Herniated disk: What it is, symptoms and treatment

The pain and discomfort of a herniated disk can significantly impact the quality of your life.

Here is what you should know about having a herniated disk, including what it is, its causes, symptoms, diagnosis and treatment. Plus, learn about the medication, self-care, surgery and lifestyle options that may help relieve pain.

What is a herniated disk?

The Cleveland Clinic describes a herniated disk as a spinal injury. Your spinal cord is made up of bony parts called vertebrae; between the vertebrae are disks that act as cushions. These make it easier to bend and move. When one tears or leaks, it is called a herniated disk. The injury typically occurs in the lower back or neck region. A herniated disk may also be called a slipped disk, a ruptured disk or a bulging disk.

Herniated disk causes and risk factors

Disk herniation often results from aging; the disks become less flexible over time. The Mayo Clinic lists the following risk factors:

Weight: Excess weight puts a strain on the back.
Occupation: People with physically demanding jobs that require repetitive lifting, pulling, pushing and bending are more likely to have a herniated disk.
Genetics
Smoking: It is believed smoking lessens the oxygen supply to the disks and may cause them to break down more quickly.
Frequent driving: Sitting for long periods can put pressure on the spine.
Sedentary lifestyle

Herniated disk symptoms

Penn Medicine lists the following symptoms of a herniated disk:

Pain that occurs on one side of the body
Sharp pain in one part of the leg, hip or buttocks
Numbness in part of the leg, back of calf or sole
Weakness in one leg
Pain when moving your neck
Deep pain near or over the shoulder blade
Pain that moves along your arm. It may worsen after sitting or standing, at night, when sneezing, coughing or laughing or when walking more than a few yards or bending backward.

Herniated disk diagnosis

Your health care provider will examine your pain, muscle reflexes, sensation and strength and may order diagnostic tests, including:

Magnetic resonance imaging (MRI): The most common and accurate test for herniated disk.
X-rays: These help doctors rule out other causes.
Computed tomography (CT): This is to see the bones of your spine.
Myelogram: Dye injected into your spinal cord helps locate the herniated disk.
Electromyogram (EMG): This is used to evaluate the function of your nerves.

Herniated disk treatment

“Doctors prefer nonsurgical treatments over surgery whenever possible,” Dr. Mark Wang, an orthopedic spine surgeon at the Desert Institute for Spinal Care in Phoenix, writes. “If surgery is necessary, they will opt for the most minimally invasive option with the highest chance of success, given your condition.”

Wang lists several nonsurgical treatment options:

Physical therapy: May also include hot and cold therapy.
Hot and cold therapy: Cold therapy reduces inflammation and pain, while hot therapy promotes circulation and healing.
Alternative therapies: Acupuncture and chiropractic care may help.
Selective nerve root blocks: This is a minimally invasive steroid-anesthetic injection that interrupts the pain signal between the spinal nerves and the brain.
Epidural steroid injections: Medicine is injected into the spinal column’s epidural space.

The Mayo Clinic lists several medications for herniated disks:

Nonprescription pain medications: For mild to moderate pain, acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen sodium (Aleve).
Neuropathic drugs: These decrease pain by affecting the nerve impulse to the brain, and they include gabapentin (Gralise, Horizant, Neurontin), pregabalin (Lyrica), duloxetine (Cymbalta, Drizalma Sprinkle), venlafaxine (Effexor XR).
Muscle relaxers: To reduce spasms.
Opioids: May be considered if other medications do not work, because of the risk of addiction or side effects.

There are several types of surgery for herniated disk, Wang noted. They include:

Microdiscectomy: A minimally invasive procedure to remove the part of the disk causing the pain; the disk may be repaired by reinflating it with hyaluronic acid and sealing it with collagen.
Lumbar laminectomy: A minimally invasive or open surgery in which a portion of the vertebral bone (lamina) is removed to relieve pressure on the spinal cord or nerve roots.
Spinal fusion: Surgeons fuse two or more bones in the spine; it can limit mobility but is effective at reducing painful motion of the spine.
Artificial disk replacement, or artificial cervical disk replacement: The affected disk is replaced with one made of metal or plastic.
Endoscopic foraminoplasty: Relieves pain by freeing the nerves inside the foramen (the hollow, bony tunnel where your spinal cord nerves exit to your arms or legs).

Living with a herniated disk

If you have symptoms, seek the advice of a health care provider. Early treatment may prevent more problems. Most people are better in about four weeks, according to the American Academy of Family Physicians.

Herniated disk self-care

Self-care for a herniated disk includes some lifestyle changes:

Maintain a healthy body weight
Avoid sitting or standing for long periods
Wear flat shoes, not high heels
Carry objects close to your body

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