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What Is a Herniated Disc? Causes, Diagnosis, and Treatment Options Near You in New Jersey & Florida
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atients who are experiencing back pain, numbness, and tingling may be dealing with a herniated disc, a common disc disorder that can affect a person’s mobility and comfort. At Centers for Neurosurgery, Spine & Orthopedics (CNSO), New Jersey’s most comprehensive brain and spine center, now with offices in Florida, a multidisciplinary team provides treatment for a wide variety of spine injuries and spine conditions, including herniated discs. Learn more about this condition, its causes and symptoms, and how it can be diagnosed and treated near you in New Jersey or Florida.
The incidence of a herniated disc is about 5 to 20 cases per 1000 adults annually and is most common in people in their third to the fifth decade of life, with a male to female ratio of 2:1.
Key Takeaways
- A herniated disc, also known as a slipped or ruptured disc, occurs when the gel-like center of a spinal disc oozes out of the torn outer ring and irritates the surrounding nerves.
- A herniated disc, which causes a rupture in the annulus fibrosus, is different from a bulging disc, which does not involve a rupture in the annulus fibrosus.
- The symptoms of a herniated disc include sharp pain, radiating pain that travels to the extremities, numbness, tingling, and weakness.
- To diagnose a herniated disc, the patient will undergo a physical and neurological exam and get imaging scans like magnetic resonance imaging (MRI).
- Most herniated discs can be successfully treated with non-surgical treatment methods like activity modification, physical therapy, and epidural injections. Surgery may be considered in severe cases.
- Centers for Neurosurgery, Spine & Orthopedics provides non-surgical and surgical treatment for various spinal injuries and conditions, including herniated discs, for patients in New Jersey and Florida.
What Is a Herniated Disc, and Why Is the Terminology Confusing?
A herniated disc is a common cause of back pain, numbness, and tingling. In the spine, the vertebral bones are each separated by a flat disc of cartilage, enabling smooth movement and shock absorption. Every disc has a tough outer ring, called annulus fibrosus, and a soft, jelly-like center, called nucleus pulposus. When the annulus fibrosus tears or ruptures, often due to wear and tear or an injury, the soft gel center can leak out, causing pressure and irritation on the spinal cord and nearby nerves. This is known as a herniated disc.
A herniated disc is often confused with other disc disorders like a bulging disc. A herniated disc is the same injury as a ruptured or slipped disc, and the names can be used interchangeably. However, it is different from a bulging disc, where the annulus fibrosus does not tear. Instead, it shifts out of alignment and puts pressure on surrounding nerves.
Herniated vs. Bulging Disc Comparison Table
Disc Disorder | Herniated Disc (A.K.A. Slipped or Ruptured Disc) | Bulging Disc |
Description | The annulus fibrosus is ruptured, causing the nucleus pulposus to leak out and irritate surrounding nerves. | The annulus fibrosus is not torn or ruptured, but it moves out of place and can press on nearby nerves. |
Symptoms |
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Causes |
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Diagnosis |
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Treatments |
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What Are the Symptoms of a Herniated Disc?
A herniated disc can cause symptoms that overlap with many other spinal injuries and conditions, which can make patients wonder if it is truly the cause of their symptoms. They often include sharp, shooting pain, numbness and tingling, weakness, and sciatica (radiating pain that travels to the extremities). The symptoms can also depend on where the herniated disc is located along the spine:
Cervical Herniated Disc Symptoms
The second most common type of herniated disc is a cervical herniated disc, which occurs in the cervical spine or neck region. These injuries often affect the C5-C6 and C6-C7 levels. When they happen, they can cause specific symptoms, such as:
- Pain that radiates into the upper arm, hand, or shoulder blade
- Numbness and tingling in the arm or shoulder blade region
- Weakness in the arm or hand
- Neck stiffness
- Reduced grip strength
Thoracic Herniated Disc Symptoms
A thoracic herniated disc, occurring in the mid-back area, is the least common type, as it is very rare. The rib cage provides support and keeps the spine steady, while the mid-back area does not move as much as the neck and lower back. When a thoracic herniated disc does occur, it can cause symptoms like trunk pain, band-like pain around the chest or abdomen, and leg weakness.
Lumbar Herniated Disc Symptoms
A lumbar herniated disc is the most common type of disc herniation. It occurs in the lumbar spine, or lower back area. It can result in symptoms like:
- Radiating pain into the buttock, groin, leg, or foot
- Numbness and tingling in the buttock, leg, and foot
- Weakness in the leg
- Drop foot
- Reduced balance and coordination when walking
There are also certain red-flag symptoms that signal that immediate medical attention is needed. If a person is experiencing severe weakness, numbness, or a loss of bladder or bowel control, they should get medical attention quickly.
What Are the Causes and Risk Factors of Herniated Discs?
Herniated discs are typically the result of three main causes. They include:
- Gradual wear: As people age, their spinal discs lose water and flexibility, causing them to weaken. This process, also known as degenerative disc disease, makes them more susceptible to rupturing with minor stress.
- Sudden trauma: A blow to the back, a fall, or sharp twisting and turning motions can cause a disc to rupture, especially if it is already weakened from age-related degeneration.
- Improper lifting: When a person lifts heavy items using their back muscles instead of their leg muscles, it strains the spine and can cause a disc to rupture.
Certain risk factors also make a person more likely to experience a herniated disc, although they do not automatically mean the person will have one. They include having excess body weight, working a physically demanding job, smoking, living a sedentary lifestyle, and having a family history of disc disorders.
How Does CNSO Diagnose a Herniated Disc?
If a patient comes to CNSO with symptoms like back pain, numbness, and weakness, a neurosurgeon, orthopedic spine surgeon, or pain management doctor, all of whom are spine specialists, will perform a thorough diagnostic process to see if a herniated disc is the most likely cause of their symptoms. It generally includes:
- Physical and neurological exams: This part includes a discussion of the patient’s symptoms and medical history, an assessment of the spine, and other tests, including reflex and strength tests, gait and posture checks, and movement checks, to see if there may be damage to spinal nerves.
- Imaging scans: Imaging scans, most often a magnetic resonance imaging (MRI) scan, are used to visualize the soft tissues and determine the exact location of the herniated disc. An electromyogram (EMG) may also be ordered to look for any damage to the nerves.
Through this comprehensive diagnostic process, the spine specialist will be able to confirm or rule out a diagnosis of a herniated disc.
What Are the Non-Surgical Treatment Options for a Herniated Disc?
Nearly 90% of herniated discs can be treated with conservative, non-surgical methods. They aim to reduce pain and inflammation and help the patient feel more comfortable during the healing process. They include:
- Activity modification: This involves limiting everyday activities that can stress the disc, including heavy lifting, bending, or twisting. However, bed rest should be avoided to prevent weakened muscles and stiff joints.
- McKenzie method: Also known as Mechanical Diagnosis and Therapy, this method involves specific repeated movements to centralize symptoms away from the legs, shift disc material away from pinched nerves, and relieve pain. It is often used for lumbar herniated discs.
- Physical therapy: A physical therapist designs a personalized treatment plan, which often includes targeted therapeutic exercises to strengthen the core and back and relieve pressure on the herniated disc. It may also include gentle stretching, hot and cold therapy, massage, and other modalities to help improve mobility.
- Epidural injections: In cases of severe pain, epidural steroid injections may be given next to the affected spinal nerves to relieve pain and inflammation. They are generally given in sets of three or four, spaced one to two weeks apart.
- Selective nerve root blocks (SNRBs): This is a type of injection that combines numbing medicine and anti-inflammatory steroids. When it is injected into a nerve, it will help determine whether that specific nerve is causing sciatica symptoms. It also provides relief from radiating nerve pain.
These conservative methods may be combined to provide the most effective relief. At CNSO, our team takes a conservative approach to treatment, trying out non-surgical methods before resorting to surgical procedures.
When Does a Herniated Disc Need Surgery?
Most herniated discs do not require surgery, as they often heal with conservative treatment methods. However, surgery may be considered when the patient does not experience symptom relief after six to 12 weeks of conservative care (which might require epidural steroid injections), or if urgent red flags, such as a loss of bladder control, appear.
Most herniated discs are treated with a minimally invasive procedure called a microdiscectomy. The surgeon makes a small incision near the affected disc and uses an external operating microscope to visualize the area. Using specialized instruments, the surgeon will remove the herniated portion of the disc to relieve the pressure on the surrounding nerves.
A discectomy may also be used, which involves the same process but via traditional open surgery. However, the CNSO team uses minimally invasive and robotic options whenever possible to improve outcomes and reduce recovery periods.
In some cases where the patient has severe neurological symptoms or spinal cord compression, a microdiscectomy, an anterior cervical discectomy and fusion (ACDF), a cervical disc replacement, a laminectomy, or an anterior laminectomy and interbody fusion (ALIF) may be used. ACDF and ALIF are types of fusion surgery that remove the damaged portion of the disc and fuse the bones together; cervical disc replacement replaces the herniated disc with a replacement disc; and laminectomy helps create more room at the nerve root by removing the lamina.
Find Expert Herniated Disc Care Near You in New Jersey and Florida
Patients struggling with pain or weakness because of a herniated disc can access comprehensive treatment at Centers for Neurosurgery, Spine & Orthopedics. The CNSO team consists of neurosurgeons, orthopedic spine surgeons, interventional pain management physicians, oncologists, physiatrists, rehabilitation specialists, and certified physical therapists who collaborate to provide high-quality care.
With office locations across New Jersey and Florida, patients do not have to travel far for trusted treatment. Contact CNSO today to learn more about herniated disc treatment near you.
Frequently Asked Questions About Herniated Discs
What does a herniated disc feel like?
A herniated disc typically feels like sharp, shooting pain in the neck or lower back, often with numbness, tingling, or muscle weakness.
What is the difference between a bulging disc and a herniated disc?
A herniated disc causes the annulus fibrosus to tear, causing the gel-like center to ooze out and irritate nearby nerves. With a bulging disc, the annulus fibrosus does not tear but rather moves out of alignment and puts pressure on surrounding nerves.
Is a slipped disc the same as a herniated disc?
Yes, a slipped disc is a colloquial term for a herniated disc.
What is a ruptured disc?
A ruptured disc is the same thing as a herniated disc, when the annulus fibrosus ruptures and the gel-like center leaks out.
Can a herniated disc heal on its own?
Yes, the vast majority of herniated discs will heal on their own without surgery. Through natural shrinkage, water loss, and immune responses, the body shrinks the herniated portion.
How long does a herniated disc take to heal?
Most patients can heal from a herniated disc within six to 12 weeks of using non-surgical, conservative treatments. However, full structural healing can take six months or more.
What is the best sleeping position for a herniated disc?
The best sleeping position for a herniated disc is lying on the back with a pillow under the knees or on the side with a pillow between the knees. These positions help keep the spine aligned and relieve pressure on the affected disc.
When does a herniated disc need surgery?
A herniated disc does not often require surgery, but it may be recommended when the patient still has symptoms after six to 12 weeks of conservative care, or if there are red flag symptoms present.
What is microdiscectomy and how quick is recovery?
A microdiscectomy is a minimally invasive procedure that involves removing the part of a herniated disc that is pressing on a spinal nerve. The recovery is fairly quick, with patients typically returning to desk work in two to four weeks and resuming normal activities by six to 12 weeks.
Can a herniated disc come back after surgery?
Yes, a herniated disc can come back after surgery. This is because during surgery, the surgeon may only remove the portion of the disc that is pressing on the nerve rather than the entire disc for a less invasive surgery. The remaining disc can still rupture again.
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