| A spinal disc herniation, commonly called a | | | | Cervical disc herniation |
| "slipped disc", is a medical condition | | | | |
| affecting the spine, in which a tear in the | | | | Cervical disc herniations occur in the neck, |
| outer, fibrous ring (annulus fibrosus) of an | | | | most often between the sixth and seventh |
| intervertebral disc allows the soft, central | | | | cervical vertebral bodies. Symptoms can |
| portion (nucleus pulposus) to bulge out. | | | | affect the back of the skull, the neck, |
| | | | shoulder girdle, scapula, shoulder, arm, and |
| It is normally a further development of a | | | | hand. The nerves of the cervical plexus and |
| previously existing disc protrusion, a | | | | brachial plexus can be affected. |
| condition in which the outermost layers of | | | | |
| the annulus fibrosus are still intact, but | | | | Thoracic disc herniation |
| can bulge when the disc is under pressure. | | | | |
| | | | Thoracic discs are very stable and |
| Terminology | | | | herniations in this region are quite rare. |
| | | | Herniation of the uppermost thoracic discs |
| Some of the terms commonly used to describe | | | | can mimic cervical disc herniations, while |
| the condition include herniated disc, | | | | herniation of the other discs can mimic |
| prolapsed disc, ruptured disc, and the | | | | lumbar herniations. |
| misleading expression "slipped disc." Other | | | | |
| terms that are closely related include disc | | | | Lumbar disc herniation |
| protrusion, bulging disc, pinched nerve, | | | | |
| sciatica, disc disease, disc degeneration, | | | | Lumbar disc herniations occur in the lower |
| degenerative disc disease, and black disc. | | | | back, most often between the fourth and fifth |
| | | | lumbar vertebral bodies or between the fifth |
| The popular term "slipped disc" is quite | | | | and the sacrum. Symptoms can affect the lower |
| misleading, as an intervertebral disc, being | | | | back, buttocks, thigh, and may radiate into |
| tightly sandwiched between two vertebrae, | | | | the foot and/or toe. The sciatic nerve is the |
| cannot actually "slip," "slide," or even get | | | | most commonly affected nerve, causing |
| "out of place." The disc is actually grown | | | | symptoms of sciatica. The femoral nerve can |
| together with the adjacent vertebrae and can | | | | also be affected. Can cause the patient to |
| be squeezed, stretched, and twisted, all in | | | | experience a numb, tingling feeling |
| small degrees. It can also be torn, ripped, | | | | throughout one or both legs and even feet. |
| herniated, and degenerated, but it cannot | | | | |
| "slip." | | | | Causes |
| | | | |
| The spelling "disc" is based on the Latin | | | | Causes of a disc herniation can include |
| root discus. Most English language | | | | general wear and tear on the disc over time, |
| publications use the spelling "disc" more | | | | repetitive movements, stress on the disc that |
| often than "disk." Nomina Anatomica | | | | occurs while twisting and lifting, or other |
| designates the structures as "disci | | | | injuries. |
| intervertebrales" [plural form] and | | | | |
| Terminologia Anatomica as "discus | | | | Symptoms |
| intervertebralis/Intervertebral disc," | | | | |
| | | | While the chief complaint for spinal disc |
| Regional distribution | | | | herniation is low back pain, symptoms of a |
| | | | herniated disc can vary depending on the |
| Frequency | | | | location of the herniation and the types of |
| | | | soft tissue that become involved. They can |
| Disc herniation can occur in any disc in the | | | | range from little or no pain if the disc is |
| spine, but the two most common forms are the | | | | the only tissue injured to severe and |
| cervical disc herniation and the lumbar disc | | | | unrelenting neck or back pain that will |
| herniation. The latter is the most common, | | | | radiate into the regions served by an |
| causing lower back pain (lumbago) and often | | | | affected nerve root when it is irritated or |
| leg pain as well, in which case it is | | | | impinged by the herniated material. Other |
| commonly referred to as sciatica. | | | | symptoms may include sensory changes such as |
| | | | numbness, tingling, muscular weakness or |
| Lumbar disc herniation occurs 15 times more | | | | paralysis, and affection of reflexes. Unlike |
| often than cervical (neck) disc herniation, | | | | a pulsating pain or pain that comes and goes, |
| and it is one of the most common causes of | | | | which can be caused by muscle spasm, pain |
| lower back pain. The cervical discs are | | | | from a herniated disc is usually continuous. |
| affected 8% of the time and the | | | | |
| upper-to-mid-back (thoracic) discs only 1 - | | | | It is possible to have a herniated disc |
| 2% of the time.[5] | | | | without any pain or noticeable symptoms, |
| | | | depending on its location. If the extruded |
| The following locations have no discs and are | | | | nucleus pulposus material doesn't press on |
| therefore exempt from the risk of disc | | | | soft tissues or nerves, it may not cause any |
| herniation: the upper two cervical | | | | symptoms. It has been estimated that as many |
| intervertebral spaces, the sacrum, and the | | | | as 50% of the population have focal herniated |
| coccyx. | | | | discs in their cervical region that do not |
| | | | cause noticeable symptoms. |
| Most disc herniations occur when a person is | | | | |
| in their thirties or forties when the nucleus | | | | Typically, symptoms are experienced only on |
| pulposus is still a gelatin-like substance. | | | | one side of the body. If the prolapse is very |
| With age the nucleus pulposus changes ("dries | | | | large and presses on the spinal cord or the |
| out") and the risk of herniation is greatly | | | | cauda equina in the lumbar region, affection |
| reduced. At the same time osteoarthritic | | | | of both sides of the body may occur, often |
| degeneration makes its inroads. | | | | with serious consequences. |
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