Herniated Discs and Spinal Stenosis

The National Center for Health Statistics reports that 14% of all new visits to doctors are for low-back pain. About one in four back pain patients has a herniated disc. Spinal stenosis, a narrowing of the spinal column, is another common cause of back pain.

Dr. Foroohar offers a number of non-surgical and surgical treatments to relieve the pain of herniated discs and spinal stenosis. “Only 10 to 15% of patients I evaluate for spine problems need surgery,” she says.

What are discs?

The spine consists of 33 bony vertebrae. Discs—also known as intervertebral discs—are the shock absorbers between the vertebrae. Each disc is made up of:

  • A tough outer ring called the annulus, and
  • A soft inner core called the nucleus, filled with a gel-like substance

What is a herniated disc?

A herniated or ruptured disc occurs when the gel-like filling of the nucleus bulges or leaks out through the disc's outer ring. This bulging or leaking disc filling can press on nerves in the neck and spine, causing severe pain.

What can cause a herniated disc?

Several factors can weaken the discs in your spine. Discs, which have high water content in children and young adults, lose some of their water content with age. This makes the discs smaller and less flexible—decreasing the spaces between the spinal vertebrae and increasing the risk of a herniated disc and compression of the nerve.

Discs can also be weakened by:

  • Improper lifting—a common cause of work-related injuries
  • Engaging in repetitive strenuous activities
  • Putting sudden pressure on the spine
  • Suffering an accident or injury
  • Being overweight
  • Smoking

What are the symptoms of a herniated disc?

Herniated disc symptoms vary, depending on whether the affected disc is in the upper back (cervical spine) or lower back (lumbar spine). It is not very common to have a herniated disc in the thoracic spine, or middle back, because that section of the spine is anchored and supported by the rib cage.

Although the problem originates in the spine, herniated discs can produce symptoms in the arms or legs when the disc filling irritates nearby nerves. This condition is called radiculopathy.

Symptoms of a herniated disc in the neck or upper back may include:

  • Neck pain
  • Arm or shoulder pain
  • Arm or hand weakness, numbness or tingling

Symptoms of a herniated disc in the lower back may include:

  • Back pain
  • Leg pain
  • Leg or foot weakness, numbness or tingling
  • Bowel or bladder complaints

What is spinal stenosis?

Spinal stenosis is a narrowing of the spinal canal, leading to painful pinching of the spinal cord and/or nerves in the spine. Degenerative spinal stenosis results from the aging process. Much less common, spinal stenosis can be congenital—something you're born with. It can occur anywhere in the spine including neck and upper back (cervical spine), mid-back (thoracic spine) or lower back (lumbar spine).

What are the symptoms of lumbar spinal stenosis?

Lumbar (lower-back) spinal stenosis can cause:

  • Buttock pain
  • Leg pain and cramping
  • Leg numbness and tingling
  • Loss of sensation in the legs and feet
  • Inability to walk

What are the symptoms of cervical spinal stenosis?

Cervical (neck) spinal stenosis can cause:

  • Neck pain
  • Shoulder and arm pain
  • Arm numbness and tingling
  • Difficulty walking due to balance problems
  • Arm or leg weakness