Herniated Disc

The multidisciplinary team at UT Southwestern Medical Center offers all available evidence-based treatments for herniated discs, including nonsurgical options.

At the Spine Center, we perform some interventional procedures, such as epidural injections, on an outpatient basis. This type of treatment can result in tremendous benefits, quickly decreasing inflammation.

Spine Center

Comprehensive Spine Care to Reclaim Quality of Life

The specialized spine doctors at UT Southwestern Spine Center are dedicated to helping patients overcome spine problems, providing comprehensive care and access to the latest and most effective treatments.

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Why Choose UT Southwestern for a Herniated Disc?

A herniated disc can make simple tasks excruciating, but our team helps patients overcome pain and return to their normal lives – usually without surgery.

At the Spine Center, we don’t believe in the one-size-fits-all concept. Each patient's treatment plan is as unique as their pain. Our multimodal approach aims to eliminate pain and restore normal function – without unnecessary surgery.

Unlike other clinics that may offer only specific treatments, UT Southwestern provides a full range of therapeutic options to meet our patients’ needs.

Healing is a journey best taken together. We build strong partnerships with our patients, encouraging them to be active participants in their care.

What Is a Herniated Disc?

Herniated discs are known by other names as well, such as slipped, ruptured, bulging, compressed, or prolapsed discs.

The cushioned discs between the 26 vertebrae of the spine act as shock absorbers and allow for flexibility. Each consists of a tough outer layer (annulus fibrosus) and a soft, jellylike center (nucleus pulposus).

A herniated disc occurs when the annulus fibrosus tears and the nucleus pulposus pushes out, causing irritation and pressure on nearby nerves. Sometimes the nucleus leaks out, possibly impinging on the nearby spinal cord or nerves.

What Are the Types of Herniated Discs?

Herniated discs can be classified according to where they occur in the spine:

Cervical herniated disc: Occurs in the neck region (C1-C7)
Thoracic herniated disc: Occurs in the upper and middle back (T1-T12)
Lumbar herniated disc: Occurs in the lower back (L1-L5)

Herniated discs occur most commonly in the lumbar spine, causing symptoms such as back pain and pain that radiates down the legs.

What Causes a Herniated Disc?

Herniated discs can result from factors typically related to aging, lifestyle, and physical stress. Common causes include:

Disc degeneration

Disc degeneration is primarily caused by the natural process of aging. The spinal discs lose their flexibility and elasticity, making them more prone to tearing or rupturing even with minor strains or twists. As people age, the discs in the spine dry out and weaken, increasing the likelihood of herniation.

Injury

Traumatic events such as falls, blows to the back, or heavy lifting using improper techniques can cause a disc to rupture. Even routine activities that involve repetitive twisting or bending can increase the risk if the discs are already weakened.

Risk factors

Certain people are at a higher risk of developing a herniated disc. Risk factors include:

Excess body weight, which puts additional stress on discs in the lower back
Occupations that involve heavy lifting, pulling, pushing, or repetitive activities
Smoking, which reduces the oxygen supply to the discs, causing them to break down more quickly

What Are the Symptoms of a Herniated Disc?

Common symptoms of a herniated disc include:

Pain: Herniated disc pain varies depending on the location of the disc:
- Lumbar herniated disc: Low back pain from a herniated disc can radiate through the buttocks, legs, and feet (sciatica). This sensation is typically sharp or burning and can worsen with movement, sitting, or standing for extended periods.
- Cervical herniated disc: A herniated disc in the neck region may cause a sharp or dull ache in the neck, shoulders, or arms. It can radiate down to the hands and fingers, intensifying with certain neck movements.
Numbness and tingling: Herniated discs can compress nearby nerves, causing numbness or a tingling sensation in the affected areas. People with lumbar herniations usually feel this in their legs and feet, while those with cervical herniations experience numbness or tingling in their arms and hands.
Weakness: Muscle weakness is a common symptom, where the muscles served by the affected nerves become weaker. This can lead to difficulties in performing everyday tasks, such as lifting objects or even walking.

In severe cases, such as cauda equina syndrome, a herniated disc can compress the nerves that control the bladder and bowels, leading to incontinence – a medical emergency requiring immediate attention.

How Are Herniated Discs Diagnosed?

If our doctors suspect that a patient has a herniated disc, we’ll conduct a physical examination and order spine imaging studies.

Tests, procedures, and imaging studies used to diagnose herniated discs might include:

Bone scan: An imaging test that uses a small amount of radioactive material to look for abnormalities in the bones
Computed tomography (CT) scan: Uses specialized X-ray equipment to create images of the body that can help detect bone abnormalities in particular.
Magnetic resonance imaging (MRI): Uses magnetic fields and radio waves to produce detailed images of soft tissues, including muscles and nerves
Myelography: Involves injecting a contrast dye into the spinal canal to highlight the spinal cord and nerve roots on X-rays or CT scans
X-ray: Uses radiation to produce images of bones and joints

How Are Herniated Discs Treated?

The spine specialists at UT Southwestern treat herniated discs with therapies that include:

Anti-inflammation drugs: Medications that reduce inflammation and relieve pain
Biofeedback: A technique that teaches patients to control physiological processes such as muscle tension, heart rate, and pain perception
Cortisone injections: Anti-inflammatory steroid injections that can help relieve pain and reduce inflammation
Physical therapy: Tailored exercises and treatments to improve mobility, strength, and function while reducing pain

Herniated Disc Surgery

When a herniated disc doesn’t respond to other treatments, our doctors may recommend one or more of the following surgeries:

Discectomy: The most common surgery for a herniated disc, discectomy involves removing the portion of the disc that is pressing on the nerve root. It can be performed as an open surgery or through a minimally invasive approach (microdiscectomy), which involves smaller incisions and typically results in a quicker recovery.
Laminectomy: This procedure involves removing part of the vertebra (the lamina) to relieve pressure on the spinal cord or nerves. It's often performed in conjunction with a discectomy.
Spinal fusion: In cases where multiple discs are herniated or there is spinal instability, spinal fusion may be performed. This surgery involves fusing two or more vertebrae together to stabilize the spine.

Recovery times from surgery vary depending on the type of procedure and the patient’s overall health.

How Can a Herniated Disc Be Treated at Home?

Herniated disc pain can often be managed effectively at home using a combination of techniques, such as:

Rest: Short periods of rest can help reduce inflammation and alleviate pain. Avoid extended bed rest, as it can lead to joint stiffness and muscle weakness.
Avoiding painful activities: Refrain from activities that exacerbate pain. Gradually resume activities as pain decreases, being careful to avoid heavy lifting.
Low-impact physical activity: Gentle exercises such as walking, swimming, or using a stationary bike can help relieve pressure on the nerve root while keeping muscles flexible.
Temperature therapy: Use cold packs initially to reduce inflammation and numb the area. After a few days, switch to heat therapy, such as warm compresses or heating pads, to relax muscles and improve blood flow.
Over-the-counter medications: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can help reduce pain and inflammation.

Additional home treatments include using supportive pillows to maintain proper spinal alignment while sleeping and practicing good posture throughout the day to reduce strain on the spine.