Quick Takeaways

Herniated discs are a top cause of pain in the lower back, neck, leg (sciatica) and arm.
Herniated discs most commonly occur in your lower back, but they can also be in your neck or middle back.
As many as 9 in 10 people improve with nonsurgical treatments.
Spine surgeries — including some that are minimally invasive — may help when pain is severe and persistent.

What Is a Herniated Disc?

A herniated disc occurs when the jelly-like substance in its center pushes against the disc’s outer ring.

The substance may push through the disc or cause a bulge that presses against your spinal cord or nerves. You may have back, neck or limb pain, or limb numbness or weakness.

What are the types of herniated discs?

Discs in your spine separate and cushion bones called vertebrae. A herniated disc can occur anywhere in your spine:

Cervical herniated discs occur in the cervical spine in your neck.
Lumbar herniated discs are the most common. They occur in the lumbar spine in your lower back.
Thoracic herniated discs occur in the thoracic spine in the middle of your back. This type is the least common.

What are other names for a herniated disc?

Other names for a herniated disc include:

Bulging disc
Protruding disc
Ruptured disc
Slipped disc

Herniated Disc Symptoms

What does a herniated disc feel like?

Herniated discs can be painful. Where you feel the pain depends on the location of the herniated disc.

Signs of a herniated disc in your neck

Neck pain and stiffness are the most common signs of a herniated cervical disc. Other symptoms may include:

Balance or coordination problems
Difficulty holding or lifting objects
Headaches
Muscle spasms and pain in your neck, shoulders or both
Numbness, tingling or weakness in the arm or hand
Sharp, shooting pain that runs from your neck down to your arms or fingers

Signs of a herniated disc in your lower back

Lower back pain that comes and goes is a common sign of a herniated lumbar disc. Other symptoms may include:

Balance or coordination problems in the legs
Difficulty walking
Numbness, tingling or weakness in the leg or foot
Sharp, shooting pain that starts in your buttocks and runs down the leg (sciatica)

Signs of a herniated disc in your middle back

Middle back pain that occurs with chest pain may be a sign of a herniated thoracic disc. You may also have lower back pain. Other symptoms include:

Balance or coordination problems in the legs
Difficulty walking
Numbness, tingling or weakness in the leg or foot

When should you see a medical professional?

You should see your primary care physician if you have chronic, severe pain or limb weakness that makes it difficult to complete daily tasks and enjoy life. However, a herniated disc that presses against certain spinal nerves can cause you to lose control of your bladder or bowels. This issue, known as cauda equina syndrome, requires immediate medical attention.

Your doctor may refer you to one of these spine care specialists:

Causes of Herniated Discs

Why do you have a herniated disc?

The aging process and natural wear and tear on your spine can cause herniated discs.

As you get older, the amount of cushioning fluid inside a disc naturally decreases. The disc shrinks, narrowing the space between the vertebrae above and below it. With less fluid, the disc becomes less flexible. Lifting something (even if it’s not very heavy) or twisting your body may cause the disc to herniate

Risk Factors for Herniated Discs

Are you at risk for a herniated disc?

Certain risk factors — some of them preventable — increase your risk for a herniated disc.

These risk factors include:

Being male between the ages of 20 and 50
Diabetes
Excess weight or obesity
Improper lifting of heavy items using your back muscles instead of your leg muscles
Family history of spinal conditions
Repetitive bending, lifting and twisting during sports, hobbies or jobs
Sitting for long periods of time, such as while at work or driving
Smoking

Diagnosing Herniated Discs

How do doctors diagnose herniated discs?

Your doctor will ask about your symptoms and perform a physical exam to look for signs of muscle weakness and loss of sensation.

You may also take one or more of these tests:

Straight leg test: While you lie on your back and keep your legs straight, your doctor will gently lift the affected leg. Pain below your knee or down your leg may indicate a herniated disc.
Imaging tests: An MRI provides detailed images of your spine and discs. It can show the location of the herniated disc and the affected nerves. In some cases, you may get X-rays or a CT myelography scan that uses an injectable contrast dye.
Nerve conduction test and electromyography (EMG): Less commonly, your doctor may order an EMG study to check for signs of nerve damage.

Herniated Disc Treatment

How do doctors treat herniated discs?

Treatments for a herniated disc depend on the severity of symptoms and the location. We always start with the least invasive treatments.

Your doctor will discuss treatment options with you and create a personalized care plan. Treatments may include:

Nonsurgical treatments for herniated discs

Nonsurgical treatments for a herniated disc include:

Epidural corticosteroid injections
Muscle relaxants
Nerve pain medications, such as antidepressants and antiseizure drugs
Nonsteroidal anti-inflammatory drugs (NSAIDS)
Physical therapy

Surgical treatments for herniated discs

If symptoms don’t improve with nonsurgical treatments and affect your quality of life, your doctor may refer you to an orthopedic spine surgeon or neurosurgeon. Both surgical experts treat herniated discs and spinal conditions. The type of surgery depends on your unique diagnosis and needs.

When possible, we use minimally invasive surgical approaches. Surgery may take place using a scope device inserted through a small cut in your skin. Less tissue damage and pain usually leads to an easier recovery.

Surgical treatments for a herniated disc include:

Discectomy: During a discectomy, your surgeon removes just the herniated part of the disc. In some cases, they may remove the entire disc and perform a fusion procedure to stabilize the spine.
Disc replacement: Your surgeon replaces a damaged disc with an artificial (prosthetic) disc. This treatment can help if you have a herniated disc in your neck or low back.
Endoscopic discectomy: Your surgeon uses a thin flexible tube with a camera and light (endoscope) to remove the herniated disc through a small (approximately 1/3 of an inch) cut off to the side of the disc. This is a minimally invasive procedure.
Laminectomy: This procedure removes the entire back part of the spine (lamina) to relieve pressure on nerves. Your surgeon may also perform a discectomy.
Laminotomy: Your surgeon removes a small piece of lamina to ease pressure on a nerve. You may also get a discectomy.
Microdiscectomy: During this minimally invasive surgery, your surgeon inserts a microscope and tiny tools through a small (approximately 1 1/2 inches) cut in your back. They may perform a laminotomy to access and remove all or part of the herniated disc.

Prognosis

What’s the outlook when you have a herniated disc?

An estimated 9 in 10 people with a herniated disc improve with nonsurgical treatments.

However, there’s a 25% chance that a herniated lumbar disc will rupture again. Your doctor may recommend limiting activities for a short period of time. If symptoms worsen or continue for more than four to six weeks, you may need to see a spine surgeon.

Prevention

Can you prevent a herniated disc?

Yes, certain actions can help protect all parts of your spine.

You can:

Achieve and maintain a healthy weight.
Be physically active.
Learn the proper way to lift using your leg muscles instead of your back.
Seek help to quit smoking. Smoking decreases blood flow to your bones. It also increases your risk of developing osteoporosis and vertebral fractures.
Take breaks and stretch so you aren’t sitting for too long.