Herniated Disc: Symptoms, Causes and Treatment

What is a herniated disc?

A herniated disc occurs when the soft center of a spinal disc pushes through a weak or damaged area in its outer layer. It most often occurs in the neck or lower back. You may also hear a herniated disc called a ruptured or slipped disc.

Discs sit between the bones of your spine, called vertebrae, and act as cushions or shock absorbers. Each disc has a soft, jelly-like center surrounded by a stronger outside ring.

Over time, the outer layer of a disc can weaken or tear, allowing the soft center to herniate, or push through, the outside ring. A herniated disc may cause neck or low back pain. If it presses on a nearby nerve, it can also cause pain, numbness, tingling or weakness in an arm or leg.

What are the symptoms of a herniated disc?

Herniated disc symptoms can develop gradually or begin suddenly. Symptoms vary depending on where the herniated disc is located and whether it affects a nearby nerve.

Herniated disc symptoms in the lower back

If your herniated disc is in your lower back, symptoms may include:

• Back pain
• Numbness, tingling, pain or weakness in one or both legs, sometimes called sciatica
• Changes in bladder or bowel habits

Herniated disc symptoms in the neck

If your herniated disc is in your neck, symptoms may include:

• Neck pain
• Numbness, tingling, pain or weakness in one or both arms
• Difficulty straightening or turning your neck
• Severe pain that may begin suddenly or develop after waking up

What causes a herniated disc?

A herniated disc can happen when the outer layer of a spinal disc becomes weak or damaged, allowing the soft center to push through.

A disc may become damaged from:

• A fall or accident
• Repeated strain on your back
• Lifting something heavy
• A sudden or forceful twisting movement

How is a herniated disc diagnosed?

Your provider will ask about your symptoms, when your pain started and how it affects you. They will also examine your spine and check the movement, strength and reflexes in your arms and legs. 

Your provider may also recommend one or more tests to get a closer look at your spine and help find the cause of your symptoms: 

• X-ray: Creates images of the bones in your spine.
• MRI: Uses a magnetic field and radio waves to create detailed images of your spine, including the discs and nerves.
• CT scan: Uses computerized X-ray to created detailed images of your spine.
• Electromyography (EMG): Tests the electrical activity of your muscles and nerves.
• Myelography: Uses a special dye injected into the fluid around the spinal cord and imaging to help your provider see the spinal cord and nerves.
• Discography: Uses dye injected to the spinal disc and imaging to help determine whether the disc may be causing pain.

How is a herniated disc treated?

Most people with a herniated disc do not need surgery. Treatment often starts with nonsurgical care to relieve pain, reduce inflammation and help you return to normal activities. Your treatment will depend on your symptoms and whether the herniated disc is in your neck or lower back.

Nonsurgical treatment for a herniated disc

Initially, your provider may recommend a short period of rest or changes to your activities. As your pain improves, you can gradually return to normal movement and activity. 

Other treatments may include:

• Anti-inflammatory or pain-relieving medications
• Muscle relaxants
• Heat or cold therapy
• Physical therapy
• Neck collar or brace: May help support your neck and reduce muscle spasms if you have a herniated disc in your neck.
• Massage
• Traction: Uses gentle stretching to create space in the spine, which may help relieve pressure on nerves and reduce pain.
• Steroid injections to help reduce pain and inflammation

Your provider will recommend treatment based on your symptoms and individual needs.

Physical therapy for a herniated disc

As your pain improves, physical therapy can help you safely return to everyday activities. Exercises may help strengthen the muscles that support your spine and improve how you move. Your physical therapist may also teach you how to protect and control the movement of your spine during work, exercise and other activities.

When is surgery needed for a herniated disc? 

Most people with a herniated disc do not need surgery. Surgery may be considered if your symptoms continue despite nonsurgical treatment or if the herniated disc is causing certain nerve problems. Your spine specialist can help determine whether surgery is appropriate based on your symptoms, exam and imaging.

How long does it take to recover from a herniated disc? 

Severe pain from a herniated disc often improves within a few weeks, but some pain may last for several months. Recovery is different for each person and depends on your symptoms and the location of the herniated disc.

As you heal, protect your spine when lifting, exercising or doing other physical activities. Your provider or physical therapist can show you ways to move safely and help prevent future back or neck pain.

When can I return to exercise and sports after a herniated disc? 

Recovery from a herniated disc is different for everyone. Your return to exercise, sports and other physical activities should be based on how well you have recovered, not simply how much time has passed. Returning to strenuous activity too soon may make your symptoms or injury worse.

You may be ready to return to sports or strenuous activity when you can:

• Move your back or neck through its full range of motion without pain
• Complete your rehabilitation exercises without pain
• Move without shooting pain into your arms or legs
• Run, jump and twist without pain, when these movements are part of your activity

Your provider or physical therapist can help you safely return to your activities based on your symptoms, strength and progress.

How can I help prevent a herniated disc? 

Not all herniated discs can be prevented, but healthy habits may help protect your spine and lower your risk of injury. Ways to keep your spine healthy include:

• Stay active: Regular exercise can strengthen the muscles that support your spine.
• Build strength and flexibility: Strong, flexible back and core muscles can help support and protect your spine.
• Use safe lifting techniques: Bend your knees and keep heavy objects close to your body when lifting.
• Maintain a healthy weight: A healthy weight can help reduce stress on your spine.
• Choose spine-friendly activities: Walking and swimming are low-impact exercises that can help you stay active and build strength.

Talk with your provider about which exercises and activities are safe for you, especially if you have back or neck pain.

Why choose WashU Medicine for herniated disc care?

At WashU Medicine Orthopedics, our St. Louis spine specialists have extensive experience treating herniated discs in the neck and back. Our team provides personalized care based on your symptoms, needs and goals.

Whenever possible, treatment begins with nonsurgical options to reduce pain and help you return to the activities you enjoy. If nonsurgical treatments do not provide enough relief, our spine surgeons can evaluate whether surgery may be right for you. When appropriate, minimally invasive surgical options may help reduce tissue damage and support a faster recovery.

Frequently asked questions 

Can a herniated disc heal on its own?

Many herniated discs improve over time without surgery. Pain and other symptoms may get better as inflammation decreases, and the body naturally breaks down some of the herniated disc material. Treatment such as medication, physical therapy or injections may help manage symptoms while you recover.

Can a herniated disc come back?

Yes. A herniated disc can happen again in the same area or develop in another part of the spine. Staying active, strengthening the muscles that support your spine and using safe lifting techniques may help lower your risk of another injury.

What happens if a disc is left untreated?

Some herniated discs improve on their own and may not need treatment. However, a disc that continues to press on a nerve can cause ongoing pain, numbness or weakness. Seek medical care right away if you develop worsening weakness or changes in bladder or bowel control.

When should I see a spine specialist for a herniated disc? 

Consider seeing a spine specialist if your neck or back pain does not improve, interferes with everyday activities or is accompanied by pain, numbness, tingling or weakness in an arm or leg. A spine specialist can determine what is causing your symptoms and recommend the right treatment.

Get care for neck or back pain

Our spine specialists can help find the cause of your symptoms and recommend the right treatment.