Herniated disc symptoms & treatment

A herniated disc is an injury to the round rubbery section (disc) located between each of your vertebrae (bones in the spine). These discs act as cushions that allow your spine to bend and move easily.

For various reasons, these damaged discs may tear or compress the nerves in the spinal cord. This is known as herniated disc.

A herniated disc most often occurs in the lumbar (lower back) or cervical (neck) spine. These types of herniated disks are referred to as a lumbar herniated disc or cervical herniated disc, respectively.

In most cases, a herniated disc can heal on its own and be treated without surgery. However, if conservative care doesn’t provide relief over time, herniated disc surgery may be necessary.

Causes & risk factors for a herniated disc

Disc herniation is usually the result of gradual wear and tear related to aging.

The discs become more prone to tearing or rupturing as you get older. Factors that can increase the risk of a herniated disc include:

• Sedentary lifestyle: Sitting in one place for long periods of time can lead to a herniated disc and make herniated disc symptoms worse.
• Occupation: People who have physically demanding jobs have a greater risk of back problems like a herniated disc from repetitive motions like pulling, pushing, lifting and bending.
• Excess body weight: Carrying too much weight puts strain on the discs in your lower back, leading to disc herniation and spinal nerve pain.
• Smoking: Smoking reduces the oxygen supply to your discs, which can cause them to break down sooner.

Herniated disc symptoms

Pain is one of the most common herniated disc symptoms. However, a herniated disc may not always cause pain. If a herniated disc in the lower back or neck compresses your spinal nerves, you may experience symptoms, such as:

Lumbar disc herniation symptoms

• Decreased reflexes in your knee or ankle
• Intermittent or continuous pain, often on one side of your body
• While rare, loss of bladder or bowel control
• Lower back pain
• Muscle weakness or spasms in the lower back
• Numbness, tingling or a “pins-and-needles” sensation in the legs or feet
• Sciatic nerve pain, which begins in the lower back and travels down the leg to the foot

Cervical disc herniation symptoms

• Sharp neck pain that sometimes travels to your shoulder, arms, hands and fingers
• Worsening pain when you bend or turn your neck
• Tingling, numbness or muscle weakness in your neck or arms and hands
• Headaches

Diagnosing a herniated disc

Getting relief from back pain caused by a herniated disc starts with a physical exam, which includes a review of your symptoms, lifestyle and medical background.

To diagnose a herniated disc, your provider will evaluate your reflexes, muscle strength, mobility, and responsiveness to various stimuli like light touches, pin pricks, or vibration.

To pinpoint your herniated disc diagnosis, a series of tests may be employed:

• Electromyography (EMG): Utilizing small needles, an EMG measures muscle activity to determine if a herniated disc is impacting nerve roots.
• Imaging scans: Whether through a CT scan or MRI, detailed images of your discs aid your doctor in identifying the precise location of the herniated disc.
• Myelogram: This specialized CT scan involves injecting dye into your spine to precisely locate and assess the size of the herniated disc.
• Straight-leg raise test: During this examination, you'll lie on your back as your doctor raises your leg. Any discomfort experienced in your back or leg could indicate a herniated disc in your lower back.

Do herniated discs heal on their own?

Herniated discs can sometimes heal on their own, but it depends on many factors such as your overall health, the severity of the herniation and your lifestyle habits.

In many cases, the symptoms associated with a herniated disc improve with conservative treatments such as physical therapy, rest, lifestyle modifications and medications for inflammation and pain.

However, not all herniated discs will heal completely on their own. In some cases, surgery may be needed if conservative herniated disc treatments don’t provide relief from symptoms or if there are severe neurological abnormalities or loss of nerve function.

If a herniated disc goes untreated, some complications may occur, depending on the severity of the herniation, including sciatica, nerve damage or loss of mobility.

Herniated disc treatment

Once you have a diagnosis, your provider will discuss your personalized herniated disc treatment plan. In most cases, your provider will try nonsurgical herniated disc treatments to relieve your back or neck pain and restore your function.

Nonsurgical herniated disc treatments may include:

• Pain medication: If your pain is mild to moderate, your provider might recommend herniated disc treatment options of nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen to relieve your pain. The doctor may recommend prescription pain medications or muscle relaxants for more severe pain and muscle spasms.
• Cortisone injections: If the pain doesn’t get better with medications, your doctor might recommend injecting a corticosteroid into the area around the spinal nerves for herniated disc treatment.
• Physical therapy: A customized physical therapy plan can strengthen the muscles around your spine and improve your flexibility, which can help prevent further damage. Our physical therapists can also teach you to properly move and lift things to prevent the herniated disc injury from happening again.

If nonsurgical herniated disc treatments don’t provide enough relief for a herniated disc in your back or neck, your doctor may discuss surgical options with you.

Herniated disc surgery may be a good option if you have progressive nerve damage. Spine surgery options available for herniated disc treatment include the most advanced and minimally invasive procedures available.