​Herniated Disc (Slipped or Ruptured Disc)

Disc Herniation Diagnosis

In order to diagnose a herniated disc, the doctor will perform a physical exam and medical history. The doctor will check for numbness or loss of feeling in the extremities and check the patient’s reflexes, muscle strength, and posture.

Herniated disc symptoms

Symptoms of a herniated disc vary depending on the location of the affected disc. The most common symptoms may include:

• Pain in one or both legs (buttocks, thigh, and calf)
• Numbness, tingling, or weakness in the legs or feet or in one or both arms
• Inability to find comfort even lying down
• Sudden aching or twisted neck that cannot be straightened without severe pain
• Cauda equina syndrome (bowel or bladder changes and/or numbness in the groin)

A physical exam will be performed, and imaging tests such as x-ray, CT scan, MRI, discography, and myelogram may be ordered. Myelogram is a type of x-ray that uses dye injected into the space around the spinal cord to more clearly outline the space containing the spinal cord and nerves, which helps the doctor view any disc herniation. Electromyograms and nerve conduction studies may also be ordered to help identify the location of the nerve damage.

Herniated Disc Treatment

Non-surgical treatments

At UPMC, we begin with conservative treatment, such as pain medication, physical therapy, or a combination of both. Drug therapy may include non-steroidal anti-inflammatory drugs (NSAIDs), narcotics, nerve pain medications, muscle relaxers, or epidural cortisone injections.

A physical therapist can recommend muscle strengthening exercises and stretches to minimize the pain of a herniated disc.

Herniated disc surgery

Patients whose symptoms are not improved by conservative therapy may benefit from surgery. Additionally, patients who experience progressive muscle weakness from a compressed nerve can get relief from surgery.

A laminectomy removes some of the bone over the spine and the problem disc. Spinal fusion is a technique in which two vertebrae (back bones) are fused together with bone grafts or metal rods. By fusing the vertebrae, the painful motion is eliminated. A microdiscectomy may also be done to remove the fragments of a herniated disc through a small incision.