Most herniated discs occur in the lower back (lumbar herniated discs), but they can also occur in the neck (cervical herniated discs).
When a herniated disc presses on nerve roots, it can cause pain, numbness and weakness in the area of the body where that nerve travels. A herniated disc often disproportionately causes symptoms on one side of the body.
Lumbar herniated disc
A herniated disc in the lower back can cause pain and numbness in the buttock and down a leg. This is what’s called “sciatica,” the most common symptom of a herniated disc in the lower back.
However, if a herniated disc isn’t pressing on a nerve, you might not experience any pain at all. If you have weakness or numbness in both legs along with a loss of bladder and/or bowel control, seek medical care right away, as it could be a sign of a rare but serious issue called cauda equina syndrome.
Cervical herniated disc
Herniated discs in the neck (or cervical spine) can cause pain, numbness or weakness in the neck, shoulders, chest, arms and hands.
In some cases, a very large herniated disc in the neck could cause weakness or tingling that affects other parts of the body, including the legs.
Herniated discs are typically caused by wear and tear of the disc. As we age, the discs in our spines lose some of the fluid that helps them stay flexible.
A herniated disc also can be caused by an injury to the spine, causing tiny tears or cracks in the outer layer (annulus or capsule) of the disc. The jellylike material inside the disc may be forced out of the disc through those tears or cracks, causing the disc to bulge, rupture or break into fragments.
Herniated discs also are more common in people who smoke.
Diagnosing herniated discs
Following a thorough history, physical and neurological exam, Ohio State Spine Care specialists may recommend imaging tests, including:
- Magnetic resonance imaging (MRI)
- Electromyography study (EMG), a test that measures the electrical activity of muscles
- Nerve block to identify the specific nerve irritated by a herniated disc
Herniated disc treatment
Ohio State offers treatments ranging from physical therapy to the most complex neck and spine surgeries. Because 90% of herniated discs get better on their own, our specialists explore other options before recommending surgery.
Our spine specialists offer multiple options to increase mobility and reduce pain:
One of Ohio State’s strengths is our physical therapy program, with therapists who specialize in complex, degenerative spine conditions. Following an examination of posture, neck and back mobility, strength and flexibility, our physical therapists customize a plan for you. We take into account any impairments or functional limitations you have. Typically, you’ll work one-on-one with a therapist on pain-relieving movement strategies and on improvements in strength and flexibility.
Additional nonsurgical treatments
- Education on neck and back care, and recommendations for specific needs (such as job demands, recreational activities, home activities)
- Real-time ultrasound imaging (RUSI) of movement in the spine area to re-train the deep stabilizing musculature of your spine (a highly researched, evidence-based intervention)
- Anti-inflammatory medications
- Injection around the nerve that’s being irritated by the disc
- Nerve blocks to relieve pain
- Weight loss guidance emphasizing healthier eating and exercise to ease pressure on the spine
- Pilates, yoga and aquatic therapy to strengthen back muscles
- Acupuncture (provided at Ohio State Spine Care) or dry needling for pain control through Ohio State’s Center for Integrative Medicine
Herniated disc surgery
We perform minimally invasive surgery (using small incisions, working through a tube) only if the disc is causing severe weakness, pain that does not improve over time or loss of function or mobility.