Disc herniation

A herniated (slipped) disk occurs when all or part of a disk is forced through a weakened part of the disk.

Being safe at work and play, using proper lifting techniques, and controlling weight may help prevent back injury.

Your health care provider may recommend a back brace to help support the spine. A brace can help prevent injuries in people who lift heavy objects at work. But using these devices too much can weaken the muscles that support your spine and make the problem worse.

 

The pain most often occurs on one side of the body.
  • With a slipped disk in your lower back, you may have sharp pain in one part of the leg, hip, or buttocks and numbness in other parts. You may also feel pain or numbness on the back of the calf or sole of the foot. The same leg may also feel weak.
  • With a slipped disk in your neck, you may have pain when moving your neck, deep pain near or over the shoulder blade, or pain that moves to the upper arm, forearm, and fingers. You can also have numbness along your shoulder, elbow, forearm, and fingers.
The pain often starts slowly. It may get worse:
  • After standing or sitting
  • At night
  • When sneezing, coughing, or laughing
  • When bending backward or walking more than a few yards

You may also have weakness in certain muscles. Sometimes, you may not notice it until your doctor examines you. In other cases, you will notice that you have a hard time lifting your leg or arm, standing on your toes on one side, squeezing tightly with one of your hands, or other problems.

The pain, numbness, or weakness often goes away or improves a lot over weeks to months.

 

A careful physical exam and history is almost always the first step. Depending on where you have symptoms, your doctor examines your neck, shoulder, arms, and hands, or your lower back, hips, legs, and feet.

Your doctor will check:

  • For numbness or loss of feeling
  • Your muscle reflexes, which may be slower or missing
  • Your muscle strength, which may be weaker
  • Your posture, or the way your spine curves

Your doctor may also ask you to:

  • Sit, stand, and walk. While you walk, your doctor may ask you to try walking on your toes and then your heels.
  • Bend forward, backward, and sideways
  • Move your neck forward, backward, and sideways
  • Raise your shoulders, elbow, wrist, and hand and check your strength during these tasks

Leg pain that occurs when you sit down on an exam table and lift your leg straight up usually suggests a slipped disk in your lower back.

In another test, you will bend your head forward and to the sides while the health care provider puts slight downward pressure on the top of your head. Increased pain or numbness during this test is usually a sign of pressure on a nerve in your neck.

 

The first treatment for a slipped disk is a short period of rest with medicines for the pain. This is followed by physical therapy. Most people who follow these treatments recover and return to normal activities. Some people will need to have more treatment. This may include steroid injections or surgery.

MEDICINES

Medicines can help with your pain. Your doctor may prescribe any of the following:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) for long-term pain control
  • Narcotics if the pain is severe and does not respond to NSAIDs
  • Medicines to calm the nerves
  • Muscle relaxants to relieve back spasms
LIFESTYLE CHANGES

If you are overweight, diet and exercise are very important for improving back pain.

Take care of your back at home:

  • Reduce activity for the first few days. Slowly restart your usual activities.
  • Avoid heavy lifting or twisting your back for the first 6 weeks after the pain starts.
  • After 2 to 3 weeks, gradually start exercising again.
INJECTIONS

Steroid medicine injections into the back in the area of the herniated disk may help control pain for several months. These injections reduce swelling around the disk and relieve many symptoms. Spinal injections are usually done in your doctor's office.

 

Most people improve with treatment. But you may have long-term back pain even after treatment.

It may take several months to a year or more to go back to all of your activities without having pain or straining your back. People who work in jobs that involve heavy lifting or back strain may need to change their job activities to avoid injuring their back again.