What are spinal disc problems?

Spinal disc problems involve issues with the discs between the bones in the spine. When a disc is damaged, it may bulge, tear or rupture. This can cause pain by pressing on nearby nerves.

Common spinal disc problems include:

• prolapsed disc (also known as a slipped or herniated disc) — this is when the inner gel-like material bulges out of a disc and presses on a nerve
• sciatica — where a disc presses on the sciatic nerve
• degenerative disc disease — where discs wear down over time as you age
• discitis — inflammation of the discs

What are spinal discs?

There is a spinal disc between each of the bones (called vertebrae) in your spine. The spinal discs help absorb impacts, so that your bones don't rub against each other and can move smoothly. The rubbery discs, also known as intervertebral discs, are filled with gel-like fluid. This makes the spine flexible.

The spinal cord is the bundle of nerves that connects your brain to the nerves in your body. Together, the vertebrae and the discs surround and protect your spinal cord.

What are the symptoms of spinal disc problems?

Spinal disc problems can lead to acute or chronic back pain. Some people may experience numbness, tingling or weakness in their arms or legs.

Pain

Spinal disc problems often lead to back pain. The location and type of back pain will depend on which disc is affected and what the problem is.

• Lower back — disc issues in the lower (lumbar) spine can lead to lower back pain. Pain may radiate down the legs.
• Upper back — upper back pain can happen when the discs in the middle of your back (thoracic spine) are affected. This may lead to pain around the ribs and chest area.
• Neck, shoulders and arms — disc problems in the upper (cervical) spine can lead to neck pain. Pain may also radiate to your shoulders, arms and hands.
• Legs (sciatica) — herniated discs in the lower back often compress nerves. This may lead to sciatica, which is pain radiating down the buttocks and back of the leg.

Nerve symptoms

Nerve pain can occur if the affected disc is pressing on a nerve.

A common type of nerve pain caused by disc problems is sciatica. This is where the affected disc presses on the sciatic nerve. This nerve travels from your lower back down the back of your leg.

Sometimes the pressure on the nerve can make your leg feel numb or weak.

What causes spinal disc problems?

As people age, their spinal discs go through natural changes that can make them more vulnerable to problems. Over time, the discs lose hydration and flexibility, which reduces their ability to cushion the spine and absorb shock.

This drying out and weakening of the discs can lead to cracks or tears in the outer layer. This allows the inner part to bulge or herniate. This may press on nearby nerves. These changes can lead to symptoms, as well as conditions, such as disc degeneration or herniated discs.

You have a higher chance of developing disc problems if you do lots of heavy lifting or forceful bending.

Discitis is caused by infection spreading to a disc through your bloodstream.

When should I see my doctor?

See your doctor if you have back or neck pain that interferes with your usual activities or doesn't get better after a few weeks.

Also see your doctor if your pain is worse at night. This could be a sign of a more serious problem in your spine.

Go to the emergency department immediately if you have back or neck pain with:

• a fever
• trouble controlling your urine or bowel motions
• difficulty moving your arm or leg
• numbness in your arm, leg or genital area

How are spinal disc problems diagnosed?

Your doctor may diagnose your disc problems by:

• talking to you about your symptoms including any pain you experience
• performing a physical examination — your doctor may check the movements of your spine and legs, your muscle strength and reflexes
• ordering imaging scans, such as an x-ray, CT scan or MRI scan, depending on your symptoms

Imaging scans can help diagnose spinal disc problems and rule out rare or serious causes such as spinal cancer, infections, fractures or spinal canal narrowing.

A blood test may be done to find the type of bacteria causing discitis.

How are spinal disc problems treated?

Disc problems usually improve by themselves. Treatment depends on the cause and severity of your symptoms and may include:

• pain medicines, including medicines for nerve pain
• physical treatments such as massage, physiotherapy or osteopathy
• complementary therapy such as acupuncture
• placing a heat or cold pack on the affected area
• keeping active
• exercises to strengthen your muscles and improve your posture
• surgery, such as discectomy or laminectomy — may be needed if you have severe nerve symptoms or if you don't get better with other treatments

If you have discitis, you will need antibiotics.

Living with spinal disc problems

Living with spinal disc problems involves regular care and simple lifestyle changes. This may help manage symptoms and improve daily function.

Stay active, maintain a healthy weight and practice relaxation techniques to cope with symptoms. See your doctor for regular checks to prevent complications.

What are the complications of spinal disc problems?

If a disc presses on the lower part of the spinal cord, it can cause an emergency called 'cauda equina syndrome'. This is where the nerves needed for bladder and bowel control and sexual function are at risk of damage.

If a herniated disc isn't treated, it can lead to chronic back pain. In rare situations, it may also lead to permanent nerve damage if the nerve is severely compressed.

Discitis can lead to changes in spine shape and sometimes nerve problems.

Can spinal disc problems be prevented?

There are things you can do to reduce your risk of a prolapsed disc:

• keep your body in the correct posture for sitting, standing and sleep
• take regular stretch breaks
• exercise regularly
• choose a good pillow
• maintain a healthy weight
• quit smoking

Resources and support

• Australian Physiotherapy Association has information on how physiotherapy can help manage sciatica.
• Musculoskeletal Health Australia has support and information no back pain and neck pain.
• Choosing Wisely Australia has resources on pain medicines.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available 24 hours a day, 7 days a week.

Do you prefer to read in languages other than English?

• Health Translations has a video on when medical imaging can help manage back pain, in several languages.
• NSW Government provides fact sheets in several languages about understanding lower back pain.

Looking for information for Aboriginal and/or Torres Strait Islander people?

• Pain Management Network has pain management resources for Aboriginal and/or Torres Strait Islander people.