Herniated Disc

	Topic Overview
	Health Tools
	Cause
	Symptoms
	What Happens
	What Increases Your Risk
	When To Call a Doctor
	Exams and Tests
	Treatment Overview
	Prevention
	Home Treatment
	Medications
	Surgery
	Other Treatment
	Other Places To Get Help
	Related Information
	References
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What is a herniated disc?

The bones (vertebrae) that form the spine in your back are cushioned by small, spongy discs. When these discs are healthy, they act as shock absorbers for the spine and keep the spine flexible. But when a disc is damaged, it may bulge or break open. This is called a herniated disc. It may also be called a slipped or ruptured disc.

See a picture of a herniated disc.

You can have a herniated disc in any part of your spine. But most herniated discs affect the lower back (lumbar spine). Some happen in the neck (cervical spine) and, more rarely, in the upper back (thoracic spine). This topic focuses mainly on the lower back.

What causes a herniated disc?

A herniated disc may be caused by:

• Wear and tear of the disc. As you age, your discs dry out and aren't as flexible.
• Injury to the spine. This may cause tiny tears or cracks in the hard outer layer of the disc. When this happens, the gel inside the disc can be forced out through the tears or cracks in the outer layer of the disc. This causes the disc to bulge, break open, or break into pieces.

What are the symptoms?

When a herniated disc presses on nerve roots, it can cause pain, numbness, and weakness in the area of the body where the nerve travels. A herniated disc in the lower back can cause pain and numbness in the buttock and down the leg. This is called sciatica (say "sy-AT-ih-kuh"). Sciatica is the most common symptom of a herniated disc in the low back.

If a herniated disc is not pressing on a nerve, you may have a backache or no pain at all.

If you have weakness or numbness in both legs, along with loss of bladder or bowel control, seek medical care right away. This could be a sign of a rare but serious problem called cauda equina syndrome.

How is a herniated disc diagnosed?

Your doctor may diagnose a herniated disc by asking questions about your symptoms and examining you. If your symptoms clearly point to a herniated disc, you may not need tests.

Sometimes a doctor will do tests such as an MRI or a CT scan to confirm a herniated disc or rule out other health problems.

How is it treated?

Symptoms from a herniated disc usually get better in a few weeks or months. To help you recover:

• Rest if you have severe pain. Otherwise, stay active. Staying in bed for more than 1 or 2 days can weaken your muscles and make the problem worse. Walking and other light activity may help.
• Try using a heating pad on a low or medium setting, or a warm shower, for 15 to 20 minutes every 2 or 3 hours. You can also try an ice pack for 10 to 15 minutes every 2 to 3 hours.
• Do the exercises that your doctor or physical therapist suggests. These will help keep your back muscles strong and prevent another injury.
• Ask your doctor about medicine to treat your symptoms. Medicine won't cure a herniated disc, but it may help with pain and swelling.

Usually a herniated disc will heal on its own over time. About half of people with a herniated disc get better within 1 month, and most are better within 6 months. Only about 1 person in 10 eventually has surgery.¹

Be patient, and stay with your treatment. If your symptoms don't get better in a few months, you may want to talk to your doctor about surgery.

Can a herniated disc be prevented?

After you have hurt your back, you are more likely to have back problems in the future. To help keep your back healthy:

• Protect your back when you lift. For example, lift with your legs, not your back. Don't bend forward at the waist when you lift. Bend your knees and squat.
• Use good posture. When you stand or walk, keep your shoulders back and down, your chin back, and your belly in. This will help support your lower back.
• Get regular exercise.
• Stay at a healthy weight. This may reduce the load on your lower back.
• Don't smoke. Smoking increases the risk of a disc injury.

Frequently Asked Questions

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	Herniated disc: Should I have surgery?
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A herniated disc usually is caused by wear and tear of the disc (also called disc degeneration). As we age, our vertebral discs lose some of the fluid that helps them maintain flexibility. A herniated disc also may result from injuries to the spine, which may cause tiny tears or cracks in the outer layer (annulus or capsule) of the disc. The jellylike material inside the disc (nucleus) may be forced out through the tears or cracks in the capsule, which causes the disc to bulge, break open (rupture), or break into fragments. See a picture of a herniated disc.

Injury to the disc can occur from:

• A sudden heavy strain or increased pressure to the lower back. Sometimes a sudden twisting movement or even a sneeze will force some of the nucleus (the material inside the disc) out through the disc's outer layer (annulus or capsule).
• Activities that are done over and over again that may stress the lower back, including poor lifting habits, prolonged exposure to vibration, or sports-related injuries.

Symptoms of a herniated disc vary greatly depending on the position of the herniated disc and the size of the herniation.

If the herniated disc is:

• Not pressing on a nerve, you may have an ache in the low back or no symptoms at all.
• Pressing on a nerve, you may have pain, numbness, or weakness in the area of your body to which the nerve travels.
  • With herniation in the lower (lumbar) back, sciatica may develop. Sciatica is pain that travels through the buttocks and down a leg to the ankle or foot because of pressure on the sciatic nerve. Low back pain may accompany the leg pain.
  • With herniation in the upper part of the lumbar spine, near the ends of the lowest ribs, you may have pain in the front of the thigh.
  • With herniation in the neck (cervical spine), you may have pain or numbness in the shoulders, arms, or chest.

Leg pain caused by a herniated disc:

• Usually occurs in only one leg.
• May start suddenly or gradually.
• May be constant or may come and go (intermittent).
• May get worse ("shooting pain") when sneezing, coughing, or straining to pass stools.
• May be aggravated by sitting, prolonged standing, and bending or twisting movements.
• May be relieved by walking, lying down, and other positions that relax the spine and decrease pressure on the damaged disc.

Nerve-related symptoms caused by a herniated disc include:

• Tingling ("pins-and-needles" sensation) or numbness in one leg that can begin in the buttock or behind the knee and extend to the thigh, ankle, or foot.
• Weakness in certain muscles in one or both legs.
• Pain in the front of the thigh.
• Weakness in both legs and the loss of bladder and/or bowel control, which are symptoms of a specific and severe type of nerve root compression called cauda equina syndrome. This is a rare but serious problem, and a person with these symptoms should see a doctor immediately.

Other symptoms of a herniated disc include severe deep muscle pain and muscle spasms.

The gradual wearing out of spinal discs is a natural part of aging that can often lead to a herniated disc. However, only a few people who have herniated discs have severe or troublesome symptoms.

Due to age, injury, or both, a disc's outer layer, the capsule or annulus, may dry out and develop tiny cracks. This causes the disc to bulge, break open (rupture), or break apart. Often herniated discs bulge but do not rupture or break apart.

• Bulging disc. Some of the jellylike material (nucleus) that fills the disc may leak into the cracks in the capsule. The disc may begin to bulge out from between the bones of the spine (vertebrae). It often bulges away from the spinal cord and nerve roots and therefore doesn't cause symptoms.
• Ruptured disc. The nucleus material inside the disc breaks through the capsule.
• Free fragment. Fragments of a ruptured disc may break completely free of the disc and lodge in the spinal canal, the opening in the vertebrae through which the spinal cord runs.

Any of these stages can cause pressure on a nerve root and symptoms of pain and numbness.

The cracks in the disc capsule do not repair themselves, but the pain usually fades over time. About 50% of people with a herniated disc in the low back recover within 1 month. And within 6 months, most recover.¹

Often material from a herniated disc is broken down and absorbed by the body, a process called resorption. In about 2 out of 3 people, the disc herniation is at least partly gone after 6 months.²

Long-term herniated disc problems can develop.

• Pain may come and go. Periods of time when pain goes away (remission) occur less frequently.
• Long-lasting (chronic) and recurring pain can develop because of continued tissue irritation caused by the disc pressing on a nerve.
• Chronic pain syndrome can result from having ongoing pain, causing depression, anxiety, and difficulty coping with daily life.
• Symptoms caused by long-term nerve root compression include loss of agility, strength, or sensation in one or both legs and feet.

Compression of the bundle of nerve roots in the lower back (lower lumbar region) can lead to weakness in both legs, and the loss of bowel, bladder, and sexual function. This rare condition, called cauda equina syndrome, requires immediate medical attention.

There are various risk factors for a herniated disc.

Risk factors that you cannot change

There are some things you cannot change. But if you know about them, you can be prepared to consider how they will affect you. These include:

• Advancing age. The process of aging of the discs in the lower back, as well as repeated injury to the discs and spinal muscles, makes a person more likely to have low back problems, which usually begin in midlife.
• Being male.
• History of back injury, previous herniated disc, or back surgery.

Risk factors that you can change

Some risk factors you can change, with lifestyle changes or medical treatment. If you take steps to limit the risks from these factors, you can decrease your overall risk of having a herniated disc. Risk factors you can change include:

• Your job or other activities that increase the risk of developing a herniated disc, such as long periods of sitting, lifting or pulling heavy objects, frequent bending or twisting of the back, heavy physical exertion, repetitive motions, or exposure to constant vibration (such as driving).
• Not exercising regularly, doing strenuous exercise for a long time, or starting to exercise too strenuously after a long period of inactivity.
• Smoking. Nicotine and other toxins from smoking can keep spinal discs from absorbing all the nutrients they need from the blood, making disc injury more likely. Smoking also increases your sensitivity to pain. For information on how to quit smoking, see the topic Quitting Smoking.
• Being overweight. Carrying extra body weight (especially in the stomach area) may put additional strain on the lower back, although this has not been proven. But being overweight often also means being in poor physical condition, with weaker muscles and less flexibility. These can lead to low back pain. For information on how to maintain a healthy weight, see the topic Weight Management.

Call 911 or other emergency services immediately if:

• A fall from a height (such as off a stool or ladder) or significant injury (such as a motor vehicle accident) has caused numbness or weakness in one or both legs. A person who has a severe back injury should not be moved until emergency medical assistance arrives.
• Low back pain is accompanied by an inability to move the arms or legs (paralysis), confusion, or shock.
• A ground-level fall or moderate injury (twisting the back, lifting a heavy object) has caused numbness or weakness in one or both legs.
• You have a sudden loss of bowel or bladder control.

Call your doctor if:

• Leg pain is accompanied by persistent weakness, tingling, or numbness in any part of the leg from the buttock to the ankle or foot.
• New low back pain is accompanied by vomiting and/or fever [101°F (38.33°C) or higher] that lasts longer than 48 hours.
• Leg pain or intermittent weakness, tingling, or numbness persists longer than 1 week despite home treatment.
• You have back pain that either persists or builds in intensity over a few weeks.
• A back injury is work-related and symptoms do not improve in 2 to 3 days.
• Back pain is accompanied by pain during urination or blood in the urine.
• You have back pain that is worse when you are resting than when you are active.
• You notice a gradual increase in problems with bowel or bladder control.

Watchful Waiting

If you have pain, numbness, or tingling in one leg that gets worse with sitting, standing, or walking (without any obvious leg weakness):

• You may try a brief period of bed rest—usually no more than 1 to 2 days—then gradually begin activities if the pain is manageable.
• Take short walks.
• Avoid movements and positions that increase pain or numbness.
• Call your doctor if:
  • Your leg pain does not improve.
  • Nerve-related symptoms—such as tingling or numbness in your leg, or weakness in both legs and loss of bladder or bowel control—get worse during or after a short period of bed rest.
  • You have gradually increasing weakness in both legs or loss of bladder or bowel control.

Who To See

For diagnosis and nonsurgical treatment of a herniated disc, you may see:

• A family medicine doctor.
• An internist.
• A physical therapist.
• A physiatrist (a specialist in physical medicine and rehabilitation).
• A rheumatologist.
• A neurologist.
• A doctor of osteopathy (osteopath).

For diagnosis and surgical treatment of a herniated disc, specialists include:

• An orthopedic surgeon.
• A neurosurgeon.

To prepare for your appointment, see the topic Making the Most of Your Appointment.

Initial examination

Your doctor will evaluate your symptoms of leg and back pain using a medical history and physical examination. Your diagnosis will be based on any features that point to irritation of one or more spinal nerves and to the loss of strength, sensation, or reflexes that are normally associated with the nerve or nerves. If your medical history and physical examination suggest you have a herniated disc, you will probably not need additional tests during your first medical visit.

Follow-up tests sometimes used

Imaging tests may help confirm a diagnosis of a herniated disc or may be needed when nonsurgical treatment has not worked to relieve pain. If you still have symptoms after 4 weeks of nonsurgical treatment, your doctor may recommend imaging tests. If the results of an imaging test are not expected to change a treatment decision, the test is probably not needed.

• Magnetic resonance imaging (MRI) may be done to confirm a diagnosis as well as the location and severity of a herniated disc or to look for another serious condition, such as an infection or tumor. An MRI provides detailed images of the soft tissues of the spine, such as the muscles, spinal nerves, tendons, ligaments, discs, and the softer inner part (marrow) of the bones of the spine.
• Computed tomography (CT) scan may be done to help confirm a diagnosis as well as the location and severity of a herniated disc and to look for any other problems in the bones of the spine. This test may be done if you cannot have an MRI (for example, if you have a pacemaker) or if the results of an MRI are not clear. A CT scan can provide detailed images of bony structures of the spine.

An MRI is generally preferred over a CT scan for diagnosing a suspected herniated disc in the lower back (lumbar spine).

X-rays generally are not useful or needed for diagnosing a herniated disc. But if your medical history and physical exam suggest a more serious condition (such as a tumor, infection, fracture, or severe nerve damage), or if your leg pain and other symptoms do not get better after 4 weeks of nonsurgical treatment, your doctor may order X-rays. Other tests, such as blood tests, may be done to rule out other conditions.

Follow-up tests occasionally used

The following imaging tests are not used as often as an MRI or a CT scan, but they may give your doctor additional information:

• Electromyogram and nerve conduction test, which can be used to diagnose certain nerve and muscle disorders, may be done in some cases for people who have signs of prolonged pressure on a nerve root.
• Myelogram, an X-ray study of the spinal canal that uses dye to more clearly outline the space containing the spinal cord. When myelography is used, it is almost always combined with a CT scan. This test may be done if you cannot have an MRI (for example, if you have a pacemaker) or if the results of an MRI are not clear.
• Discography, which involves the injection of a dye into the jellylike center of a spinal disc to help diagnose disc problems
• Selective nerve root block, in which local anesthesia is injected beside a spinal nerve to confirm which nerve is causing the problem

The goals of treatment for a herniated disc are to:

• Relieve pain, weakness, or numbness in the leg and lower back caused by pressure on a spinal nerve root or the spinal cord.
• Promote a return to normal work, recreation, and other activities.
• Prevent reinjury to your back and reduce the risk of disability from back pain.

Because inflammation usually fades over time, about 50% of people with a herniated disc in the low back recover within 1 month. And within 6 months, most people recover.¹ Only 10% of people with herniated disc problems that cause noticeable symptoms eventually have surgery.² Often a herniated disc heals on its own as the jellylike material (nucleus) inside the disc is broken down and absorbed by the body, a process called resorption. For this reason, nonsurgical treatment is typically recommended before surgery is considered.

Nonsurgical treatment

Nonsurgical treatment is intended to help you return to your daily activities and usually includes:

Education. Learn how to take care of your back, which may include training in pain and symptom control. Your doctor may recommend physical therapy. A physical therapist can provide treatment with physical or mechanical means—such as through exercise or heat—and teach you exercises to do at home to strengthen the muscles that support your lower back.

Rest. Your doctor may recommend a short period of rest or reduced activity followed by a gradual increase in activity.

Pain relief. Some people can deal with pain without medicine if they know there is a good chance it will go away on its own. However, you can use medicine to control pain and inflammation. Pain medicines include:

• Nonprescription and prescription pain relievers, such as acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs).
• Muscle relaxants.
• Corticosteroids.
• Opioids.
• Antidepressants.

Exercise. Keep active and use exercises, as recommended by your doctor or physical therapist, to help you return to your usual level of activity. Core stabilization exercises can help you strengthen the muscles of your trunk to protect your back.

Fitness: Increasing core stability

Surgery

Surgery is eventually the treatment for about 10% of people who have a herniated disc. Surgery can be a good choice for people who have nerve damage that is getting worse, or severe weakness or numbness, or if pain is not improved after at least 4 weeks of nonsurgical treatment.¹ The most common and effective surgery for herniated disc is discectomy, in which disc material is removed through an incision. Discectomy is done mostly to relieve pain and other symptoms in the leg. It is not done if the herniated disc only causes back pain.

Should I have surgery for a herniated disc?

Many people are able to resume work and daily activities soon after surgery. In some cases, your doctor may recommend a rehabilitation program after surgery, which might include physical therapy and home exercises.

What To Think About

Pain management counseling can help you develop mental skills for coping with and reducing chronic pain.

Teens and young adults rarely develop herniated discs, but when they do, nonsurgical treatment based on rehabilitation and anti-inflammatory medicines usually helps to relieve symptoms.³

Measures that may help prevent low back pain or a herniated disc include:

• Maintaining a healthy body weight. This may reduce the load on your lower back. For information on maintaining a healthy weight, see the topic Weight Management.
• Exercising regularly.
• Quitting smoking. Nicotine and other toxins from tobacco smoke can be harmful to your body in many ways. Nicotine can harm the discs in your back because it lowers the ability of the discs to absorb the nutrients they need to stay healthy and it may cause them to become dry and brittle. For information on quitting smoking, see the topic Quitting Smoking.
• Practicing good posture. To reduce the stress that improper posture puts on your back:
  • Use good posture while standing or walking, keeping your shoulders back and down, chin back, abdomen in, and your lower back supported.
  • Sit in the neutral position, using a small pillow or rolled towel to support your lower back if your chair doesn't give enough support.
  • Keep your back in the neutral position while sleeping, with techniques such as using a towel roll to support your lower back or placing a pillow under your knees when sleeping on your back. See pictures of sleeping positions.
  • Use proper lifting techniques, such as lifting by squatting and bending your knees, and using your legs to push yourself up.

Home treatment can help relieve symptoms caused by a herniated disc. Home treatment can also strengthen your back, which may help prevent further injury.

Steps to reduce pain

The following steps may help to reduce pain:

• Avoid movements and positions that increase pain or numbness.
• Limit your activities, and try briefly resting your back if your pain is severe. Try taking short walks and doing light activities that do not cause pain. Then gradually start your regular activities. Even if you have severe pain, bed rest of more than 1 to 2 days can cause the muscles in your back—as well as the rest of your body—to become weaker.
• Use ice or heat to relieve pain. Apply ice 3 times a day. Do not use ice for longer than 15 to 20 minutes at a time. Heat relieves pain for some people, but it should not be used too soon after an injury. Ask your doctor about using ice and heat to reduce your pain.
• Take nonprescription pain relievers to help reduce pain. Examples include aspirin (such as Bayer), acetaminophen (such as Tylenol), ibuprofen (such as Motrin), and naproxen sodium (such as Aleve).

Steps to strengthen your back

Exercising may help speed your recovery, prevent reinjury to your back, and reduce the risk of disability from back pain. Other steps that may help keep your back strong and healthy include losing weight if you are overweight, and quitting smoking if you smoke.

Medicine is often used to treat pain caused by a herniated disc. Although medicine does not cure a herniated disc, it may reduce inflammation and pain and allow you to begin an exercise program that can strengthen your stomach and back muscles.

Medication Choices

Medicines that may be used to relieve symptoms caused by a herniated disc include:

• Pain relievers, such as acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin.
• Muscle relaxants.
• Corticosteroids.
• Opioids.
• Antidepressants.

Enzyme injection into the damaged disc (chemonucleolysis) can be done to dissolve a bulging disc. (An enzyme is a chemical or protein that is able to speed up a specific chemical reaction.) This procedure is rarely done.¹

What To Think About

The use of pain relievers or corticosteroid injections alone will not cure a herniated disc. It is important to take care of your back and exercise to increase strength and fitness in addition to using medicine to control your symptoms.

Some of the medicines used, such as opioid pain relievers and corticosteroid injections, can have serious side effects. Discuss this issue with your doctor before deciding to use a medicine.

Most people who have a herniated disc do not need surgery because their symptoms tend to improve over time. About 50% of people with a herniated disc in the low back recover within 1 month. And within 6 months, 96% recover.¹ Only 10% of people with herniated disc problems that cause noticeable symptoms eventually have surgery.¹

When surgery is used to treat a herniated disc, it is done to decrease pain and allow for more normal movement and function. It is considered if the following conditions are present:⁴

• You have a history of persistent leg pain that has not improved with at least 4 weeks of nonsurgical treatment, as well as weakness and limitation of daily activities.
• Results of a physical examination find that you currently have weakness, loss of motion, or abnormal sensitivity.
• Diagnostic testing, such as magnetic resonance imaging (MRI), computed tomography (CT), or myelogram, indicates that you have a herniated disc that can be treated surgically.

Surgery is appropriate only for people who have specific symptoms and conditions. A decision to have surgery should take into consideration results from diagnostic tests and physical examinations, your response to nonsurgical treatment, and discussions between you and your doctor about your options and expected results.⁴ Other factors include your age, overall health, the severity of symptoms, and what impact the symptoms have on your life (such as the inability to work). For example, you and your doctor may consider surgery if your job requires a rapid recovery, and there is no time to wait for the herniated disc to heal itself. If you are an older adult, you may be offered surgery if your herniated disc is less likely to improve without surgery because of other spinal diseases.

Disc surgery is not considered effective treatment for low back pain that is not caused by a herniated disc. Disc surgery is also not done if back pain is the only symptom the herniated disc causes.

Surgery Choices

• Discectomy (also called open discectomy) is the surgical removal of herniated disc material that presses on a nerve root or the spinal cord. It is also used for bulging discs or ruptured discs. Discectomy may be the most effective type of surgery for people who have tried nonsurgical treatment without success and who have severe, disabling pain.
• Laminotomy and laminectomy are surgeries done to relieve pressure on the spinal cord and/or spinal nerve roots caused by age-related changes in the spine. Laminotomy removes a portion of the thin part of the vertebrae that forms a protective arch over the spinal cord (lamina). Laminectomy removes all of the lamina on selected vertebrae and also may remove thickened tissue that is narrowing the spinal canal, the opening in the vertebrae through which the spinal cord runs. Either procedure may be done at the same time as a discectomy, or separately.
• Percutaneous discectomy is used for bulging discs and discs that have ruptured into the spinal canal. This procedure inserts a special tool through a small incision in the back. The herniated disc tissue is then removed, thereby reducing the size of the disc herniation. Percutaneous discectomy is considered less effective than open discectomy, and its use is declining. Unless future studies show that this technique is safe and effective, percutaneous discectomy should be considered experimental.⁵

What To Think About

All surgery involves some risk. If you are considering surgery, consider the following factors:

• People with moderate to severe symptoms may gain relief from surgery. Surgery is usually not done unless symptoms are severe enough to interfere with normal activities and work, and to require strong pain medicines. People who have surgery may feel better faster. But in the long run, people treated with surgery and people treated without surgery have similar abilities to work and to be active.^{6, 7}
• People with milder symptoms tend to do well without surgery.
• Some people require additional disc surgery after their first surgery.
• A number of technologies using small incisions or injections for destroying the disc are used by some surgeons. Examples are endoscopic discectomy and electrothermal disc decompression.⁸ These techniques are experimental and unproven. If your doctor recommends one of them to treat your herniated disc, make sure to get as much information as possible about the procedure. Consider a second opinion to further evaluate whether such a procedure is appropriate for you.

Should I have surgery for a herniated disc?

Many people are able to gradually resume work and daily activities soon after surgery. In some cases, your doctor may recommend a rehabilitation program after surgery, which might include physical therapy and home exercises.

The goals of rehabilitation, exercise, and complementary and alternative treatments for a herniated disc are to:

• Relieve pain, weakness, or numbness in the leg and lower back caused by pressure on a spinal nerve root or the spinal cord.
• Prevent further injury by learning how to take care of your back and by doing exercises that strengthen the muscles that support the lower back.
• Provide comfort and reassurance during the recovery process.

Other Treatment Choices

Learn how to take care of your back, which may include training in pain and symptom control.

• Physical therapy may be recommended by your doctor. A physical therapist can treat you with physical or mechanical means—such as through exercise or heat—and teach you exercises to do at home to strengthen the muscles that support your lower back and help prevent reinjury.
• Rehabilitation programs such as back schools teach you how to care for your back.
• Chronic pain management programs teach you to manage your pain with a combination of approaches, including medicine, physical therapy, complementary medicine, and psychological counseling.

Complementary and alternative medicine

You can use complementary and alternative medicine along with standard or conventional care to treat leg and back pain caused by a herniated disc. Although no large studies have proved the effectiveness or safety of these treatments, they may help some people. Some examples include:²

• Acupuncture.
• Massage, to help relieve pain.
• Manipulation, such as chiropractic or osteopathic therapies, which has produced mixed results for people with herniated discs but is likely to help some people.

Talk to your doctor about the potential benefits and risks before using complementary and alternative medicine to treat a herniated disc.

Experimental treatments

Research continues on herniated disc treatments that do not involve open surgery. For example, laser discectomy uses a focused beam of light to dissolve a herniated disc. Although this technology has been used by some surgeons for several years, it is considered experimental because of the lack of studies on its effectiveness and safety.² It appears to be less effective than standard discectomy.⁵

Other treatments that have been tried include removing the center of the disc, and removing all or part of the disc by using suction. These treatments are not considered to be effective.

What To Think About

Consider waiting 4 weeks before using manipulation to treat a herniated disc. Many people with a herniated disc have a significant improvement in symptoms during this time period.¹

Ask your doctor about other treatments that may help your symptoms caused by a herniated disc.

Organizations

Related Information

• Back Problems and Injuries
• Cervical Disc Herniation
• Degenerative Disc Disease
• Low Back Pain
• Neck Pain
• Neck Problems and Injuries
• Sciatica

Citations

1. Hu SS, et al. (2006). Lumbar disc herniation section of Disorders, diseases, and injuries of the spine. In HB Skinner, ed., Current Diagnosis and Treatment in Orthopedics, 4th ed., pp. 246–249. New York: McGraw-Hill.

2. Jordan J, et al. (2007). Herniated lumbar disc, search date November 2006. Online version of Clinical Evidence (8).

3. Kraft DE (2002). Low back pain in the adolescent athlete. Pediatric Clinics of North America, 49: 643–653.

4. North American Spine Society Task Force on Clinical Guidelines (2000). Herniated disc. North American Spine Society Phase III Clinical Guidelines for Multidisciplinary Spine Care Specialists. La Grange, IL: North American Spine Society.

5. Deyo RA, Weinstein JN (2001). Low back pain. New England Journal of Medicine, 344(5): 363–370.

6. Atlas SJ, et al. (2001). Surgical and nonsurgical management of sciatica secondary to a lumbar disc herniation: Five-year outcomes from the Maine Lumbar Spine Study. Spine, 26(10): 1179–1187.

7. Atlas SJ, et al. (2005). Long-term outcomes of surgical and nonsurgical management of sciatica secondary to a lumbar disc herniation: 10-year results from the Maine Lumbar Spine Study. Spine, 30(8): 927–935.

8. Deen GH, et al. (2003). Minimally invasive procedures for disorders of the lumbar spine. Mayo Clinical Procedures, 78: 1249–1256.

Other Works Consulted

• Peul WC, et al. (2007). Surgical versus prolonged conservative treatment for sciatica. New England Journal of Medicine, 356(22): 2245–2256.

• Weinstein JN, et al. (2006). Surgical vs nonoperative treatment for lumbar disk herniation: The spine patient outcomes research trial (SPORT): A randomized trial. JAMA, 296(20): 2441–2450.

• Weinstein JN, et al. (2006). Surgical vs nonoperative treatment for lumbar disk herniation: The spine patient outcomes research trial (SPORT): Observational cohort. JAMA, 296(20): 2451–2459.