What is a Herniated Disc? Symptoms, Diagnosis, Recovery, & More

Back pain can be debilitating and have a profound impact on your daily life. It can be especially frustrating if you don’t know what is causing it – did you sleep on it wrong? Lift a box that was too heavy? Or is there something more serious going on?

Could your back pain be attributed to a herniated disc? What is it, and what does that mean for your treatment and prognosis?

What is a Herniated Disc?

Your back is made up of a system of 33 bones (vertebrae) stretching from the base of your skull to your tailbone, with rubbery cushions between each called discs. These discs provide padding for your bones, aiding in bending and movement. Each disc has a soft, jellylike center, a nucleus, with a tougher exterior, the annulus. A herniated disc occurs when part of the nucleus pushes out through a tear or leak in the annulus, causing pressure on your spinal cord and irritation in the spinal nerves. It can also be called a slipped, ruptured, bulging, or protruding disc.

Herniated discs are one of the most common forms of spine injuries, with more than 3 million people being diagnosed in the US every year (1). While a herniated disc can happen anywhere along the spine, it most often occurs in the lower back or neck.

Herniated Disc Symptoms

Symptoms from a herniated disc correlate to where it is on the spine and many people have no symptoms at all.

Some common symptoms include:

In the lower back:

Pain in your lower back, thigh, calf, buttocks, and/or foot

In the neck:

Pain, often described as burning or sharp, in your shoulder and arm and sometimes hand and fingers
Neck pain
Pain that possibly worsens and shoots into your limbs when you cough, sneeze, or move certain ways

Overall:

Numbness, tingling, or weakness in the parts of the body supported by the affected nerves
Pain on one side of the body
Pain that worsens with activity and lessens with rest

Emergency symptoms:

If you experience pain that is so severe that you are unable to perform daily activities, it is time to seek medical attention. It is also important to be checked by a doctor if you have a history of metastatic cancer.

You should seek care immediately if you experience:

Leg or arm weakness
Infection or fever
Loss of feeling in the rectum or genital area
Bladder or bowel dysfunction

Causes and Risk Factors of Herniated Discs

Herniated discs can be caused by a number of factors including:

Traumatic injuries like falls or car accidents
Repetitive bending or twisting motion
Improper lifting
Aging

Certain conditions or lifestyles can increase your risk of a herniated disc, including:

Weight: Carrying excess body weight can put added stress on the discs in your back.
Genetics: It’s possible to inherit a predisposition to herniated discs
Occupation: Some jobs, especially those that are physically demanding or require repetitive bending or twisting, can increase your risk of a herniated disc
Smoking: Smoking can decrease the oxygen supply to your discs, increasing the chances of the discs breaking down or being injured
A sedentary lifestyle: Being seated for long periods of time, or not exercising can put pressure on your spine
Medical conditions: Conditions like a connective tissue disorder or diabetes can increase your risk of a herniated disc

Diagnosing a Herniated Disc

While your symptoms may align with those above, the only way you can truly know if you have a herniated disc is to be evaluated by a doctor. During your visit, your doctor will likely guide you through a series of movements to assess your pain level, range of motion, reflexes, and muscle strength. They may utilize a straight leg test, where you lie on your back while the physician raises your leg straight in the air. Pain in your leg during this examination likely indicates a herniated disc.

They will probably also run some form of diagnostic test, including:

Electromyogram (EMG) uses an electrode needle to record natural cellular electricity to help identify which nerves have been impacted and are causing your pain
Nerve conduction tests are usually used in conjunction with EMG tests to stimulate and detect nerve impulses to help identify possible nerve damage
Myelogram can reveal the size and location of the herniated disc through a combination of injected dye and a CT scan or X-ray
MRI (Magnetic Resonance Imaging) uses radio waves, a magnetic field, and computer technology to recreate a three-dimensional image of your spinal cord and the surrounding structures to locate the position of the damaged disc, examine it, and identify which nerves are impacted
CT (Computed Tomography) scan takes X-ray images from several angles to show where the herniated disc is putting pressure on the spine
X-ray can reveal associated physical problems, like a fracture or tumor, and help rule them out, but won’t specifically show a herniated disc

Complications Associated with a Herniated Disc

Although rare, sometimes a herniated disc can compress your spinal canal, which could require emergency surgery.

More common complications include:

Worsening symptoms
Bladder or bowel dysfunction
Saddle anesthesia, which is a progressive loss of sensation along the inner thighs, back of the legs, and the area around the rectum

Treating a Herniated Disc

In many cases, a herniated disc will heal on its own and be treated at home through:

Rest while maintaining movement to avoid stiffness
Over-the-counter pain relievers like ibuprofen or acetaminophen
Applying heat or ice to the affected area

If your pain doesn’t improve after utilizing these measures for a few weeks, you may need more advanced treatment such as:

Prescription anti-inflammatory pain relievers or muscle relaxers
Physical therapy to help loosen tight muscles and improve circulation
Spine injections like an epidural or nerve block

If other treatments don’t improve your pain, or if your doctor suspects spinal compression, you may need surgery. These options include:

Diskectomy to remove the damaged disc
Artificial disc replacement to replace the damaged disc
Spinal fusion

Herniated Disc Prognosis

For most people, the pain from herniated discs improves with rest and simple medical care, often within the month. But it is possible for a herniated disc to get worse, especially if you don’t follow any treatment plan or continue the activities that may have caused it, like your occupation. This may cause chronic pain as well as loss of sensation in the affected area. If you experience increasing symptoms, it is critical to consult a doctor.

One of our patients, Beatrice, was suffering severe back pain when she came to see Dr. Cole. They worked together to determine surgery was her best option. “Dr. Cole operated on my back around 6 years ago and I have been back to riding, swimming,” Beatrice shared of her recovery. After her husband Steve was suffering similar back pain, they turned back to Dr. Cole. “So, when my husband was in excruciating pain with his back, of course we went to Dr. Cole. Traveled from Toms River but would have gone across the country to see him. He performed surgery on 4 discs and had immediate relief. Dr. Cole is one of the most compassionate, excellent, and talented surgeons I’ve ever met. We highly recommend him. You will be in very good hands,” Beatrice said of her experience.

Preventing a Herniated Disc

Herniated discs are not always preventable, but there some things you can do to protect your overall back health, including:

Maintain a healthy body weight and get regular exercise
Practice good posture
Take stretching breaks if/when you sit for an extended time
Quit smoking
Use proper lifting techniques – lift with your legs, not your back

Seeking Medical Care

If you do not see improvements after four to six weeks, you should seek medical treatment, especially if your pain:

Interferes with your daily life
Worsens
Includes loss of bladder or bowel control, tingling, numbness, or loss of strength in your arms, hands, legs, or feet
Interrupts your ability to stand or walk

When you see a medical professional, you should consider asking them:

What is a good balance between rest and minimal physical activity?
What pain medications will help?
Will ice or heat help?
Should I consider surgery?

A herniated disc can be painful and inconvenient, and while many resolve with conservative care, you shouldn’t have to suffer.

At Englewood Spine Associates, our goal is to help you feel better so that you can get back to living with less pain. With over 25 years of experience in providing spinal care and surgery, our board-certified spine surgeon has the expertise and resources to treat your back condition—regardless of complexity or severity. We always strive to treat our patients with the most conservative approach possible. But when conservative care fails, we have many state-of-the-art, minimally invasive solutions that can be tailored to treating your condition. 

Patient satisfaction is our highest priority, and that’s truly what sets us apart. 

If we can help get you back to feeling your best, please contact us. 

https://pubmed.ncbi.nlm.nih.gov/37072094/