Herniated Disk

A herniated disk is a back injury that is one of the most common causes of neck and back pain. In some cases, it can also lead to arm and leg pain. Herniated disks can be caused by gradual injury or wear and tear. The pain can make it hard to do everyday activities like laundry, shopping and even bending down to feed a pet.

Here’s what to know about what causes a herniated disk, how it’s diagnosed and the best treatment options available. With the right care, most people find relief without spine surgery.

What is a herniated disk?

Your spine is made up of 24 vertebrae (bones), arranged in a stack. They protect the nerves within the spine. 

In between the bones are flat, round disks that are about a half-inch thick. They are tough on the outside and soft and jelly-like on the inside. They work like shock absorbers and make it possible for you to move and flex your spine.

A herniated disk happens when the soft inner part of the disk pushes (herniates) through a crack in its outer layer. This can put pressure on the nerves and cause pain, weakness or numbness.

Herniated disks are also called slipped disks or disk herniations. They most commonly occur in the cervical spine (neck) and lumbar spine (lower back).

What causes a herniated disk?

A herniated disk is usually caused by a gradual injury due to repetitive stress. Although a sudden, traumatic injury can contribute to a herniated disk, it is not usually the cause.

These factors may increase your risk:

• Natural wear and tear: As you age, disks lose water content, making them more brittle.
• Heavy lifting: Poor lifting technique can stress your back.
• Certain jobs or activities: Repetitive bending, twisting, lifting or driving can strain your spine.
• Age: Herniated disks are most common in people age 20 to 50, though they can also strike younger and older people.
• Sudden movements or trauma: Falls, car accidents or twisting injuries can damage disks. However, this is not typically a common cause of herniated disks.

What are signs and symptoms of a herniated disk?

Symptoms vary depending on where the disk is located in the spine and the severity of the herniation. It’s possible to have a herniated disc that doesn’t cause any symptoms but sometimes they cause intense pain.

Common symptoms of a herniated disk include:

• Neck pain or lower back pain
• A type of leg pain called sciatica, which feels like a sharp pain that shoots down one leg 
• Pain that gets worse when you move, cough or sit or lie down for a long time
• Pain that radiates or feels like it changes location
• Numbness, tingling or burning in the arms, hands, legs or feet
• Muscle weakness or trouble walking
• In severe cases, loss of bladder or bowel control

Learn more about your back and neck pain, take our free assessment. 

How is a herniated disk diagnosed?

A health care provider will start with a full physical exam, looking for signs of nerve root irritation or muscle weakness. They may ask you to walk on your heels or toes, check to see if you feel a light tough and test your reflexes.

They may perform a straight leg raise test, where you lie flat and they lift your leg. If this test causes pain or discomfort, it could be a sign of a lumbar herniation.

Depending on your symptoms, they may order:

• MRI: To see soft tissues and nerve compression
• CT scan: For detailed imaging of bones and disks
• X-ray: To rule out other conditions
• Nerve testing: To measure how signals travel through your body

Other health problems may cause similar symptoms, so your provider may need to rule out:

• Muscle strain
• Ligament injury
• Arthritis
• Spinal stenosis (narrowing of the spinal canal)
• Sciatica from other causes
• Spinal tumors 
• Infections

How are herniated disks treated?

Most of the time, you don’t need spine surgery to treat a herniated disk. Most people feel better with other treatments, though it could take a few weeks to a few months. Your provider may recommend:

• Rest and activity modification: Avoid painful movements and include gentle activity. 
• Cold and heat therapy: Applying cold packs several times a day in the first few days can help reduce inflammation. After that, heat can help relax your muscles and improve flexibility.
• Medications: Over-the-counter (OTC) pain relievers or prescription muscle relaxers can control pain and reduce inflammation.
• Physical therapy: A personalized plan may strengthen your muscles, improve flexibility and reduce pressure on the nerves in your spine.
• Steroid injections: Injections near the spinal canal could reduce inflammation and pain temporarily.

When is spine surgery needed?

If symptoms don’t improve after a few weeks or if there’s severe nerve damage, your provider may recommend one of these types of spine surgery:

• Microdiscectomy: This procedure removes the part of the disk that’s pressing on the nerve and any fragments. It’s usually done with a small incision close to the disk that’s affected. Your surgeon may use a microscope or special surgical glasses to get a clear view of the injured area.
• Endoscopic diskectomy: For this procedure, your surgeon uses a thin tube with a camera to see the area that needs treatment. With endoscopic diskectomy, you may have smaller incisions, less scarring and a faster recovery than with other types of surgery.
• Laminectomy: This procedure removes part of the vertebrae to relieve pressure on the spinal canal. Your surgeon could also need to perform a laminectomy so they can reach the damaged disk.

Can a herniated disk cause nerve damage?

If a herniated disk presses on a nerve for too long, it could cause permanent nerve damage, long-term weakness and paralysis. Call your health care provider right away if you have:

• A sudden loss of strength
• Numbness in the groin area
• Trouble controlling your bladder or bowel

These may be signs of a serious neurological condition like cauda equina syndrome, which needs emergency treatment.

Preventing future disk problems

You can’t always prevent a herniated disk, but it can help to:

• Use proper lifting techniques: Bend your knees, not your back.
• Strengthen your core and improve your posture: Exercise strengthens the muscles that support your spine.
• Use good ergonomics at work: Having your chair and workspace set up for good posture is important, especially if you sit or stand for long periods.
• Stay active and manage your weight: Excess weight adds strain to your spine.
• Stretch regularly: Stretching makes your spine more flexible and less stiff.
• Quit smoking: Your disks get better blood flow and stay healthier when you don’t smoke.

Why choose Banner Health for spine care?

At Banner Health, you can count on our team of orthopedic and spine care specialists. We use the latest equipment and techniques to diagnose your spine condition. We coordinate with primary care providers and physical therapists, and we aim to treat herniated disks without surgery.

If you need surgery, our highly trained experts recommend the best option for you, so you have less pain and can move more freely. You don’t have to live with back, neck or leg pain. Reach out today to connect with a Banner Health spine expert and learn more about the treatment options that can help.