Topic Overview
What is a herniated disc?
The bones
(vertebrae) that form the
spine in your back are cushioned by small, spongy
discs. When these discs are healthy, they act as shock absorbers for the spine
and keep the spine flexible. But when a disc is damaged, it may bulge or break
open. This is called a herniated disc. It may also be called a slipped or
ruptured disc.
See a picture of a
herniated disc.
You can have a herniated
disc in any part of your spine. But most herniated discs affect the lower back
(lumbar spine). Some happen in the neck (cervical spine) and, more rarely, in
the upper back (thoracic spine). This topic focuses mainly on the lower
back.
What causes a herniated disc?
A herniated disc may be caused by:
- Wear and tear of the disc. As you age, your
discs dry out and aren't as flexible.
- Injury to the spine. This may
cause tiny tears or cracks in the hard outer layer of the disc. When this
happens, the gel inside the disc can be forced out through the tears or cracks
in the outer layer of the disc. This causes the disc to bulge, break open, or
break into pieces.
What are the symptoms?
When a
herniated disc presses on
nerve roots, it can cause pain, numbness, and weakness
in the area of the body where the nerve travels. A herniated disc in the lower
back can cause pain and numbness in the buttock and down the leg. This is
called sciatica (say "sy-AT-ih-kuh"). Sciatica is the most
common symptom of a herniated disc in the low back.
If a
herniated disc is not pressing on a nerve, you may have a backache or no pain
at all.
If you have weakness or numbness in both legs, along with
loss of bladder or bowel control, seek medical care right away. This could be a
sign of a rare but serious problem called
cauda equina syndrome.
How is a herniated disc diagnosed?
Your doctor may
diagnose a herniated disc by asking questions about your symptoms and examining
you. If your symptoms clearly point to a herniated disc, you may not need
tests.
Sometimes a doctor will do tests such as an
MRI or a
CT scan to confirm a herniated disc or rule out other
health problems.
How is it treated?
Symptoms from a herniated disc
usually get better in a few weeks or months. To help you recover:
- Rest if you have severe pain. Otherwise, stay
active. Staying in bed for more than 1 or 2 days can weaken your muscles and
make the problem worse. Walking and other light activity may help.
- Try using a heating pad on a low or medium setting for 15 to 20 minutes every 2 or 3 hours. Try a warm
shower in place of one session with the heating pad. You can also buy single-use heat wraps that last up to 8 hours. You can also try an ice pack
for 10 to 15 minutes every 2 to 3 hours.
- Do the exercises that your
doctor or physical therapist suggests. These will help keep your back muscles
strong and prevent another injury.
- Ask your doctor about medicine
to treat your symptoms. Medicine won't cure a herniated disc, but it may help
with pain and swelling.
Usually a herniated disc will heal on its own over time.
About half of people with a herniated disc get better within 1 month, and most
are better within 6 months. Only about 1 person in 10 eventually has
surgery.1
Be patient, and stay with your
treatment. If your symptoms don't get better in a few months, you may want to
talk to your doctor about surgery.
Can a herniated disc be prevented?
After you have
hurt your back, you are more likely to have back problems in the future. To
help keep your back healthy:
- Protect your back when you lift. For example,
lift with your legs, not your back. Don't bend forward at the waist when you
lift. Bend your knees and squat.
- Use good posture. When you stand
or walk, keep your shoulders back and down, your chin back, and your belly in.
This will help support your lower back.
- Get regular exercise.
- Stay at a healthy weight. This may reduce the load on your lower
back.
- Don't smoke. Smoking increases the risk of a disc
injury.
Frequently Asked Questions
Learning about herniated disc: | |
Being diagnosed: | |
Getting treatment: | |
Ongoing concerns: | |
Cause
A
herniated disc usually is caused by wear and tear of
the disc (also called
disc degeneration). As we age, our vertebral discs
lose some of the fluid that helps them maintain flexibility. A herniated disc
also may result from injuries to the spine, which may cause tiny tears or
cracks in the outer layer (annulus or capsule) of the disc. The jellylike
material inside the disc (nucleus) may be forced out through the tears or
cracks in the capsule, which causes the disc to bulge, break open (rupture), or
break into fragments. See a picture of a
herniated disc.
Injury to the disc can occur from:
- A sudden heavy strain or increased pressure to
the lower back. Sometimes a sudden twisting movement or even a sneeze will
force some of the nucleus (the material inside the disc) out through the disc's
outer layer (annulus or capsule).
- Activities that are done over and
over again that may stress the lower back, including poor lifting habits,
prolonged exposure to vibration, or sports-related injuries.
Symptoms
Symptoms of a
herniated disc vary greatly depending on the position
of the herniated disc and the size of the herniation.
If the
herniated disc is:
- Not pressing on a nerve, you may have an ache
in the low back or no symptoms at all.
- Pressing on a nerve, you may
have pain, numbness, or weakness in the area of your body to which the nerve
travels.
- With herniation in the lower (lumbar) back,
sciatica may develop.
Sciatica is pain that travels through the buttock and
down a leg to the ankle or foot because of pressure on the sciatic nerve. Low
back pain may accompany the leg pain.
- With herniation in the upper
part of the lumbar spine, near the ends of the lowest ribs, you may have pain
in the front of the thigh.
- With herniation in the neck (cervical spine), you may have pain or numbness in the shoulders, arms, or
chest.
Leg pain caused by a herniated
disc:
- Usually occurs in only one leg.
- May
start suddenly or gradually.
- May be constant or may come and go
(intermittent).
- May get worse ("shooting pain") when sneezing,
coughing, or straining to pass stools.
- May be aggravated by
sitting, prolonged standing, and bending or twisting movements.
- May
be relieved by walking, lying down, and other positions that relax the spine
and decrease pressure on the damaged disc.
Nerve-related symptoms caused by a
herniated disc include:
- Tingling ("pins-and-needles" sensation) or
numbness in one leg that can begin in the buttock or behind the knee and extend
to the thigh, ankle, or foot.
- Weakness in certain
muscles in one or both legs.
- Pain in the front of the
thigh.
- Weakness in both legs and the loss of bladder and/or bowel
control, which are symptoms of a specific and severe type of nerve root
compression called
cauda equina syndrome. This is a rare but serious
problem, and a person with these symptoms should see a doctor
immediately.
Other symptoms of a herniated disc
include severe deep muscle pain and muscle spasms.
What Happens
The gradual wearing out of
spinal discs is a natural part of aging that can often
lead to a
herniated disc. But only a few people who have
herniated discs have severe or troublesome symptoms.
Due to age,
injury, or both, a disc's outer layer, the capsule or annulus, may dry out and
develop tiny cracks. This causes the disc to bulge, break open (rupture), or
break apart. Often herniated discs bulge but do not rupture or break
apart.
- Bulging disc. Some of the jellylike material
(nucleus) that fills the disc may leak into the cracks in the capsule. The disc
may begin to bulge out from between the bones of the spine (vertebrae). It
often bulges away from the spinal cord and nerve roots and therefore doesn't
cause symptoms.
- Ruptured disc. The nucleus material inside the disc
breaks through the capsule.
- Free fragment. Fragments of a ruptured disc may
break completely free of the disc and lodge in the
spinal canal, the opening in the vertebrae through which the spinal cord
runs.
Any of these stages can cause pressure on a nerve
root and symptoms of pain and numbness.
The cracks in the disc
capsule do not repair themselves, but the pain usually fades over time. About
50% of people with a herniated disc in the low back recover within 1 month. And
within 6 months, most recover.1
Often
material from a herniated disc is broken down and absorbed by the body, a
process called
resorption. In about 2 out of 3 people, the disc
herniation is at least partly gone after 6 months.2
Long-term herniated disc problems can
develop.
- Pain may come and go. Periods of time when pain
goes away (remission) occur less frequently.
- Long-lasting (chronic)
and recurring pain can develop because of continued tissue irritation caused by
the disc pressing on a nerve.
- Chronic pain syndrome can result from having ongoing pain, causing depression,
anxiety, and difficulty coping with daily life.
- Symptoms caused by
long-term nerve root compression include loss of agility, strength, or
sensation in one or both legs and feet.
Compression of the bundle of nerve roots in the lower back
(lower lumbar region) can lead to weakness in both legs, and the loss of bowel,
bladder, and sexual function. This rare condition, called
cauda equina syndrome, requires immediate medical
attention.
What Increases Your Risk
There are various risk
factors for a
herniated disc.
Risk factors that you cannot change
There are some
things you cannot change. But if you know about them, you can be prepared to
consider how they will affect you. These include:
- Advancing age. The process of aging of the
discs in the lower back, as well as repeated injury to the discs and spinal
muscles, makes a person more likely to have low back problems, which usually
begin in midlife.
- Being male.
- History of back injury,
previous herniated disc, or back surgery.
Risk factors that you can change
Some risk
factors you can change, with lifestyle changes or medical treatment. If you
take steps to limit the risks from these factors, you can decrease your overall
risk of having a herniated disc. Risk factors you can change include:
- Your job or other activities that increase
the risk of developing a herniated disc, such as long periods of sitting,
lifting or pulling heavy objects, frequent bending or twisting of the back,
heavy physical exertion, repetitive motions, or exposure to constant vibration
(such as driving).
- Not exercising regularly, doing strenuous
exercise for a long time, or starting to exercise too strenuously after a long
period of inactivity.
- Smoking. Nicotine and other toxins from
smoking can keep spinal discs from absorbing all the nutrients they need from
the blood, making disc injury more likely. Smoking also increases your
sensitivity to pain. For information on how to quit smoking, see the topic
Quitting Smoking.
- Being overweight.
Carrying extra body weight (especially in the stomach area) may put additional
strain on the lower back, although this has not been proven. But being
overweight often also means being in poor physical condition, with weaker
muscles and less flexibility. These can lead to low back pain. For information
on how to maintain a healthy weight, see the topic
Weight Management.
When To Call a Doctor
Call 911 or other emergency services immediately if:
- A fall from a height (such as off a stool or
ladder) or significant injury (such as a motor vehicle accident) has caused
numbness or
weakness in one or both legs. A person who has a
severe back injury should not be moved until emergency medical assistance
arrives.
- Low back pain is accompanied by an inability to move the
arms or legs (paralysis), confusion, or shock.
- A ground-level fall or moderate injury (twisting the back,
lifting a heavy object) has caused numbness or weakness in one or both
legs.
- You have a sudden loss of bowel or bladder control.
Call your doctor if:
- Leg pain is accompanied by persistent weakness,
tingling, or numbness in any part of the leg from the buttock to the ankle or
foot.
- New low back pain is accompanied by vomiting and/or fever
[101°F (38.33°C) or higher]
that lasts longer than 48 hours.
- Leg pain or intermittent weakness,
tingling, or numbness persists longer than 1 week despite home
treatment.
- You have back pain that either persists or builds in
intensity over a few weeks.
- A back injury is work-related and
symptoms do not improve in 2 to 3 days.
- Back pain is accompanied by
pain during urination or blood in the urine.
- You have back pain that is worse when you are resting than when
you are active.
- You notice a gradual increase in problems with
bowel or bladder control.
Watchful Waiting
If you have pain, numbness, or tingling in one
leg that gets worse with sitting, standing, or walking (without any obvious leg
weakness):
- You may try a brief period of bed
rest—usually no more than 1 to 2 days—then gradually begin activities if the
pain is manageable.
- Take short walks.
- Avoid movements
and positions that increase pain or numbness.
- Call your doctor if:
- Your leg pain does not
improve.
- Nerve-related symptoms—such as tingling or numbness in
your leg, or weakness in both legs and loss of bladder or bowel control—get
worse during or after a short period of bed rest.
- You have
gradually increasing weakness in both legs or loss of bladder or bowel control.
Who To See
For diagnosis and nonsurgical treatment of a
herniated disc, you may see:
For diagnosis and surgical treatment of a herniated disc,
specialists include:
To prepare for your appointment, see the topic Making the Most of Your Appointment.
Exams and Tests
Initial examination
Your doctor will evaluate your
symptoms of leg and back pain using a
medical history and physical exam. Your
diagnosis will be based on any features that point to irritation of one or more
spinal nerves and to the loss of strength, sensation, or reflexes that are
normally associated with the nerve or nerves. If your medical history and
physical exam suggest you have a
herniated disc, you will probably not need additional
tests during your first medical visit.
Follow-up tests sometimes used
Imaging tests may
help confirm a diagnosis of a herniated disc or may be needed when nonsurgical
treatment has not worked to relieve pain. If you still have symptoms after 4
weeks of nonsurgical treatment, your doctor may recommend imaging tests. If the
results of an imaging test are not expected to change a treatment decision, the
test is probably not needed.
- Magnetic resonance imaging (MRI) may be done to confirm a diagnosis as well as the location
and severity of a herniated disc or to look for another serious condition, such
as an infection or tumor. An MRI provides detailed images of the soft tissues
of the spine, such as the muscles, spinal nerves, tendons, ligaments, discs,
and the softer inner part (marrow) of the bones of the spine.
- Computed tomography (CT) scan may be done to help
confirm a diagnosis as well as the location and severity of a herniated disc
and to look for any other problems in the bones of the spine. This test may be
done if you cannot have an MRI (for example, if you have a pacemaker) or if the
results of an MRI are not clear. A CT scan can provide detailed images of bony
structures of the spine.
An MRI is generally preferred over a CT scan for
diagnosing a suspected herniated disc in the lower back (lumbar spine).
X-rays generally are not useful or needed for
diagnosing a herniated disc. But if your medical history and physical exam
suggest a more serious condition (such as a tumor, infection, fracture, or
severe nerve damage), or if your leg pain and other symptoms do not get better
after 4 weeks of nonsurgical treatment, your doctor may order X-rays. Other
tests, such as blood tests, may be done to rule out other conditions.
Follow-up tests occasionally used
The following
imaging tests are not used as often as an MRI or a CT scan, but they may give
your doctor additional information:
- Electromyogram and nerve conduction test, which can be used to diagnose certain nerve and
muscle disorders, may be done in some cases for people who have signs of
prolonged pressure on a
nerve root.
- Myelogram, an
X-ray study of the spinal canal that uses dye to more clearly outline the space
containing the spinal cord. When myelography is used, it is almost always
combined with a CT scan. This test may be done if you cannot have an MRI (for
example, if you have a pacemaker) or if the results of an MRI are not
clear.
- Discography, which involves the
injection of a dye into the jellylike center of a spinal disc to help diagnose
disc problems
- Selective
nerve root block, in which
local anesthesia is injected beside a spinal nerve to
confirm which nerve is causing the problem
Treatment Overview
The goals of treatment for a
herniated disc are to:
- Relieve pain, weakness, or numbness in the leg
and lower back caused by pressure on a spinal
nerve root or the spinal cord.
- Promote a
return to normal work, recreation, and other activities.
- Prevent
reinjury to your back and reduce the risk of disability from back pain.
Because inflammation usually fades over time, about 50% of
people with a herniated disc in the low back recover within 1 month. And within
6 months, most people recover. Only 10% of people
with herniated disc problems that cause noticeable symptoms eventually have
surgery.1
Often a
herniated disc heals on its own as the jellylike material (nucleus) inside the
disc is broken down and absorbed by the body, a process called
resorption. For this reason, nonsurgical treatment is
typically recommended before surgery is considered.
Nonsurgical treatment
Nonsurgical treatment is
intended to help you return to your daily activities and usually
includes:
Education. Learn how to take care
of your back, which may include training in pain and symptom control. Your
doctor may recommend
physical therapy. A physical therapist can provide
treatment with physical or mechanical means—such as through exercise or
heat—and teach you exercises to do at home to strengthen the muscles that
support your lower back.
Rest. Your doctor
may recommend a short period of rest or reduced activity followed by a gradual
increase in activity.
Pain relief. Some
people can deal with pain without medicine if they know there is a good chance
it will go away on its own. But you can use medicine to control pain and
inflammation. Pain medicines include:
Exercise. Keep active and use
exercises, as recommended by your doctor or physical therapist, to help you
return to your usual level of activity.
Core stabilization exercises can help you strengthen
the muscles of your
trunk to protect your back.
Fitness: Increasing Core Stability
Surgery
Surgery is eventually the treatment for
about 10% of people who have a herniated disc. Surgery can be a good choice for
people who have nerve damage that is getting worse, or severe weakness or
numbness, or if pain is not improved after at least 4 weeks of nonsurgical
treatment.1 The most common and effective surgery for
herniated disc is
discectomy, in which disc material is removed through
an incision. Discectomy is done mostly to relieve pain and other symptoms in
the leg. It is not recommended if the herniated disc only causes back pain. Discectomy can relieve leg symptoms such as pain and numbness, but it does not relieve back pain.
Herniated Disc: Should I Have Surgery?
Many people are able to resume work and daily activities soon after
surgery. In some cases, your doctor may recommend a rehabilitation program
after surgery, which might include
physical therapy and home exercises.
What To Think About
Pain management counseling or cognitive behavioral therapy can
help you develop mental skills for coping with and reducing chronic pain.
Teens and young adults rarely develop herniated discs, but when
they do, nonsurgical treatment based on rehabilitation and anti-inflammatory
medicines usually helps to relieve symptoms.3
Prevention
Measures that may help prevent low back
pain or a
herniated disc include:
- Maintaining a healthy body weight. This may
reduce the load on your lower back. For information on maintaining a healthy
weight, see the topic
Weight Management.
- Exercising regularly.
- Quitting smoking. Nicotine and
other toxins from tobacco smoke can be harmful to your body in many ways.
Nicotine can harm the discs in your back because it lowers the ability of the
discs to absorb the nutrients they need to stay healthy and it may cause them
to become dry and brittle. For information on quitting smoking, see the topic
Quitting Smoking.
- Practicing good posture.
To reduce the stress that improper posture puts on your back:
Home Treatment
Home treatment can help relieve
symptoms caused by a
herniated disc. Home treatment can also strengthen
your back, which may help prevent further injury.
Steps to reduce pain
The following steps may help
to reduce pain:
- Relax. Find a comfortable position for rest. Some people are comfortable on the floor or a medium-firm bed with a small pillow under their head and another under their knees. Some people prefer to lie on their side with a pillow between their knees. Don't stay in one position for too long.
- Walk. Take a short walk (10 to 20 minutes) on a level surface (no slopes, hills, or stairs) every 2 to 3 hours. Walk only distances you can manage without pain, especially leg pain.
- Take pain medicine if needed, such as acetaminophen (Tylenol) or medicines that reduce pain, swelling, and irritation, including ibuprofen (such as Advil or Motrin) or naproxen (such as Aleve). These medicines usually work best if you take them on a regular schedule instead of waiting until the pain is severe.
- Try heat or ice. Try using a heating pad on a low or medium setting for 15 to 20 minutes every 2 to 3 hours. Try a warm shower in place of one session with the heating pad. Or you can buy single-use heat wraps that last up to 8 hours. You can also try an ice pack for 10 to 15 minutes every 2 to 3 hours. You can use an ice pack or a bag of frozen vegetables wrapped in a thin towel. There is not strong evidence that either heat or ice will help, but you can try them to see if they help. You may also want to try switching between heat and cold.
Steps to strengthen your back
Exercising may help
speed your recovery, prevent reinjury to your back, and reduce the risk of
disability from back pain. Other steps that may help keep your back strong and
healthy include losing weight if you are overweight, and quitting smoking if
you smoke.
Medications
Medicine is often used to treat pain
caused by a
herniated disc. Although medicine does not cure a
herniated disc, it may reduce
inflammation and pain and allow you to begin an
exercise program that can strengthen your stomach and back muscles.
Medication Choices
Medicines that may be used to relieve symptoms caused by
a herniated disc include:
Enzyme injection into the damaged disc (chemonucleolysis) can be done to try to dissolve a bulging
disc. (An enzyme is a chemical or protein that is able to speed up a specific
chemical reaction.) This procedure is rarely done.1
What To Think About
The use of pain relievers or
corticosteroid injections alone will not cure a herniated disc. It is important
to take care of your back and exercise to increase strength and fitness in
addition to using medicine to control your symptoms.
Some of the
medicines used, such as opioid pain relievers and corticosteroid injections,
can have serious side effects. Discuss this issue with your doctor before
deciding to use a medicine.
Surgery
Most people who have a
herniated disc do not need surgery because their
symptoms tend to improve over time. About 50% of people with a herniated disc
in the low back recover within 1 month. And within 6 months, 96%
recover. Only 10% of people with herniated disc
problems that cause noticeable symptoms eventually have surgery.1
When surgery is used to treat a herniated disc, it is done to decrease
pain and allow for more normal movement and function. It is considered if the
following conditions are present:
- You have a history of persistent leg pain that
has not improved with at least 4 weeks of nonsurgical treatment, as well as
weakness and limitation of daily activities.
- Results of a physical
exam find that you currently have weakness, loss of motion, or abnormal
sensitivity.
- Diagnostic testing, such as magnetic resonance imaging
(MRI), computed tomography (CT), or myelogram, indicates that you have a
herniated disc that can be treated surgically.
Surgery is appropriate only for people who have specific
symptoms and conditions. A decision to have surgery should take into
consideration results from diagnostic tests and physical examinations, your
response to nonsurgical treatment, and discussions between you and your doctor
about your options and expected results. Other
factors include your age, overall health, the severity of symptoms, and what
impact the symptoms have on your life (such as the inability to work). For
example, you and your doctor may consider surgery if your job requires a rapid
recovery, and there is no time to wait for the herniated disc to heal itself.
If you are an older adult, you may be offered surgery if your herniated disc is
less likely to improve without surgery because of other spinal diseases.
Disc surgery is not considered effective treatment for low back pain that
is not caused by a herniated disc. Disc surgery is also
not done if back pain is the only symptom the herniated disc causes.
Surgery Choices
- Discectomy
(also called open discectomy) is the surgical removal of herniated disc
material that presses on a nerve root or the spinal cord. It is also used for
bulging discs or
ruptured discs. Discectomy may be the most effective
type of surgery for people who have tried nonsurgical treatment without success
and who have severe, disabling pain.
- Percutaneous discectomy is used for
bulging discs and discs that have not ruptured into the spinal canal. This
procedure inserts a special tool through a small incision in the back. The
herniated disc tissue is then removed, thereby reducing the size of the disc
herniation. Percutaneous discectomy is considered less effective than open
discectomy, and its use is declining. Unless future studies show that this
technique is safe and effective, percutaneous discectomy should be considered
experimental.4
- Laminotomy and laminectomy are surgeries done to relieve pressure on the spinal cord
and/or spinal nerve roots caused by age-related changes in the spine.
Laminotomy removes a portion of the thin part of the vertebrae that forms a
protective arch over the spinal cord (lamina). Laminectomy removes all of the
lamina on selected vertebrae and also may remove thickened tissue that is
narrowing the
spinal canal, the opening in the vertebrae through which the spinal cord runs.
Either procedure may be done at the same time as a discectomy, or
separately.
What To Think About
All surgery involves some risk.
If you are considering surgery, consider the following factors:
- People with moderate to severe symptoms may
gain relief from surgery. Surgery is usually not done unless symptoms are
severe enough to interfere with normal activities and work, and to require
strong pain medicines. People who have surgery may feel better faster. But in
the long run, people treated with surgery and people treated without surgery
have similar abilities to work and to be active.5
- People with milder
symptoms tend to do well without surgery.
- Some people require
additional disc surgery after their first surgery.
- A number of technologies using small incisions or injections
for destroying the disc are used by some surgeons. Examples are endoscopic
discectomy and electrothermal disc decompression.
These techniques are experimental and unproven. If your doctor recommends one
of them to treat your herniated disc, make sure to get as much information as
possible about the procedure. Consider a second opinion to further evaluate
whether such a procedure is appropriate for you.
- Herniated Disc: Should I Have Surgery?
Many people are able to gradually resume work and daily activities soon
after surgery. In some cases, your doctor may recommend a rehabilitation
program after surgery, which might include
physical therapy and home exercises.
Other Treatment
The goals of rehabilitation,
exercise, and complementary and alternative treatments for a
herniated disc are to:
- Relieve pain, weakness, or numbness in the leg
and lower back caused by pressure on a spinal
nerve root or the spinal cord.
- Prevent
further injury by learning how to take care of your back and by doing exercises
that strengthen the muscles that support the lower back.
- Provide comfort and reassurance during the recovery
process.
Other Treatment Choices
Learn how to take care of your back, which may include
training in pain and symptom control.
- Physical therapy may be recommended by
your doctor. A physical therapist can treat you with physical or mechanical
means—such as through exercise or heat—and teach you exercises to do at home to
strengthen the muscles that support your lower back and help prevent
reinjury.
- Rehabilitation programs such as back schools teach you
how to care for your back.
- Chronic pain management programs teach
you to manage your pain with a combination of approaches, including medicine,
physical therapy, complementary medicine, and psychological counseling.
Complementary and alternative medicine
You can
use complementary and alternative medicine along with standard or conventional
care to treat leg and back pain caused by a herniated disc. Although no large
studies have proved the effectiveness or safety of these treatments, they may
help some people. Some examples include:2
- Acupuncture.
- Massage, to help
relieve pain.
- Manipulation, such as chiropractic or osteopathic
therapies, which has produced mixed results for people with herniated discs but
is likely to help some people.
Talk to your doctor about the potential benefits and
risks before using complementary and alternative medicine to treat a herniated
disc.
Experimental treatments
Research continues on
herniated disc treatments that do not involve open surgery. For example, laser
discectomy uses a focused beam of light to dissolve a herniated disc. Although
this technology has been used by some surgeons for several years, it is
considered experimental because of the lack of studies on its effectiveness and
safety.2 It appears to be less effective than standard
discectomy.4
Other treatments that have
been tried include removing the center of the disc, and removing all or part of
the disc by using suction. These treatments are not considered to be
effective.
What To Think About
Consider waiting 4 weeks before
using manipulation to treat a herniated disc. Many people with a herniated disc
have a significant improvement in symptoms during this time period.1
Ask your doctor about other treatments that may
help your symptoms caused by a herniated disc.
Other Places To Get Help
Organizations
|
RadiologyInfo
|
| 820 Jorie Boulevard |
| |
| |
| Oak Brook, IL 60523-2251 |
| USA |
| |
| Phone: |
|
| Fax: | |
| TDD: | |
| Email: | |
| Web Address: | www.radiologyinfo.org |
| |
RadiologyInfo is a joint project of the American College of Radiology and The Radiological Society of North America. The Web site is designed to answer consumer questions about radiology procedures and therapies. RadiologyInfo has information on X-ray, CT scan, MRI, ultrasound, and other procedures. The information includes how they are used for diagnosis and treatment, how to prepare for the procedures, and what a patient may experience. |
|
|
North American Spine Society
|
| |
| 7075 Veterans Boulevard |
| Burr Ridge, IL 60527 |
| |
| Phone: |
(630) 230-3600
|
| Fax: | (630) 230-3700 |
| Web Address: | www.spine.org |
| |
The North American Spine Society (NASS) has a patient education Web site http://KnowYourBack.org. This Web site includes information on the cause, treatment, and prevention of neck and back problems. This information includes references and brochures to help patients make health decisions. NASS promotes education, research, and advocacy for spine care. NASS members include spine care professionals such as orthopedic surgeons, neurosurgeons, neurologists, physical therapists, and researchers. |
|
| American Academy of Orthopaedic Surgeons
(AAOS) |
| 6300 North River Road |
| Rosemont, IL 60018-4262 |
| Phone: | 1-800-346-AAOS (1-800-346-2267)
(847) 823-7186 |
| Fax: | (847) 823-8125 |
| Email: | orthoinfo@aaos.org |
| Web Address: | www.orthoinfo.aaos.org |
| |
The American Academy of Orthopaedic Surgeons (AAOS)
provides information and education to raise the public's awareness of
musculoskeletal conditions, with an emphasis on preventive measures. The AAOS
website contains information on orthopedic conditions and treatments, injury
prevention, and wellness and exercise. |
|
| National Institute of Arthritis and Musculoskeletal and
Skin Diseases (NIAMS), National Institutes of Health |
| 1 AMS Circle |
| Bethesda, MD 20892-3675 |
| Phone: | 1-877-22-NIAMS (1-877-226-4267) toll-free |
| Phone: | (301) 495-4484 |
| Fax: | (301) 718-6366 |
| TDD: | (301) 565-2966 |
| Email: | niamsinfo@mail.nih.gov |
| Web Address: | www.niams.nih.gov |
| |
The National Institute of Arthritis and Musculoskeletal
and Skin Diseases (NIAMS) is a governmental institute that serves the public
and health professionals by providing information, locating other information
sources, and participating in a national federal database of health
information. NIAMS supports research into the causes, treatment, and prevention
of arthritis and musculoskeletal and skin diseases and supports the training of
scientists to carry out this research. The NIAMS website provides
health information referrals to the NIAMS Clearinghouse, which has information
packages about diseases. |
|
References
Citations
- Hu SS, et al. (2006). Lumbar disc herniation section
of Disorders, diseases, and injuries of the spine. In HB Skinner, ed.,
Current Diagnosis and Treatment in Orthopedics, 4th ed.,
pp. 246–249. New York: McGraw-Hill.
- Jordan J, et al. (2009). Herniated lumbar disc, search
date July 2008. Online version of Clinical Evidence: http://www.clinicalevidence.com.
- Kraft DE (2002). Low back pain in the adolescent
athlete. Pediatric Clinics of North America, 49:
643–653.
- Deyo RA, Weinstein JN (2001). Low back pain.
New England Journal of Medicine, 344(5):
363–370.
- Atlas SJ, et al. (2005). Long-term outcomes of
surgical and nonsurgical management of sciatica secondary to a lumbar disc
herniation: 10-year results from the Maine Lumbar Spine Study. Spine, 30(8): 927–935.
Other Works Consulted
- Atlas SJ, et al. (2001). Surgical and nonsurgical
management of sciatica secondary to a lumbar disc herniation: Five-year
outcomes from the Maine Lumbar Spine Study. Spine,
26(10): 1179–1187.
- Deen GH, et al. (2003). Minimally invasive procedures
for disorders of the lumbar spine. Mayo Clinical Procedures, 78: 1249–1256.
- Peul WC, et al. (2007). Surgical versus prolonged
conservative treatment for sciatica. New England Journal of Medicine, 356(22): 2245–2256.
- Weinstein JN, et al. (2006). Surgical vs nonoperative
treatment for lumbar disk herniation: The spine patient outcomes research trial
(SPORT): A randomized trial. JAMA, 296(20):
2441–2450.
- Weinstein JN, et al. (2006). Surgical vs nonoperative
treatment for lumbar disk herniation: The spine patient outcomes research trial
(SPORT): Observational cohort. JAMA, 296(20):
2451–2459.
Credits
| By | Healthwise Staff |
|---|
| Primary Medical Reviewer | William H. Blahd, Jr., MD, FACEP - Emergency Medicine |
|---|
| Specialist Medical Reviewer | Robert B. Keller, MD - Orthopedics |
|---|
| Last Revised | July 21, 2010 |
|---|
Seton is proud to have four hospitals – the only hospitals in Central Texas - that have earned the Magnet designation, the highest award for nursing excellence given by the American Nurses Association.