A disc herniation happens when a disc is worn out and some material bulges or leaves the disc.

**Please note, if you have a disc herniation and have a loss of bowel/bladder function or saddle anesthesia, please go to your local emergency room as this is an emergency (Cauda Equina Syndrome).

 

If the herniation is pressing on a nerve or spinal cord, it can cause dysfunction, pain, and weakness. Think of it as a boxer’s punch to the face.

Typically this happens to a disc that’s degenerating, but a sudden insult causes it to “herniate.”

Herniations can happen in the cervical, thoracic, or lumbar spine. Depending on location, this can cause back pain, nerve irritation, bowel/bladder issues, balance problems, or spinal cord problems.

 

Diagnosis

The success of treatment options depend on an accurate diagnosis, using a combination of but not limited to: physical exam, x-ray, CT scan, MRI, diagnostic injections, and EMG investigation.

Treatment

Treatment options include steroids, therapy, anti-inflammatories, core strengthening, weight loss, injections, surgically removing that disc, surgical decompression, surgical fusion, or surgical disc replacement. All treatment options depend on the location/type of disc herniation and a custom treatment plan is recommended for each and every patient.

Herniation of disc into the spinal canal (MRI)

FAQs

Disc Herniation

1. What is a herniated disc?

A herniated disc occurs when the inner gel-like center of a spinal disc (nucleus pulposus) pushes through a tear in the outer layer (annulus fibrosus), often compressing nearby nerves and causing pain.

2. What causes a herniated disc?

Most herniated discs result from age-related degeneration (disc wear and tear), genetics, improper lifting, trauma, or repetitive strain. Genetics and lifestyle factors like smoking and sedentary habits can also contribute.

3. What are the symptoms of a herniated disc?

Symptoms depend on the location and severity, but common ones include:

  • Back or neck pain

  • Radiating pain (sciatica/leg or arm pain)

  • Numbness or tingling

  • Muscle weakness

  • In emergencies, bowel/bladder dysfunction (cauda equina syndrome)

4. How is a herniated disc diagnosed?

Diagnosis typically involves:

  • Physical and neurological exams

  • Imaging studies like MRI (gold standard) or CT scans

  • X-rays to rule out other conditions

5. Can a herniated disc heal on its own?

Yes, in most cases symptoms improve within a few weeks to months with conservative treatment. The disc can shrink or resorb over time, relieving nerve pressure.

6. What are the non-surgical treatment options?

  • Physical therapy

  • Medications (NSAIDs, muscle relaxants)

  • Activity modification

  • Epidural steroid injections

  • Heat/ice and posture correction

7. When is surgery necessary?

Surgery is considered if:

  • Pain is severe and persistent despite exhausting other options (usually after 6–12 weeks)

  • There is progressive neurological deficit (e.g., weakness)

  • There is cauda equina syndrome (surgical emergency)

8. What kind of surgery is done for a herniated disc?

The most common procedure is a microdiscectomy or discectomy, which removes the herniated portion of the disc to relieve nerve pressure, as well as fusions or disc replacements when indicated.

9. What is the recovery time after surgery?

Most patients return to light activities within a week and full activity within 6–12 weeks, depending on individual factors and job demands.

10. Will the herniated disc come back?

There is a risk of recurrence at the same or different level, but it’s relatively low (about 5–15%). Proper body mechanics, core strengthening, and weight control reduce the risk.