A herniated disc occurs when the soft, jelly-like center of a spinal disc pushes out through a tear in the tougher outer exterior. This is sometimes called a slipped or ruptured disc. While a herniation can happen anywhere along the spine, it is most common in the lower back (lumbar spine) and the neck (cervical spine). The pain is usually caused by the leaked material irritating nearby nerves or the disc itself pressing against the spinal cord.
Symptoms depend on where the disc is situated and whether it is pressing on a nerve. It is possible to have a herniated disc with no symptoms at all.
Arm or Leg Pain: If the herniation is in your lower back, you will typically feel the most pain in your buttocks, thigh, and calf. If it is in your neck, the pain is usually most intense in the shoulder and arm.
Numbness or Tingling: People who have a herniated disc often experience radiating numbness or a pins and needles sensation in the body part served by the affected nerves.
Weakness: Muscles served by the affected nerves tend to weaken, which can cause you to stumble or affect your ability to lift or hold items.
Sciatica: A sharp, shooting pain that travels from the lower back through the hip and down the back of the leg.
Doctors usually perform a physical exam and review your medical history to determine the source of the pain.
Neurological Exam: A clinician will check your reflexes, muscle strength, walking ability, and ability to feel light touches or vibrations.
Straight Leg Raise Test: A common test for lumbar herniation where you lie on your back and the doctor lifts your straight leg to see if it triggers pain.
MRI: The most common imaging test used to confirm a herniated disc. It shows the location of the disc and which nerves are affected.
CT Scan: Useful for seeing the bony structures around the disc to see if the spinal canal is narrowed.
Electromyogram (EMG): This test measures how well electrical impulses are moving along nerve tissue to help pinpoint the location of nerve damage.
Most herniated discs improve on their own with conservative care over several weeks or months.
Rest and Gentle Movement: Avoiding heavy lifting or strenuous activity while maintaining light movement like walking to prevent stiffness.
Physical Therapy: Learning specific positions and exercises designed to minimize the pain and take pressure off the nerve.
NSAIDs: Medications like ibuprofen or naproxen to reduce the inflammation around the nerve root.
Oral Steroids: Short courses of corticosteroids to reduce significant swelling.
Epidural Steroid Injections: Injecting medication directly into the space around the spinal nerves to provide localized relief.
Surgery: Indicated when there are severe neurologic deficits or when conservative treatments have not helped.