A herniated disc, often referred to as a slipped, ruptured, or bulging disc, is a condition that occurs when the soft, gel-like center of an intervertebral disc in your spine pushes against or leaks through a tear or weakened area in the outer layer of the disc. These discs act as shock absorbers and cushions between the vertebrae in your spine, providing flexibility and support to your spine’s structure.

If a herniated disc is putting pressure on a nerve, back or neck pain can result. If you experience sudden pain that worsens with movement, it could be a sign of a herniated disc. Other symptoms may include:

• Sciatica, which causes intense nerve pain down the leg
• Muscle weakness
• Numbness or tingling in the legs or feet
• Pain concentrated on one side of the body
• Radiculopathy

The specific location of pain or numbness depends on the affected disc. Although herniated discs are most common in the lower back, they can occur in any region of the spine. To determine the cause of your symptoms, it is important to consult with a specialist like Dr. Gottlieb for a thorough evaluation and diagnostic imaging tests.

A herniated disc may occur due to changes in your spine. Various factors can contribute to disc herniation, including:

• Disc degeneration: Natural wear and tear of your intervertebral discs that come with age can weaken the discs, allowing them to herniate.
• Trauma or injury: Sports injuries, auto accidents, or any other sudden trauma to your spine can cause disc damage and herniation.
• Improper form: Poor form when lifting, whether at work or in the gym, can cause damage to an intervertebral disc. It’s important to lift with your legs, not your back when heavy lifting to avoid injury.
• Excessive weight: Being overweight puts additional strain on your spine and increases the risk of spinal injury.
• Unhealthy lifestyle: A sedentary lifestyle and bad eating habits can contribute to weak core muscles, which make your back more susceptible to injuries.

Additional risk factors for a herniated disc include occupations or activities that involve repetitive back motions, or lifting and twisting. Your spine surgeon will be able to determine the cause of your herniated disc after your diagnosis.

If you are only experiencing mild pain or discomfort, your doctor may suggest trying at-home treatment for herniated discs. Recommended home remedies include:

• Applying ice or heat
• Avoiding activities that worsen the pain
• Taking over-the-counter pain medication, like anti-inflammatories
• Stretching exercises

If at-home herniated disc treatment does not alleviate your pain, Dr. Gottlieb may suggest additional options:

• Muscle relaxant
• Prescription pain medication
• Cortisone injection to reduce inflammation and swelling
• Exercise program with a physical therapist, who can teach you how to treat a herniated disc with specific exercises and stretches

For most individuals, herniated disc treatment should lead to improvement of your condition within a few weeks. If these treatments are unsuccessful, surgery may be considered by your spine surgeon. Herniated disc surgery is only recommended if conservative treatments have been unsuccessful.

Determining if you need herniated disc surgery is a decision that should be made along with your spine surgeon. It is considered only when conservative herniated disc treatment has already been tried with no success. Your surgeon will evaluate your specific condition, review the results of diagnostic tests (such as CT scans or MRI (magnetic resonance imaging) scans), and discuss the potential risks and benefits of spine surgery.

Other factors that may contribute to your decision to have spine surgery include:

• Severity of symptoms: If your symptoms are affecting your quality of life, surgery may be recommended. These symptoms may include severe pain, numbness or tingling in the arms or legs, or muscle weakness.
• Failed conservative treatments: If physical therapy, pain medication, and other non-surgical herniated disc treatments do not provide adequate relief, surgery may be an option.
• Nerve compression: If your herniated disc is pressing on nerves in the spinal canal, you may experience muscle weakness, loss of bladder or bowel control, or difficulty walking. Herniated disc surgery may be necessary to relieve this pressure and prevent permanent nerve damage.
• Specific spine conditions: There are certain conditions related to herniated discs that may require surgery more urgently, like cauda equina syndrome.

If you and your surgeon decide to move forward with herniated disc surgery, your surgical options may include:

• Laminectomy to expand the spinal canal by removing part or all of the bone surrounding the disc
• Discectomy or microdiscectomy to remove all or part of the herniated disc
• Disc replacement surgery where an artificial disc replaces the damaged one

Expert surgeons like Dr. Gottlieb use small incisions and minimally invasive techniques to provide the best possible outcomes for patients undergoing herniated disc surgery. The choice of procedure will depend on the specific circumstances of the patient and the herniated disk. Your spine is responsible for most of your mobility, and when one of its delicate components, like a disc, gets damaged, it can disrupt your life.