In many cases, the cause of disc herniation may be unclear. However, there are a range of factors (some preventable and some inevitable) that can play a part in someone experiencing symptoms of a disc herniation:

• • • Engaging in jobs, sports, or other activities that involve repetitive lifting, bending, twisting, or pulling
    • A family history of herniated discs
    • Being overweight or obese
    • Older adults, since the aging process causes wear and tear along with disc degeneration
    • Improper lifting techniques (using your back muscles instead of your leg muscles) when moving heavy objects
    • A traumatic event or injury to the back, such as a fall or car accident
    • Smoking and other lifestyle choices that impair circulation

Most cases of herniated discs result from a combination of injury and age-related changes. But each of these causes places someone at risk of developing a herniated disc.

Each individual will experience slightly different symptoms based on the severity of their herniated disc and where the rupture has occurred. The majority of slipped discs are located in the lower back, but they can also occur in the neck from time to time.

Symptoms also depend on whether or not the disc is placing pressure on a nerve, since this usually causes more severe issues. A herniated disc causes some of the following symptoms:

• • • Arm pain or leg pain
    • Arm and shoulder pain usually results from a herniated cervical disc in the neck
    • Pain in the thigh, calf, buttocks, and foot is more common with herniated discs located in the lower back or lumbar spine
    • Generalized lower back pain, often in the lumbar spine
    • Changes in sensation, including numbness or tingling to the arm or leg
    • Weakness in the arm or leg, which can cause someone to have difficulty holding items, walking, or otherwise moving around
    • Bladder or bowel changes, such as incontinence or trouble urinating (this is more common in severe cases of lumbar disc herniation)
    • Permanent loss of sensation to the backs of the legs, inner thighs, and sometimes even part of the rectum (this is more common in severe cases of lumbar disc herniation)

Your doctor may use traditional imaging tests, such as magnetic resonance imaging scans (MRIs) and computed tomography (CT) scans, to diagnose a herniated disc. X-rays are not as commonly part of the diagnostic process for this condition.

However, in some cases, your doctor may rely on this test to rule out spinal fractures, infections, or tumors, all of which may cause similar symptoms to a herniated disc. Your doctor may also use a myelogram, which involves injecting dye into the spinal cord before taking an x-ray. This allows them to pinpoint the exact spots where there is excess pressure on the spinal cord.

Along the same lines are two other tests: a nerve conduction study and an electromyography (EMG). These both involve using a small, painless needle to measure the electrical activity of the nerves in a certain area. A nerve conduction study measures the body’s response to a very small electrical current, while an EMG measures the electrical activity in a muscle when it contracts compared to when it’s at rest.

These tests are combined with a traditional exam by your doctor, which involves reviewing your medical history, medications, past surgeries, other treatments, and family history. Your doctor will also complete a physical exam, orthopedic exam, MRS testing, and other palpation tests to determine the diagnoses and the affected area.

If you are diagnosed with a herniated disc and experience symptoms (particularly severe back pain), your doctor will usually recommend pain relief strategies, such as anti-inflammatory medications, muscle relaxers, and cortisone injections into the spinal cord.

These are intended to lower swelling in the area and relieve the pressure that the disc is placing on any nearby nerve(s) or spinal nerve roots. If these are not effective, your doctor may recommend opioid analgesics to relieve pain on a short-term basis. This can help with pain relief, but opioid medications are addictive, so they are often prescribed (and meant to be used) with caution.

Physical therapy and chiropractic care are other treatments that can help with herniated discs. In particular, chiropractic care helps stop the progression of degenerative changes that have caused the herniated disc and restore proper joint motion. Both disciplines utilize treatment approaches such as manipulative therapy, flexion distraction, intersegmental traction, and myofascial release (also known as manual therapy).

Other interventions such as kinesiotape can assist with relieving muscle tension and stabilize muscles and joints. Chiropractors and physical therapists alike also educate patients on appropriate posture and lifting techniques to avoid aggravating symptoms and prevent herniation in the future. Strengthening exercises may improve stability of the low back, and in turn, improving symptoms.

Individuals who are still reporting symptoms of a herniated disc after five or six weeks of non-surgical treatment may be candidates for spine surgery. Surgery for a herniated disc usually involves removing the portion of the disc that is bulging out and placing pressure on the spinal canal.

In some cases, surgeons will need to remove the entire disc due to the extent of damage that is present. If this occurs, doctors will either place a bone graft in between the vertebrae or use metal to fuse them together.

Consult your doctor for medical advice regarding your symptoms of herniated disc. After hearing about your pain levels and medical history, your doctor will provide health information about the treatments that are best for you.