Herniated disc

The back is made up of bones called 'vertebrae'. Between these vertebrae are elastic 'intervertebral discs'. These have a soft core. A herniated disc is a protrusion of the soft core of such an intervertebral disc. This leads to pain in the lower back. The symptoms can also radiate to one or both legs due to pressure on a nerve.

The soft core of an intervertebral disc is also called the nucleus pulposus. In the medical world, a herniated disc is therefore also described as a hernia nuclei pulposi (HNP).

What causes a herniated disc?

Each year, about 75,000 people in the Netherlands experience symptoms as a result of a herniated disc. In more than half of the cases, there is a congenital weakness of the intervertebral disc. However, there are more factors that contribute to the development of a herniated disc.

Risk factors for a herniated disc

A lack of sufficient physical activity, poor muscle condition, and being overweight negatively affect the intervertebral disc. An unhealthy lifestyle, for example smoking and/or poor nutrition, completes the list of risk factors.

It is incorrect to say that physically heavy work with a lot of bending and lifting causes a herniated disc. However, it is possible that it worsens the symptoms in an already existing herniated disc.

Although the intervertebral disc becomes less elastic and therefore more vulnerable as age increases, most herniated discs are seen in people between 35 and 55 years of age, generally more often in men than in women.

How can a herniated disc be recognized?

In most cases, there is a sharp pain in the lower back. This pain worsens when coughing, sneezing, or straining (bowel movement).

Due to pressure from the herniated disc on a nerve root, it is also possible that symptoms occur in the corresponding area, such as pain in one or both legs. These shooting pains can extend to the foot. This is called radiation. It causes tingling, reduced sensation, or loss of strength in the leg.

How is a herniated disc diagnosed?

If a herniated disc is suspected, the family doctor or specialist will request additional tests to obtain certainty. This additional examination can take place in different ways.

Initially, a CT scan or X-ray of the lower back will be taken. This provides a good idea of possible deformations and/or tears in the intervertebral discs.

If this still provides insufficient information, an MRI scan will be performed additionally. This usually clearly visualizes a bulge of the intervertebral disc.

How is a herniated disc treated?

Between 70 and 80 percent of herniated discs recover without surgery. A non-operative (conservative) approach is therefore definitely preferred. Exercise therapy under the guidance of a physical therapist will be started and, if necessary, medications will be prescribed to combat the pain.

Enlist the help of a physical therapist.

In more severe herniated discs, or if conservative treatment yields insufficient results, surgery will be performed. During this hernia operation, the surgeon will make an incision of about five to seven centimeters at the level of the affected intervertebral disc; a minimally invasive procedure is also possible.

The back muscles are then moved aside, and the protrusion is removed in its entirety. Even after this surgery, exercise therapy under the guidance of a physical therapist is of great value.

Herniated disc self-check

The herniated disc self-check gives you a first impression of whether your back complaints may be the result of a herniated disc. Do the self-check and get an initial indication of your symptoms.