A herniated disc (also called a ruptured, slipped, or bulged disc) involves the discs in the back that cushion the bones of the spine (vertebrae).
The discs act as shock absorbers for the vertebrae. When part of the jelly-like center of a disc is pushed out of the tough, outer layer into the spinal canal, this is called a herniated disc.
- Herniated discs occur most frequently in the lower back (lumbar spine), but they can develop in any part of the spine.
- Herniated discs can heal on their own and conservative treatment may be all that is needed.
Conservative treatments for a herniated disc include:
- Over-the-counter (OTC) pain medications, including nonsteroidal anti-inflammatory drugs (NSAIDs) such as Ibuprofen (Advil, Motrin) and Naproxen (Aleve), or analgesic pain relievers such as as acetaminophen (Tylenol)
- Muscle relaxants
- Steroid injections
- Injections of numbing medicines
- Physical therapy for strength and stretching exercises
- Spinal manipulation by a physical therapist or a chiropractor
- Massage
- Acupuncture
- Exercise and staying active
- Bed rest can worsen a herniated disc because the back can stiffen and weaken
- Take short 10-to-20-minute walks on flat surfaces (avoid hills or stairs when possible)
- Change the way you move so you do not cause or worsen symptoms
Surgery for a herniated disc is not usually needed because over time the body absorbs the jelly from the damaged disc and it heals on its own. But this recovery process can take months and surgery can relieve pain and speed up recovery time.
Both surgical and nonsurgical treatments are considered equally effective in reducing pain and other symptoms. The main difference is generally recovery time.
What Are Symptoms of a Herniated Disc?
A herniated disc may not always cause symptoms. When symptoms occur, they depend on which disc is affected and how large the herniation is, and may include:
- Herniated disc in the lower back (lumbar spine)
- Lower back pain
- Tingling, numbness, pain, burning, or weakness that spreads down one leg and sometimes into the foot
- Only one side is typically affected
- Straightening the leg can worsen the pain
- Pain may be sharp and electric shock-like
- Pain may be worse when standing, sitting, or walking
- Sciatica/radiculopathy
- Herniated disc in the neck (cervical spine)
- Dull or sharp pain in the neck or between the shoulder blades
- Pain radiates down the arm to the hand or fingers
- Numbness or tingling in the shoulder or arm
- Pain may intensify with certain positions or movements of the neck
What Causes a Herniated Disc?
The main cause of a herniated disc is natural degeneration that occurs with aging. In some people even a minor strain or twisting movement can cause a disc to rupture.
Other causes of a herniated disc include:
- Excessive strain or injury
- Genetic predisposition
How Is a Herniated Disc Diagnosed?
A patient history and physical examination is usually all that is needed to diagnose a herniated disc because most people who have symptoms of a herniated disc will recover on their own.
Doctors usually wait until a person has symptoms for at least four to six weeks before ordering tests because treatment is the same, no matter what the test might show. In cases where tests are needed, they may include imaging tests such as:
- Magnetic resonance imaging (MRI) scan
- Computerized tomography (CT) scan
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https://www.uptodate.com/contents/herniated-disc-the-basics?search=Herniated%20Disc%20&source=search_result&selectedTitle=1~107&usage_type=default&display_rank=1
https://www.uofmhealth.org/health-library/aa6282
https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Herniated-Disc