Discs are small circular, compressible cushions between the vertebral bones in the spinal column. They act as cushions for the vertebrae. A herniated disc bulges from its proper place, putting pressure on spinal nerves. This is most common in the lower spine.
Herniated Lumbar Disc
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A herniated disc is caused by reduced water content, which results in flattening and less cushioning. It can also be the result of trauma.
A herniated disc is generally associated with normal aging. It is more common in people after age 30 years of age. Other factors that may increase your chance of a herniated disc include: Trauma
from a fall, accident, or sudden twisting
Strain on the back—either repeated or sudden, as from lifting a heavy weightCertain jobs that require heavy liftingSmokingObesityDiabetes
A herniated disc may cause:
May be sharp, dull, piercing, aching, burning, or throbbing, depending on the disc and size of herniationMay spread over the back, buttocks, down the back of one thigh, and into the calfMay be in one leg or both legsNumbness, tingling, or weakness in the legs, feet, or in one or both armsIn severe cases, inability to find comfort even lying downSudden aching or twisted neck that cannot be straightened without severe painCauda equina syndrome
—involves bowel or bladder changes and/or numbness in the groin
—This is an emergency, call for emergency medical services right away.
The doctor will ask about your symptoms and medical history. A physical exam will be done. Your spine will be examined. The movement, strength, and reflexes of your arms and legs will be tested.
Images may be taken of your bodily structures. This can be done with: MRI scanCT scanBone scan
Staying active may be better than bed rest. Treatments may include:
The following therapies may be used:
Back or neck massage and physical therapy to:
Relax the neck or back musclesDecrease painIncrease strength and mobilityBack and abdominal exercisesHot or cold packs to reduce pain and muscle spasmsChiropractic careUsing weights and pulleys to relieve pressure on the discs and keep you from moving aroundA neck collar or brace for a herniated disc in the neck to relieve muscle spasms
Your doctor may advise: Over-the-counter or prescription pain relieversMuscle relaxants to reduce muscle spasms
Interventional spine care treatments may include: Steroid injections into the area around the nerve and disc to reduce pain and inflammation; the injections are used if other medications do not work
Minimally invasive procedures may include:
NucleoplastyIntradiscal electrothermy (IDET)Chemonucleolysis
Surgery may be used for people who fail to respond to other treatments. Immediate surgery is necessary for cauda equina syndrome. Options include: Laminectomy
—removal of some of the bone over the spine and of the problem disc
—removal of fragments of herniated disc through a small incision; this procedure is also known as intervertebral discectomy
—fusing of vertebrae together with bone grafts or metal rods; this is rarely done for first-time disc problems
To help reduce your chance of a herniated disc: Practice good posture. Stand and sit straight, and keep your back straight when lifting.Maintain a healthy weight.Exercise regularly. Ask your doctor about exercises to strengthen your back and stomach.Don't wear high-heeled shoes.If you sit for long periods of time, use a stool to bring your knees above your hips.
Awad JN, Moskovich R. Lumbar disc herniations: Surgical versus nonsurgical treatment.
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Humphreys CS. Clinical evaluation and treatment options for herniated lumbar disc. Am Fam Physician. 1999;59(3):575-582.
Lumbar disk herniation. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated November 26, 2014. Accessed December 18, 2014.
Last reviewed December 2014 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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