Herniated DiskSymptoms, Doctors, Treatments, Advances & More
Learn About Herniated Disk
A herniated (slipped) disk occurs when all or part of a disk is forced through a weakened part of the disk. This may place pressure on nearby nerves or the spinal cord.
Lumbar radiculopathy; Cervical radiculopathy; Herniated intervertebral disk; Prolapsed intervertebral disk; Slipped disk; Ruptured disk; Herniated nucleus pulposus; Low back pain - herniated disk; LBP - herniated disk; Sciatica - herniated disk; Herniated disk; Disc - herniated
The bones (vertebrae) of the spinal column protect nerves that come out of the brain and travel down your back to form the spinal cord. Nerve roots are large nerves that branch out from the spinal cord and leave your spinal column between each vertebra.
The spinal bones are separated by disks. These disks cushion the spinal column and put space between your vertebrae. The disks allow movement between the vertebrae, which lets you bend and reach.
With herniated disk:
- The disk may move out of place (herniate) or break open (rupture) from injury or strain. When this happens, there may be pressure on one or more spinal nerves. This can lead to pain, numbness, or weakness.
- The lower back (lumbar area) of the spine is the most common area affected by a herniated disk. The neck (cervical) disks are the second most commonly affected area. The upper-to-mid-back (thoracic) disks are rarely involved.
A herniated disk is a cause of radiculopathy. This is a condition that affects one or more of the spinal nerve roots.
Herniated disks occur more often in middle-aged and older men, usually after strenuous activity. Other risk factors may include:
- Lifting heavy objects
- Being overweight
- Repetitive bending or twisting the lower back or neck
- Sitting or standing in same position for long hours
- Inactive lifestyle
- Smoking
The pain most often occurs on one side of the body. Symptoms vary, depending on the site of injury, and may include the following:
- With a herniated disk in your lower back, you may have sharp pain in one part of the leg, hip, or buttocks, and numbness in other parts. You may also feel pain or numbness in the back of the calf or sole of the foot. The same leg may also feel weak.
- With a herniated disk in your neck, you may have pain when moving your neck, deep pain near or over the shoulder blade, or pain that moves to the upper arm, forearm, and fingers. You can also have numbness along your shoulder, elbow, forearm, and fingers.
The pain often starts slowly. It may get worse:
- After standing or sitting
- At night
- When sneezing, coughing, or laughing
- When bending backward or walking more than a few yards or meters
- When straining or holding your breath, such as when having a bowel movement
You may also have weakness in certain muscles. Sometimes, you may not notice it until your health care provider examines you. In other cases, you will notice that you have a hard time lifting your leg or arm, standing on your toes on one side, squeezing tightly with one of your hands, or other problems. You may lose control of your bladder or bowels.
The pain, numbness, or weakness often goes away or improves a lot over weeks to months.
The first treatment for a slipped disk is a short period of rest and taking medicines for the pain. This is usually followed by physical therapy. Most people who follow these treatments recover and return to normal activities. Some people will need to have more treatment. This may include steroid injections or surgery.
MEDICINES
Medicines can help with your pain. Your provider may prescribe any of the following:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) for long-term pain control
- Narcotics if the pain is severe and does not respond to NSAIDs
- Medicines to calm the nerves
- Muscle relaxants to relieve back spasms
LIFESTYLE CHANGES
If you are overweight, diet and exercise are very important for improving back pain.
Physical therapy is important for nearly everyone with disk disease. Therapists will teach you how to properly lift, dress, walk, and perform other activities. They will teach you how to strengthen muscles that help support the spine. You will also learn how to increase flexibility in your spine and legs.
Take care of your back at home:
- Reduce activity for the first few days. Slowly restart your usual activities.
- Avoid heavy lifting or twisting your back for the first 6 weeks after the pain starts.
- After 2 to 3 weeks, gradually start exercising again.
INJECTIONS
Steroid medicine injections into the back in the area of the herniated disk may help control pain for several months. These injections reduce swelling around the spinal nerve and disk and relieve many symptoms. They do not solve the underlying problem and your pain may return after weeks or months. Spinal injections are an outpatient procedure.
SURGERY
Surgery may be an option if your symptoms do not go away with other treatments and time.
One such surgery is diskectomy, which removes all or part of a disk.
Discuss with your provider which treatment options are best for you.
The Endoscopic Spine Institute Of New York
Dr. Albert Telfeian is a board-certified neurosurgeon and a pioneer in endoscopic spine surgery. He is the most published surgeon in the Western hemisphere in the field of endoscopic spine surgery and internationally recognized for performing the world’s first awake endoscopic spine tumor surgery.Dr. Telfeian is responsible for countless advances in the field of minimally invasive spine surgery.Dr. Telfeian received his undergraduate degree from Columbia University and his M.D. and Ph.D. Degrees from the Warren Alpert School of Medicine at Brown University. He completed his neurosurgery training at the Hospital of the University of Pennsylvania and his spine fellowship in Switzerland at the Centre Hospitalier Universitaire de Vaudois. Dr. Telfeian was an Assistant Professor at the Hospital of the University of Pennsylvania and a Full Professor, Vice Chairman and Director of Minimally Invasive Spine Surgery at Brown University prior to founding the Endoscopic Spine Institute of New York. Dr. Telfeian currently serves on the clinical faculty in the Neurosurgery Department at Columbia Presbyterian.Dr. Telfeian is best known for his groundbreaking work in awake endoscopic surgery and for expanding access to ultra-minimally invasive procedures globally.Clinical ExpertiseBoard-certified neurosurgeon with expertise in both pediatric and adult spine surgery.Performs awake endoscopic lumbar procedures, a field he helped pioneer globally.Special clinical focus on lumbar forami. Dr. Telfeian is rated as an Elite provider by MediFind in the treatment of Herniated Disk. He is also highly rated in 18 other conditions, according to our data. His clinical expertise encompasses Herniated Disk, Spasticity, Foot Drop, Laminectomy, and Endoscopy. Dr. Telfeian is board certified in American Board Of Neurological Surgeons. Dr. Telfeian is currently accepting new patients.
Michael Wang is a Neurosurgery provider practicing medicine in Miami, Florida. Dr. Wang is rated as a Distinguished provider by MediFind in the treatment of Herniated Disk. He is also highly rated in 14 other conditions, according to our data. His clinical expertise encompasses Spondylolisthesis, Spinal Stenosis, Scoliosis, Laminectomy, and Microdiscectomy. Dr. Wang is currently accepting new patients.
Northwell Health Physician Partners Orthopaedic Institute At Great Neck, 833 Northern Boulevard
Vincent Leone is an Orthopedics provider practicing medicine in Great Neck, New York. Dr. Leone is rated as a Distinguished provider by MediFind in the treatment of Herniated Disk. He is also highly rated in 6 other conditions, according to our data. His clinical expertise encompasses Spinal Stenosis, Herniated Disk, Invertebral Disc Disease, Laminectomy, and Microdiscectomy. Dr. Leone is board certified in American Board Of Orthopaedic Surgery. Dr. Leone is currently accepting new patients.
Most people improve with treatment. But you may have long-term back pain, even after treatment.
It may take several months to a year or more to go back to all of your activities without having pain or straining your back. People who work in jobs that involve heavy lifting or back strain may need to change their job activities to avoid injuring their back again.
In rare cases, the following problems can occur:
- Long-term back pain or leg pain
- Loss of movement or feeling in the legs or feet
- Loss of bowel or bladder function
- Permanent spinal cord injury (very rare)
Contact your provider if you have:
- Severe back pain that does not go away
- Any numbness, loss of movement, weakness, or bowel or bladder changes
To help prevent back injury:
- Use proper lifting techniques.
- Maintain a healthy weight.
- Do exercises to keep your abdominal (core) and back muscles strong.
- Evaluate your setup at work. Sometimes a standing desk or changing the location of your computer screen can help your condition.
Your provider may suggest a back brace to help support the spine. A brace may prevent injuries in people who lift heavy objects at work. But using these devices too much can weaken the muscles that support your spine and make the problem worse.
Summary: The goal of this clinical trial is to find out whether adding a bone-marrow aspirate concentrate (BMAC) injection during surgery can improve recovery in adults undergoing lumbar microdiscectomy for a lumbar disc herniation. The main questions it aims to answer are: * Does the BMAC injection lead to better disc tissue health after surgery (as seen on MRI scans)? * Does the BMAC injection lead to gr...
Objective: The primary aim of this study is to evaluate the effects of ultrasound-guided TLIP and Quadro Iliac Plane Blocks on postoperative opioid consumption after lumbar microsurgery. The secondary aim is to compare opioid-related side effects (such as nausea, vomiting, respiratory depression, etc.) and postoperative NRS pain scores between the groups.
Published Date: August 27, 2024
Published By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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Gardocki RJ, Park AL. Degenerative disorders of the thoracic and lumbar spine. In: Azar FM, Beaty JH, eds. Campbell's Operative Orthopaedics. 14th ed. Philadelphia, PA: Elsevier; 2021:chap 39.
Magee DJ, Manske RC. Lumbar spine. In: Magee DJ, Manske RC, eds. Orthopedic Physical Assessment. 7th ed. St Louis, MO: Elsevier; 2021:chap 9.