: As we age, the collagen and water content in the disc decrease, elasticity worsens, and the annulus fibrosus can easily rupture, causing the nucleus pulposus to protrude and the disc structure to break down. This is especially common in adults aged 35 to 50.

• Genetics: People with a family history of herniated discs have a higher risk of developing the condition.

• Excess body weight: Obesity increases the pressure on the lumbar spine, raising the likelihood of disc injury and herniation.

(2) Lifestyle factors

• Poor posture: Maintaining incorrect posture for long periods, such as hunching or looking down at 3C devices, puts excessive pressure on the spine and increases the risk of disc injury.

• Overuse or incorrect exertion: Improper lifting posture, repeated bending to carry loads, prolonged standing, or sitting for long periods can damage the spine.

• Smoking: Carbon monoxide and nicotine from smoking reduce the transport of oxygen and nutrients in the blood, causing malnutrition of disc cells, accelerating degeneration, and affecting disc health and repair ability.

(3) External trauma factors

• Physical injury: Sudden trauma such as falls or strong impacts may directly cause disc rupture and herniation.

4. Self-check methods for a herniated disc

Self-checks can be done at home through several simple methods, but these methods are only for reference and cannot provide an accurate diagnosis. If you suspect symptoms of a herniated disc, you should seek medical advice as soon as possible.

5. Treatment options for herniated discs

(1) Conservative treatment

• Medication: Use pain relievers, nonsteroidal anti-inflammatory drugs (NSAIDs), neuromodulating medications, and muscle relaxants to relieve pain and inflammation.

• Physical therapy: Such as electrotherapy, heat therapy, and massage, combined with exercise and strength training to strengthen the muscles around the spine and improve blood circulation.

• Injection therapy: Includes epidural steroid injections, which relieve pain by reducing inflammation around the nerves, and regenerative therapy (autologous platelet or growth factor injections) to promote tissue repair.

• Rest and lifestyle adjustments: Avoid sitting or standing for long periods, heavy physical labor, or poor posture; proper rest helps recovery.

(2) Minimally invasive treatment

• Intervertebral disc injection repair: Using precise image guidance, high-concentration growth factors or gelatinous substances are injected into the degenerated disc to restore its elasticity..

• Radiofrequency thermocoagulation neuromodulation surgery: Using an electric needle at around 40 degrees, this reduces the conduction of the compressed nerve and lowers the pain signal to a level that does not affect daily life..

• Endoscopic surgery: With a smaller incision, endoscopy is used to precisely treat the disc and bone spurs, resulting in less pain and a shorter hospital stay.

• Disc replacement and spinal fusion: When pain cannot be resolved with minimally invasive surgery, an artificial disc can be considered to replace the damaged disc and maintain spinal mobility; the latter fuses two vertebral bodies with a bone graft to stabilize the spine.

6. Not sure which treatment option to choose for a herniated disc? Let an all-around treatment clinic help improve the problem!

After reading the introduction above, are you still unsure about the cause of a herniated disc or how to choose a treatment plan? Come to "Xi Yi Clinic," and you won’t have to worry about choosing anymore. Let our professional team tailor the most suitable treatment plan for you!

Xi Yi Clinic follows the principle of "not just treatment, but companionship," from diagnosis to follow-up care, so that every patient feels cared for and professionally treated.

👉 Further reading:

• What should you do about wrist pain? A roundup of the 7 common causes, pain locations, and relief methods

• What should you do about a stiff neck? Which department should you see? Introduction to the 7 major causes and 5 relief methods for neck stiffness 

References: Taichung Veterans General Hospital, Cathay Hospital