Do you have a herniated disc? Find out what your symptoms mean—in a few painless clicks.
What is a Herniated Disc?
A herniated disc occurs when an intervertebral disc suffers damage and ruptures, releasing its gel-like internal contents into the surrounding nerve-rich space.
Each delicate vertebra of your spine is cushioned by a shock-absorbing intervertebral disc. Similar to the structure of a jelly donut, the anatomy of an intervertebral disc consists of a tire-like outer casing that encapsulates a gel-filled center. These elastic discs function to safeguard your spine from traumatic injury and to permit for the optimal flexibility of your neck and back. Unfortunately, these rubbery discs are not invulnerable to injury.
Wear and tear from repetitive lifting or the natural consequences of the aging process can cause micro-tears to appear on the exterior of an intervertebral disc. A damaged disc may then develop a protrusion, or bulge outward from the point of exterior weakness.
When a bulging disc ruptures, or herniates, the gelatinous nucleus of the intervertebral disc oozes outside of its protective casing, irritating nearby nerves and generating searing pain.
Common causes of a herniated disc—also referred to as a “slipped” disc—include:
- Degenerative Disc Disease: As we age, our intervertebral discs lose their fluid content (or desiccate). Because the jelly-like center of an intervertebral disc protects your spine from compressional or rotational injuries, this loss of flexibility can also increase your likelihood of suffering a herniated disc.
- Spinal Trauma: Vehicular accidents, sports-related injuries, and unexpected falls can cause an intervertebral disc to herniate upon impact.
- Chronic Strain: The cumulative effects of repetitive, heavy lifting or improper body mechanics while lifting can contribute to the gradual deterioration of an intervertebral disc.
- Unhealthy Habits: Smoking, abdominal obesity, and a sedentary lifestyle promote disc herniation by accelerating the rate of disc dehydration, placing unnecessary strain on the lumbar spine, and decreasing the natural flexibility of each intervertebral disc
These underlying conditions often render our intervertebral discs brittle instead of elastic, such that everyday motions—like sneezing or rotating the torso—can cause a disc to rupture instantaneously.
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What are the Symptoms of a Herniated Disc?
A herniated disc may be asymptomatic; however, more commonly, individuals rate their discomfort as moderate to severe. In certain individuals, the pain may become incapacitating, limiting daily activities or necessitating a trip to the emergency room. Although individual herniated disc symptoms vary significantly, telltale signs of a herniated disc include:
- Pinched Nerve Pain: Pain that erupts from the site of herniation and migrates down through the extremities
- Sciatica: Scorching pain that radiates from the sciatic nerve in the lower back and down through the buttocks, thighs, calves, and/or feet
- Cervical Radiculopathy: Searing pain that originates from the neck region of the spine and shoots down through the shoulders, biceps, wrists, and/or fingertips
- Activity Limitations: Pain that is aggravated by sudden movements (e.g. coughing, sneezing, etc.); bowing at the waist; or sedentary activities that encourage poor posture (e.g. sitting at a desk)
- Paresthesia: Numbness, tingling, or prickling sensations in the body regions that are supplied by the irritated nerve tissue
- Muscular Symptoms: Muscular spasms or neuromuscular weakness
- Foot Drop: Inhibition of the muscles that flex the foot while walking
- Emergency Symptoms: Seek immediate medical attention if you experience excruciating pain, paralysis, loss of bowel or bladder function, or persistent numbness/tingling in the buttocks, inner thighs, or genital region (also known as saddle anesthesia)
Are you worried that your symptoms of pinched nerve (aka radicular) pain could indicate a herniated disc? Dr. Frazier—hailed twice by the New York Times Magazine as a “Super Doctor”—has over 20 years of experience in resolving herniated disc pain.
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What are the Treatments for a Herniated Disc?
Barring unusual or emergent cases, an initial course of treatment for a herniated disc should adopt a conservative or non-surgical approach to healing. A thoughtful combination of self-management and physician-guided recovery is often all that it takes to achieve effective relief. Recommended non-surgical techniques often involve a regimen of bed rest, activity modifications, physical therapy, or medications including anti-inflammatory drugs or cortisone injections that relieve soreness.
Although these methods are often sufficient to provide lasting pain relief for a herniated disc, a minority of individuals will still require surgical intervention to eliminate their discomfort. For those individuals who do require surgical treatment, our Harvard-trained, board certified surgeon, Dr. Frazier, will recommend one of the following minimally invasive techniques:
- Endoscopic Discectomy or Microdiscectomy: Through a tiny incision (3-5 cm. in length), your surgeon will use an endoscope (a flexible tube with a high-resolution camera) or a microscope to visualize the compressed nerve tissue and extract the herniated disc material.
- Laminectomy: A laminectomy is often combined with an endoscopic discectomy or microdiscectomy. During a laminectomy, your surgeon will remove a tiny sliver of the lamina (the bony vertebral sheath that houses your spinal cord). This procedure not only enables your surgeon to better visualize your ruptured disc, but also allows for the decompression of pinched nerve tissue.
- Artificial Disc Replacement: This outpatient, or same-day surgical procedure, involves removing the herniated disc and replacing the damaged intervertebral body with a sturdier, artificial model.
However, these surgical interventions represent only a fraction of the innovative techniques that Dr. Frazier may suggest to eliminate your pain. Because we pride ourselves on treating each client as a person instead of a patient, Dr. Frazier strives to provide the highest quality of personalized care for your condition.
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Dr. Frazier is a Harvard-trained, board certified orthopedic spine surgeon. He’s held an academic appointment at Columbia University College of Physicians and Surgeons and New York’s SUNY Downstate. Dr. Frazier is also a respected lecturer, accomplished researcher, published author on spine disorders and treatment, and a consultant for several international spine companies.
After completing his undergraduate education at Brown University, Dr. Frazier attended Harvard Medical School, where he graduated cum laude. He completed a Harvard internship based at the New England Deaconess Hospital in Boston, MA, followed by a Harvard combined residency before becoming chief resident at Massachusetts General Hospital.
Education & Training
MD / cum Laude, Boston MA
Harvard Medical School
Residency, Boston MA
Harvard Combined Orthopedic Residency
Chief Residency, Boston MA
Harvard Mass. General Hospital
Spinal Deformity Fellowship, Miami FL
Doctor's Hospital, Shufflebarger Fellowship
Academic Appointments, NY, NY
Columbia University; SUNY Downstate
Nuvasive, Depuy & Stryker International Spine Cos.