Herniated Disc and Disc Surgery

What Is a Herniated Disc?

A herniated disc, sometimes called a slipped or ruptured disc, occurs when the soft inner material of a spinal disc pushes through a tear or weakened area in the outer layer.

When the displaced disc material irritates or compresses a nearby nerve, it can cause pain, numbness, tingling, or weakness. Symptoms most commonly affect the neck, lower back, arms, or legs.

Herniated discs are a common cause of sciatica and can also contribute to back and neck pain, reduced mobility, and difficulty with everyday activities.

At Orthopaedic Associates of Wisconsin, our spine specialists offer comprehensive evaluation and treatment for herniated discs, ranging from physical therapy and injections to advanced spine surgery when needed.

What Causes a Herniated Disc?

Spinal discs provide cushioning between the vertebrae and help the spine move.

Over time, discs can lose flexibility and become more susceptible to tearing or degeneration. A herniated disc may also occur after an injury or sudden movement.

Factors that may contribute include:

• Age-related disc degeneration
• Repetitive lifting, bending, or twisting
• Improper lifting technique
• Sports or work-related injuries
• Prolonged sitting or repetitive strain
• Excess stress placed on the spine

Herniated discs most often affect the lumbar spine in the lower back or the cervical spine in the neck.

What Are the Symptoms of a Herniated Disc?

Symptoms depend on the location of the herniated disc and whether it is affecting a nearby nerve.

Common symptoms include:

• Persistent lower back or neck pain
• Pain that travels into an arm or leg
• Numbness or tingling
• Muscle weakness
• Burning, shooting, or electric-like pain
• Pain that worsens with certain movements, sitting, coughing, or sneezing

A herniated disc in the lower back may cause symptoms that travel into the buttock, leg, or foot.

A herniated disc in the neck may cause pain, numbness, tingling, or weakness that travels into the shoulder, arm, or hand.

Learn more about nerve-related spine conditions.

How Is a Herniated Disc Diagnosed?

Evaluation typically begins with a physical examination and discussion of your symptoms, medical history, and activities that may be contributing to the problem.

Your physician may evaluate strength, reflexes, sensation, flexibility, and range of motion.

Diagnostic testing may include X-rays or MRI to identify the location of the damaged disc and determine whether a nerve or the spinal cord is being compressed.

Can a Herniated Disc Heal Without Surgery?

Many herniated discs can be treated without surgery.

Initial treatment may include:

• Physical therapy
• Anti-inflammatory medications
• Activity modification
• Epidural steroid injections
• Pain management

The goal of nonsurgical treatment is to reduce inflammation, improve movement, and allow irritated nerves and surrounding tissues time to recover.

When Is Surgery Considered for a Herniated Disc?

Surgery may be considered when symptoms continue despite appropriate nonsurgical treatment or when a patient develops significant or progressive neurologic symptoms.

The type of surgery depends on where the herniated disc is located, the structures being compressed, spinal stability, and the patient’s overall condition.

Surgical Options for a Herniated Disc

Depending on the diagnosis, procedures may include:

• Microdiscectomy: Removes the portion of a herniated disc that is pressing on a nerve.
• Laminectomy or decompression: Removes bone or tissue to create more space for compressed nerves.
• Spinal fusion: Stabilizes part of the spine by joining two or more vertebrae.
• Anterior cervical discectomy and fusion (ACDF): Removes a damaged cervical disc and fuses the adjacent vertebrae.
• Cervical disc replacement: Removes a damaged disc in the neck and replaces it with an artificial disc designed to preserve motion.

When Is Cervical Disc Replacement Used for a Herniated Disc?

For certain patients with a herniated or damaged disc in the cervical spine, cervical disc replacement may be an alternative to fusion.

During the procedure, the damaged disc is removed to relieve pressure on the affected nerves or spinal cord. An artificial disc is then placed between the vertebrae to help preserve motion at the treated level.

Not every patient with a cervical herniated disc is a candidate for disc replacement. Factors such as spinal stability, arthritis, bone quality, the number of affected levels, and the location of the disc problem help determine the most appropriate treatment.

Learn more about cervical disc replacement.

What Is the Difference Between Cervical Disc Replacement and Fusion?

Both procedures remove a damaged cervical disc and relieve pressure on nearby nerves.

The primary difference is what happens after the damaged disc is removed.

With cervical fusion, the adjacent vertebrae are stabilized so they can grow together. With cervical disc replacement, an artificial disc is used to preserve motion at the treated level.

The appropriate procedure depends on the patient’s diagnosis, anatomy, symptoms, and overall condition.

Personalized Spine Care from Diagnosis Through Recovery

Orthopaedic Associates of Wisconsin provides comprehensive spine care, including advanced imaging, physical therapy, pain management, injections, and surgical treatment when appropriate.

Our specialists work together to determine the underlying cause of your symptoms and recommend treatment based on your individual needs.

When Should I See a Spine Specialist?

Consider scheduling an evaluation if:

• Back or neck pain is not improving
• Pain travels into an arm or leg
• You have persistent numbness or tingling
• You notice weakness in an arm, hand, leg, or foot
• Symptoms interfere with walking, sleeping, work, or daily activities
• Conservative treatment has not provided enough relief

New or worsening weakness, difficulty walking, or loss of bowel or bladder control should be evaluated promptly.

Frequently Asked Questions

Is a bulging disc the same as a herniated disc?

The terms are sometimes used interchangeably, but they describe different changes in a spinal disc. A bulging disc generally involves a broader portion of the disc, while a herniation occurs when disc material pushes through a weakened or torn area of the outer layer.

Can a herniated disc cause numbness or tingling?

Yes. If a herniated disc compresses or irritates a spinal nerve, it can cause numbness, tingling, pain, or weakness along the path of that nerve.

Can a cervical herniated disc cause arm pain?

Yes. A herniated disc in the neck can compress a cervical nerve and cause pain that travels into the shoulder, arm, or hand.

Does every herniated disc require surgery?

No. Many patients improve with nonsurgical treatment. Surgery is generally considered when symptoms persist despite appropriate conservative care or when significant nerve compression or neurologic symptoms are present.

Can a herniated disc be treated with cervical disc replacement?

For certain patients with a herniated disc in the cervical spine, cervical disc replacement may be an option. A spine specialist can determine whether disc replacement, fusion, or another treatment is most appropriate.