Herniated Disc in the Lumbar Spine

A herniated disc is a common source of back pain and pressure. It occurs when the soft “jelly” of a spinal disc pushes through the exterior of the disc. A herniated disc (also called a slipped or ruptured disc) can happen anywhere along the spine but is most common in the lower back. 

What is a herniated disc?

Your spine is made up of vertebrae, discs, muscles, tendons and nerves. The discs are located between each vertebra and act as a cushion and shock absorber. This allows more freedom of movement along the spine and reduces pain.

Spinal discs are often compared to jelly donuts: They have a tougher exterior and softer, fluid-like center. A disc becomes herniated when the softer “jelly” pushes out of the center through a tear in the outside of the disc. 

The most common cause of herniated discs are natural wear and tear as we age. Lifting heavy objects with the back, instead of leg and thigh muscles, can also cause a herniated disc.

There are certain risk factors that can increase your chance of a herniated disc, including:

• Excess body weight
• Repetitive lifting, pushing, pulling, bending or twisting 
• Genetic disposition 

What are symptoms of a herniated disc in the low back?

Some individuals may not have any symptoms of a herniated disc. Others may experience a wide-range of symptoms, including:

• Low back pain, around the herniated disc
• Leg pain
• Numbness or tingling
• Weakness 
• Limited range of movement in the back
• Pain that increases when bending down or lifting object

How is a herniated disc treated?

Herniated discs often heal on their own. Conservative treatment can help minimize your pain and help you avoid activities that aggravate symptoms.

Pain management

Over-the-counter or prescription medicine can help relieve your pain. Your doctor will work closely with you to develop a plan that safely and effectively addresses your symptoms. That plan may also include muscle relaxing or cortisone injections to help relax the muscles and reduce inflammation. 

Physical therapy 

Physical therapy can help strengthen the back and improve symptoms. Your physical therapist will show you exercises to build muscles in your back and core, and help you adapt everyday activities to reduce the pain caused by the herniated disc.

Do I need surgery for a herniated disc?

Herniated discs generally do not require surgery. If you continue to experience pain or recurrent herniated discs, your doctor may discuss surgical to remove part of the disc. Rarely, the whole disc needs to be removed.

How is a herniated disc diagnosed?

A herniated disc can be diagnosed with a complete physical examination. Your provider will check your back for pain and tenderness. Imaging tests, such as X-ray, magnetic resonance imaging (MRI) or computerized tomography (CT) scan, may be ordered only if your doctor has additional questions or concerns about the source of your pain. Some insurance plans have pre-requisites that need to be met before ordering imaging. Be sure to discuss these options with your provider.