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This topic is for a people who have a herniated disc in the lower
back. If you are looking for information on a herniated disc in the neck, see
the topic Cervical Disc
The bones (vertebrae) that form the
spine in your back are
cushioned by small, spongy discs. When these discs are healthy, they act as
shock absorbers for the spine and keep the spine flexible. But when a disc is
damaged, it may bulge or break open. This is called a
herniated disc. It may also be called a slipped or ruptured disc.
You can have a herniated disc
in any part of your spine. But most herniated discs affect the lower back
(lumbar spine). Some happen in the neck (cervical spine) and, more rarely, in
the upper back (thoracic spine).
A herniated disc may be caused by:
herniated disc presses on nerve
roots, it can cause pain, numbness, and weakness in the area of
the body where the nerve travels. A herniated disc in the lower back can cause
pain and numbness in the buttock and down the leg. This is called
"sy-AT-ih-kuh"). Sciatica is the most common symptom of a herniated disc in the
If a herniated disc isn't pressing on a
nerve, you may have a backache or no pain at all.
If you have weakness
or numbness in both legs along with loss of bladder or bowel control, seek
medical care right away. This could be a sign of a rare but serious problem
called cauda equina
Your doctor may diagnose a herniated disc by
asking questions about your symptoms and examining you. If your symptoms
clearly point to a herniated disc, you may not need tests.
doctor will do tests such as an MRI or a
CT scan to confirm a
herniated disc or rule out other health problems.
Symptoms from a herniated disc
usually get better in a few weeks or months. To help you recover:
Usually a herniated disc will heal on its own over time. Be patient, and keep
following your treatment plan. If your symptoms don't get better in a few
months, you may want to talk to your doctor about surgery.
After you have hurt your back, you are more likely to have
back problems in the future. To help keep your back healthy:
Learning about herniated disc:
Health Tools help you make wise health decisions or take action to improve your health.
tear, also called disc
degeneration, is the usual cause of a
herniated disc. As we age,
the discs in our back lose some of the fluid that helps them stay flexible. The
outer layer of the discs can form tiny tears or cracks. The thick gel inside
the disc may be forced out through those cracks and cause the disc to bulge or
This can also happen when you injure your back. Injury can
If the herniated disc isn't pressing on a nerve, you may have an ache in the
low back or no symptoms at all.
Only a few people who have herniated
discs have severe or troublesome symptoms.
When the disc does press on a
nerve, symptoms may include:
Weakness in both legs and the loss of bladder and/or bowel control are
symptoms of a specific and severe type of nerve root compression called
cauda equina syndrome.
This is a rare but serious problem. A person with these symptoms should see a
doctor right away.
age, injury, or both, the outer layer of a
spinal disc may dry out
and form tiny cracks. Sometimes this causes a:
Any of these stages can cause pressure on a
nerve root and symptoms
of pain and numbness.
The cracks in the disc don't repair themselves,
but the pain usually fades over time. More than half of the people who have a herniated disc recover in the first 3 months.footnote 1
It's important to see your doctor
if you've had constant or increasing pain for more than 4 to 6 weeks. Getting
help early on can lower your chance of having lasting problems, such as the
Risk factors are things that increase your risk of having a herniated disc.
Some risk factors you can change, and some you can't.
Call 911 or other emergency services
your doctor now if:
waiting is a wait-and-see approach. If you get better on your own, you won't
need treatment. If you get worse, you and your doctor will decide what to do
If you have pain, numbness, or tingling in one leg that gets worse
with sitting, standing, or walking (without any obvious leg weakness):
For diagnosis and nonsurgical treatment of a herniated disc, you
For diagnosis and surgical treatment of a herniated disc, specialists
To prepare for your appointment, see the topic Making the Most of Your Appointment.
Your doctor will do a
medical history and physical
exam. If this suggests that you have a herniated disc, you
probably won't need other tests.
If your doctor needs more information,
or if treatment hasn't worked after 4 weeks, you may have an
MRI or a
aren't useful or needed. But if your medical history and physical exam suggest
a more serious condition (such as a tumor, infection, fracture, or severe nerve
damage), or if your leg pain and other symptoms don't get better after 4 weeks
of nonsurgical treatment, your doctor may order X-rays.
Other tests, such as blood tests, may be done to rule
out other conditions.
The following tests aren't used as often as an MRI
or a CT scan, but they may give your doctor more information:
Your doctor may recommend a short period of rest or reduced activity
followed by a gradual increase in activity.
Usually a herniated disc
heals on its own. So most of the time nonsurgical treatment is tried first,
to get the most benefit if you have treatment before you've had more than 6
months of symptoms.footnote 2
Surgery can be a good choice for
people who have nerve damage that is getting worse or pain that hasn't improved
after several weeks of nonsurgical treatment.footnote 1 For more information, see
To help prevent low back pain or a herniated disc:
The following steps may help to reduce pain:
Keep active and do
exercises, as recommended by your doctor or physical therapist, to help you
return to your usual level of activity. Core stabilization exercises can help you
strengthen the muscles of your trunk to protect your back.
Although medicine doesn't cure a herniated disc, it may reduce
inflammation and pain
and allow you to begin an exercise program that can strengthen your stomach and
back muscles. Be safe with medicines. Read and follow all instructions on the
Surgery is considered if the following conditions are present:
People who have surgery may feel
better faster. But in the long run, people treated with surgery and people
treated without surgery have similar abilities to work and to be
active.footnote 3 Some people require additional
disc surgery after their first surgery.
Many people are able
to gradually resume work and daily activities soon after surgery. In some
cases, your doctor may recommend a rehabilitation program after surgery, which
might include physical
therapy and home exercises.
Disc surgery isn't considered
effective treatment for low back pain that is not caused by a herniated
disc. Disc surgery is also not done if back pain is the only symptom the
herniated disc causes.
number of technologies using small incisions or injections for destroying the
disc are used by some surgeons. Examples are endoscopic discectomy and
electrothermal disc decompression. These techniques are experimental and
unproved. If your doctor recommends one of them to treat your herniated disc,
make sure to get as much information as possible about the procedure. Consider
getting a second
Laser discectomy uses a focused beam of
light to dissolve a herniated disc. Although this technology has been used by
some surgeons for several years, it is considered experimental because of the
lack of studies on its effectiveness and safety.footnote 4
Other treatments that have been tried
include removing the center of the disc and removing all or part of the disc by
using suction. These treatments are not considered to be
You can try other treatments
besides medicine and surgery, including:
Talk to your doctor before using complementary medicine to treat a herniated disc.
Some people use
complementary medicine along with standard or conventional care
to treat leg and back pain caused by a herniated disc. Some examples
Tay BKB, et al. (2014). Disorders, diseases, and injuries of the spine. In HB Skinner, PJ McMahon, eds., Current Diagnosis and Treatment in Orthopedics, 5th ed., pp. 156–229. New York: McGraw-Hill.
Rihn JA, et al. (2011). Duration of symptoms resulting from lumbar disc herniation: Effect on treatment outcomes. Journal of Bone and Joint Surgery, 93(20): 1906–1914.
Atlas SJ, et al. (2005). Long-term outcomes of surgical and nonsurgical management of sciatica secondary to a lumbar disc herniation: 10-year results from the Maine Lumbar Spine Study. Spine, 30(8): 927–935.
Jordan J, et al. (2011). Herniated lumbar disc, search date June 2010. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
Other Works Consulted
Atlas SJ, et al. (2001). Surgical and nonsurgical management of sciatica secondary to a lumbar disc herniation: Five-year outcomes from the Maine Lumbar Spine Study. Spine, 26(10): 1179–1187.
Deen GH, et al. (2003). Minimally invasive procedures for disorders of the lumbar spine. Mayo Clinical Procedures, 78: 1249–1256.
Hu SS, et al. (2006). Disorders, diseases, and injuries of the spine. In HB Skinner, ed., Current Diagnosis and Treatment in Orthopedics, 4th ed., pp. 221–297. New York: McGraw-Hill.
Peul WC, et al. (2007). Surgical versus prolonged conservative treatment for sciatica. New England Journal of Medicine, 356(22): 2245–2256.
Weinstein JN, et al. (2006). Surgical vs nonoperative treatment for lumbar disk herniation: The spine patient outcomes research trial (SPORT): A randomized trial. JAMA, 296(20): 2441–2450.
Weinstein JN, et al. (2006). Surgical vs nonoperative treatment for lumbar disk herniation: The spine patient outcomes research trial (SPORT): Observational cohort. JAMA, 296(20): 2451–2459.
ByHealthwise StaffPrimary Medical ReviewerWilliam H. Blahd, Jr., MD, FACEP - Emergency MedicineE. Gregory Thompson, MD - Internal MedicineAdam Husney, MD - Family MedicineSpecialist Medical ReviewerRobert B. Keller, MD - Orthopedics
Current as ofJuly 16, 2015
Current as of:
July 16, 2015
William H. Blahd, Jr., MD, FACEP - Emergency Medicine & E. Gregory Thompson, MD - Internal Medicine & Adam Husney, MD - Family Medicine & Robert B. Keller, MD - Orthopedics
To learn more about Healthwise, visit Healthwise.org.
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