Rheumatology’s role: This is usually a mechanical or nerve-related spine condition treated by our pain and spine physicians. A rheumatologist may be involved when there are signs of inflammatory arthritis, such as morning stiffness, swelling in several joints or abnormal inflammation tests.
For full details on this condition, see our main page: Disc Herniation.
Overview
A herniated disc occurs when some of the soft inner material of a spinal disc pushes through a weakened area of the tougher outer ring. The herniated material can press on or irritate nearby nerves.
Depending on the location, a herniated disc can cause neck and arm symptoms or low back and leg symptoms such as sciatica. Many herniations shrink over time and symptoms often improve with conservative care.
Watch and learn
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Common symptoms
- Back or neck pain
- Pain that radiates into the arm or leg
- Numbness or tingling
- Muscle weakness
- Pain that worsens with coughing, sneezing or sitting
Causes and risk factors
- Age-related disc degeneration
- Lifting with poor mechanics
- Sudden twisting or strain
- Excess body weight
- Smoking
How it is diagnosed
Diagnosis usually starts with a conversation about your symptoms and a physical exam. Depending on what we find, your clinician may order X-rays, an MRI or CT scan, or nerve tests. Imaging findings are interpreted together with your exam, because many people have changes on an MRI that do not cause pain.
Treatment options
Self-care and lifestyle
Most herniated discs improve within weeks to months. Stay active within comfort and avoid heavy lifting and long sitting early on.
Physical therapy and medications
Physical therapy and short-term medicines may help while the disc settles.
Injections and nerve blocks
Epidural steroid injections or nerve root blocks may ease leg or arm pain from nerve irritation.
Minimally invasive procedures
Minimally invasive disc decompression may be an option for selected contained herniations.
Surgical evaluation
Microdiscectomy (low back) or ACDF/disc replacement (neck) may be considered for persistent pain, weakness or nerve compression.
Frequently asked questions
Do herniated discs heal?
Many herniated discs shrink and symptoms improve within weeks to months. Your clinician will follow your progress.
When is surgery considered?
Surgery may be considered for severe or progressive weakness, symptoms that do not improve with conservative care, or emergency signs such as loss of bladder or bowel control.
Is a bulging disc the same as a herniated disc?
Not exactly. A bulge extends evenly beyond its normal border, while a herniation involves inner disc material pushing through the outer layer. Both are common on MRI and may or may not cause symptoms.
This page is general patient education and does not replace advice from your own clinician. Individual results vary.