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For example, depending on its location, a protrusion can come in contact with spinal nerves just as easily as an extrusion or sequestration can. The amount of pain and other symptoms will depend on how the nerves have been compromised.
Along with pain, herniations can press against the spinal cord or nerves and cause radiculopathy , the neuromuscular symptoms typical of a disc herniation. Depending on the site, these may include:. All that said, it's still common to have protrusions, extrusions, or sequestrations with no symptoms whatsoever.
Most terminology surrounding spinal discs are based on measurements, as well as the size and shape of the displaced disc material. Bulges also don't extend very far beyond the normal boundaries of a healthy disc, usually 3 millimeters or less, and generally cause fewer symptoms than herniations. Magnetic resonance imaging MRI is often the tool of choice when trying to assess the discs of the spinal column.
However, it has its challenges. Since disc degeneration naturally worsens with age, it's actually common to find disc abnormalities on MRI tests. For example, someone may have back pain, as well as a disc abnormality on their MRI, but that does not necessarily mean the two are related. They can be, but presuming the two are related can lead to poor treatment results. A skilled clinician can help you determine if the disc problem seen on an MRI is truly the cause of your symptoms.
It may help to seek a second opinion. To further complicate matters, the specific type of disc problem seen on an MRI does not necessarily dictate treatment, which makes next steps uncertain. A healthcare provider must correlate the MRI results with your complaints and examination findings. If these don't all point to the same underlying problem, treatment is less likely to be effective.
Most lower back pain resolves itself in four to six weeks even if you don't seek treatment. Oddly enough, the more damage to a disc, the faster spontaneous healing seems to occur. Treatment for all types of disc herniation is generally conservative and includes:. Surgery is generally recommended only when conservative treatments are ineffective after six weeks or more, if you have significant muscle weakness from nerve damage, or when motor functions are compromised.
One herniation-related condition of the lower back, cauda equina syndrome, is considered a medical emergency and requires immediate care. It can cause urinary or bowel dysfunction, numbness around the anus, along with traditional herniation symptoms.
Mild back or neck pain may not be a reason to see a healthcare provider unless it persists for several weeks, but more severe symptoms including radiculopathy warrant care. Back pain and injuries can be complex, challenging, and frustrating. If your healthcare provider suspects disc herniation, no matter the type, your diagnosis should combine MRI results along with your specific symptoms and how they progress over time. Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life.
Lumbar disc nomenclature: Version 2. Spine J. Lumbar disc herniation. Curr Rev Musculoskelet Med. American Academy of Orthopaedic Surgeons. Herniated disk in the lower back. Cervical disc herniation presenting with neck pain and contralateral symptoms: A case report. J Med Case Rep. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. The probability of spontaneous regression of lumbar herniated disc: a systematic review.
Clin Rehabil. National Institute of Neurological Disorders and Stroke. Low back pain fact sheet. By Jonathan Cluett, MD. Jonathan Cluett, MD. Learn about our editorial process. Medically reviewed Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Not all slipped discs cause symptoms. Many people will never know they have slipped a disc.
Sometimes the pain may be a result of an injury such as a sprain or strain , but often there's no obvious reason. Back pain is rarely caused by anything serious. If the pain is very bad, you may need to rest at first. But start gentle exercise as soon as you can — it'll help you get better faster.
The type of exercise is not important, just gradually increase your activity level. Alternate painkillers such as ibuprofen and paracetamol. Paracetamol on its own is not recommended for back pain. Take them regularly up to the recommended daily amount rather than just when the pain is particularly bad. This will help you to keep moving. Speak to a pharmacist if you're not sure. Stronger painkillers containing codeine may help for pain that's just started. But these types of painkillers can cause addiction and should only be used for a few days.
Your GP will usually be able to tell if you have a slipped disc from your symptoms. You may also have a physical examination. Your GP might ask you to raise your arms or do simple leg exercises to find out where the slipped disc is.
A GP might prescribe a stronger painkiller, a steroid injection or a muscle relaxant to use in the short term. They might also refer you to a physiotherapist.
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