Herniated Discs: Symptoms, Diagnosis, and Treatment

Disc herniation is a common condition resulting from movement of one of the connective tissue cushions that help separate the bones of the spine and protect them from injury. Notably, many individuals with herniated discs are asymptomatic, with prevalence rates ranging from 29% in 20-year-olds to 43% of 80-year-olds. In those with herniated discs, 2-4% will present with symptoms of nerve compression requiring the attention of a healthcare professional (1). This article provides a basic overview of some symptoms associated with disc herniation, the process of diagnosing disc herniation, and treatments available to help heal your spine.

Though the majority of patients with herniated discs show no symptoms, those with symptomatic herniations most often report midline pain in the lower back, though the exact location of back pain typically lines up with the disc that has herniated. Other symptoms that can accompany back pain include (2,3):

• Sciatica (shooting pain down the leg)
• Pain radiating to the leg
• Numbness or tingling in the extremities
• Loss of strength/muscle coordination

Some patients with disc herniation may exhibit "red flag" symptoms that suggest progressive disease requiring immediate medical attention. These include:

• Loss of bowel/bladder control
• Numbness/tingling of the genitalia/anus

First-line treatment for patients with symptomatic herniated discs is conservative management involving the use of over-the-counter medications for pain control (NSAIDs), physical therapy, and activity as tolerated. In patients with pain persisting beyond 4-6 weeks, epidural steroid injections can provide short-term pain relief but do not reliably show improved outcomes over longer periods of time.

In patients with severe or progressive symptoms not responsive to conservative management, spine surgery is a strong option. Though many approaches can be taken, most often, herniated discs requiring surgery will be treated with one of the following:

• Microdiscectomy
• Laminectomy
• Spinal Fusion

For more information on these procedures, please click the bullets above to navigate to our "procedures" section. Those with progressive symptoms or pain not responding to other treatments should discuss their treatment options with a licensed healthcare professional to determine what options are best for them. If you have the symptoms above and have not been able to get relief, talk to your primary care physician to see whether a consultation with a spine surgeon may be helpful.