By the Fitness Chiropractic team · Updated
What is a herniated disc?
Between each pair of vertebrae sits a disc — a rubbery cushion with a tough outer ring and a soft, gel-like center, a bit like a jelly donut. A herniated disc (also called a slipped or ruptured disc, and often spelled "herniated disk") happens when part of that soft center pushes through a tear in the outer ring.
The displaced material can press on a nearby nerve root and release chemicals that inflame it. That's why a herniated disc can cause pain far from the spine itself — down a leg or an arm. Most herniations happen in the lower back, with the neck the next most common site.
A herniated disc isn't the same as a bulging disc, where the disc spreads out more evenly without a tear in its outer layer — although the two are often confused.
What causes a herniated disc?
Most herniated discs come from gradual wear rather than one dramatic injury. As we age, discs lose water and flexibility, so a fairly ordinary movement — bending to pick something up, or twisting while you lift — can be the final straw. Risk factors include:
- Age-related disc changes, which make herniations most common in middle age
- Physically demanding work with repeated lifting, pulling, pushing or twisting
- Extra body weight, which adds load to the discs of the lower back
- Smoking, which reduces the disc's supply of nutrients
- Genetics — some people are simply more prone to disc problems
- Long hours of sitting or driving
Herniated disc symptoms
Symptoms depend on where the herniation is and whether it touches a nerve. Some herniated discs cause no symptoms at all and only show up on a scan.
Herniated disc in the lower back
A lumbar herniation often causes lower back pain plus pain that shoots through the buttock and down the back of the thigh and calf, sometimes into the foot. This is the classic pattern of sciatica. You may also notice numbness, tingling or weakness in the leg, and pain that flares when you sit, bend, cough or sneeze.
Herniated disc in the neck
A cervical herniation can cause neck pain along with pain, tingling or weakness in the shoulder, arm, hand or fingers. Certain neck positions may send a jolt down the arm. If your neck is the main problem, see our page on neck pain.
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Non-surgical herniated disc treatment
Every plan starts with a full orthopedic and neurological exam — testing your reflexes, muscle strength and sensation — so we know which nerve is involved and how irritated it is. If the exam suggests you need an MRI or a medical specialist, we'll tell you and refer you.
Conservative care may include:
- Spinal decompression, a gentle, non-surgical traction therapy designed to reduce pressure on the disc and nerve — read more about spinal decompression for a herniated disc
- Gentle chiropractic techniques chosen to suit a disc injury, restoring motion in the stiff segments around the problem area
- Directional exercises such as the McKenzie Method, which can help draw leg or arm pain back toward the spine
- Soft tissue therapy and massage for muscles that tighten and guard around the injury
- Core and posture work to reduce strain on the disc as you recover
- Acupuncture with our licensed acupuncturist for stubborn pain and muscle tension
You can read more about common disc pain problems and our wider approach to chiropractic treatment.
Can a herniated disc get better without surgery?
Often, yes. Many people improve over weeks to months with conservative care, and follow-up scans often show the displaced disc material shrinking over time. The aim of treatment is to calm the irritated nerve, keep you moving and protect the disc while that happens.
Your medical doctor may also suggest medication or injections to control pain during a flare-up. We're happy to work alongside your physician.
When is surgery considered?
Surgery is usually reserved for people with severe or worsening nerve weakness, or pain that doesn't respond after several weeks of good conservative care. It's needed urgently in the rare cases that affect bladder or bowel control. If your exam or progress points that way, we'll refer you for a surgical opinion.
Protecting your discs
- Lift with your legs, keep loads close to your body and avoid twisting as you lift
- Get up and move at least every 30 minutes when you sit for long periods
- Strengthen your core, hips and back with regular exercise
- Keep a healthy weight and avoid smoking
When to seek urgent care
Go to an emergency room right away if you have loss of bladder or bowel control, numbness in the groin or inner thighs, or rapidly worsening weakness in a leg or arm. These can be signs of serious nerve compression that needs immediate medical attention.
