Herniated disc pain plagues millions of people each year. Herniated discs are also called slipped discs or ruptured discs. Though many people never experience symptoms, a large percentage do experience some degree of pain along with other symptoms. Fortunately, most people can find pain relief through home or physician directed treatments.

Herniated discs (also spelled as a disk) can occur anywhere along the spine, but most occur in the neck (cervical herniated disc) or lower back (lumbar herniated disc). Spinal discs cushion the vertebra (bones) in the spine. When one of the discs experiences a tear in the tough exterior, the softer jelly-like tissue protrudes through the tear.

A bulging disc, on the other hand, only affects the tough disc exterior. The disc is not cracked or torn but is experiencing pressure, which causes it to bulge as the inner nucleus of the disc push against the exterior.

The pain from a herniated disc can occur along a spectrum from mild to severe. Pain due to a herniated is caused by the jelly-like material irritating the nerves outside the disc or the weakened disc compressing a spinal nerve. A bulging disc causes pain when the misshapen disc presses on a nerve. Sometimes the pain is mild at first but gets worse as the disc continues to deteriorate, usually due to normal aging, injury or disease. 

Disc herniation often makes itself known when someone begins to experience discomfort or pain to some degree. Other symptoms include:

• Tingling or numbness in the part of the body served by the nerves.

• Leg pain due to a lumbar herniated disc causing radiating pain from the lower back and down the back of the leg; pain is felt in the buttock, thigh, calf and possibly the foot.

• Arm pain due to a cervical herniated disc causing pain in the shoulder and arm and perhaps the fingers.

• Muscle weakness or cramping due to nerves impacted by the damaged disc.

• In severe cases, loss of reflex in the knee or ankle, a foot that drops when lifted or loss of bladder or bowel control.

• Pain that occurs when moving certain ways, like turning the head or twisting at the waist.

The symptoms of a bulging disc are usually very similar to the symptoms of a herniated disc. The nerves impacted by the bulging disc determine where the pain is felt.

People experiencing the symptoms described want to know how to diagnose a herniated disc. The first step is seeing a physician who will take a medical history, listen to an explanation of the symptoms, perform a physical examination and determine the best diagnostic tests to order. In our pain clinic, you may schedule an appointment with Dr. Majid Ghauri who is specialized in a treatment of acute and chronic pain-related conditions like a herniated disc.

Herniated disc tests are likely to include a slipped disc x-ray. The simple x-ray can only detect problems with vertebrae (bones) and not the herniation. For example, the x-ray can detect a narrowing of space between two discs. A type of x-ray procedure is the myelogram. A dye is injected into the spine's fluid and x-rays are taken to locate areas of pressure on the nerves or spinal cord. 

The physician may order a CT scan (computerized tomography) which is a series of x-rays taken from different angles. The various images are combined to produce a cross-sectional picture of the spine and surrounding structures. A CT scan and a myelogram may both be ordered in order to get the most information possible.

An MRI (magnetic resonance imaging) is another common diagnostic test. The MRI uses radio waves to produce images of internal tissues. 

The CT scan and the MRI can produce images of soft tissue, so they are used to diagnose a bulging disc or a herniated disc. 

For most people, finding herniated disc pain relief is often possible by following a home treatment plan. A herniated disc can heal, usually within 4-6 weeks, by:

• Resting for a few days

• Applying heat or ice to reduce swelling

• After a few days of rest, doing gentle home exercises to keep joints and muscles flexible and to strengthen back muscles

• Taking over-the-counter herniated disc medication

Over-the-counter medications can often relieve pain and reduce swelling. Common medications recommended are ibuprofen, naproxen and NSAIDs. If the over-the-counter medications do not work within 10 days to two weeks, the physician may prescribe more powerful medications, like muscle relaxants or nerve pain medicines. 

Additional treatments include physical therapy and massage. If pain persists, the epidural injection of a steroid can reduce inflammation and ease pain. Surgery is only recommended in severe cases and is always a last resort treatment.

Aging is the most common cause of herniated discs, but that does not mean they are unavoidable. It is important to follow a healthy diet plan, regular exercise, learn proper techniques for lifting heavy items, maintain a good posture at all times, maintain a healthy weight and keep back muscles, tendons and ligaments strong and flexible. A healthy lifestyle is always the best defense against developing a bulging or herniated disc.

Majid Ghauri, MD

Interventional Pain Management Specialist.

Medical Director and Founder of Spine and Pain Clinics of North America (SAPNA).