Herniated Discs

The vertebrae in your spine are separated by discs — round, rubbery cushions that act as shock absorbers for your spine, and allow you bend and reach. Each disc has a jelly-like interior, surrounded by a tougher exterior shell.

Spinal discs lose their elasticity with normal aging, and their shells can become cracked. A herniated disc occurs when all or part of the soft interior is forced through a weakened or cracked part of the exterior. These changes occur as a person ages. They are normal, and often cause no pain.

Also referred to as a slipped disc or a ruptured disc, herniated discs occur more often in middle-aged and older people.

Symptoms

Many people have herniated discs and never experience any symptoms at all. In fact, MRI studies on people who have never had a serious episode of low back pain commonly show bulging and herniated discs.

Sometimes, herniated discs do cause pain. Symptoms depend, in large part, on where the herniation takes place and if nerves feel the pressure or inflammation. The pain can be sudden and cause severe shooting pain into the legs.

If you experience acute pain in your back or neck, call the Spine Clinic at Virginia Mason, where you can typically get an appointment to see a spine specialist the same day.

Symptoms from a herniated disc in the back can include:

  • Sharp pain in one part of the leg, hip, or buttocks
  • Pain or numbness on the back of the calf or sole of the foot
  • Weakness in one leg

Note: If you experience increasing weakness, numbness in the groin or rectal area, or loss of control of bowel or bladder function, immediate medical attention is required. This very rare event is a red flag, a medical emergency. Contact your medical provider immediately.

Symptoms from a herniated disc in the neck include:

  • Pain when moving the neck
  • Deep pain or weakness near or over the shoulder blade
  • Pain or numbness that moves to the upper arm, forearm and fingers

Treating Herniated Discs: Self Care and Physical Therapy

Most cases of herniated discs do not require surgery. The pain, numbness or weakness usually goes away or improves dramatically within weeks or months without medical treatment. 

If you have a herniated disc, your doctor may recommend that you:

  • Reduce your activities immediately and rest
  • Take an anti-inflammatory medication
  • Work with a physical therapist

At Virginia Mason’s Spine Clinic, we will set up an exercise program that will help minimize pain, help to maintain normal activity levels and prevent further injury. We will check on your progress over time to make any necessary adjustments to your plan.

Most people who follow their physical therapy plans recover and return to normal activities.

Prescription Medications for Back and Neck Pain 

If rest and physical therapy do not alleviate your pain, other alternatives are available.

Prescription oral medications may include:

  • Nonsteroidal anti-inflammatory medications (NSAIDs) for short-term pain control
  • A short course of stronger opioid medications, if the pain is severe and does not respond to NSAIDs
  • Muscle relaxants for back spasms on a limited basis
  • Specific medications for the treatment of nerve pain

In rare cases, steroid medicines may be given, either in pill form or through an injection into the spine.

Injections of pain medication are another option. Epidural injections deliver steroid medications directly to the area in the spine causing the pain. Depending on the type of injection, pain relief may last for weeks or months. Often, this gives someone enough time to comfortably participate in physical therapy when they couldn’t before the injection.

Surgery for Herniated Discs

Surgical treatments for spine pain may be an option if your symptoms do not go away with time and other treatments. Depending on your situation, your surgeon may recommend a discectomy, laminectomy, spinal fusion or disc replacement.

The spine surgeons at Virginia Mason are nationally recognized for their expertise and for advocating the right treatment for each patient. Our surgeons are board-certified and involved in researching best practices to minimize surgical complications.

For more information about herniated discs you can contact the Spine Center at Virginia Mason by calling (206) 417-7463.