Even if you don’t know exactly what a herniated disc is, it just sounds like something you’d want to avoid. That makes perfect sense, because this health issue can be pretty freaking painful—but in a weird twist, sometimes a herniated disc doesn’t hurt at all.
The discs in your back are rubbery cushions in between your spinal vertebrae (interlocking bones). “A disc acts like a shock absorber for daily living, cushioning your spine against damage from the repetitive impact of walking and running,” Neel Anand, M.D., professor of orthopaedic surgery and director of spine trauma at Cedars-Sinai Spine Center in Los Angeles, tells SELF. These discs are kind of like jelly donuts in that they have softer centers and harder exteriors. If one becomes herniated, that means the soft inner portion is pushing through a tear in the outer part, which can lead to problems like pain, numbness, and weakness. But you can actually have a herniated disc that kind of just…hangs out, basically, without causing any symptoms. Here are some facts to know about this interesting (and somewhat avoidable) condition.
1. A herniated disc usually happens because of gradual, age-related wear and tear that’s just part of being a human with a body.
This wear and tear is called disc degeneration, the Mayo Clinic explains. As you age, your spinal discs don’t have as much water as they used to, so they’re not as pliable. This makes them more likely to rip and leave a hole for some of that inner “jelly” to spill out, even if you do something relatively minor like twist your back or rely on your back instead of your legs when lifting something. Since the precipitating movement can be so slight, you might not know what caused your herniated disc, Ferhan Asghar, M.D., an assistant professor in the Department of Orthopaedic Surgery at UC Health, tells SELF.
2. Most herniated discs happen in your lower back.
This is because your lumbar spine in your lower back supports the majority of your upper body weight, Mike Murray, M.D., an associate of Orthopaedic Surgery at Penn Medicine, tells SELF. “Most force and stress is placed there, and it’s where most motion occurs when you bend and twist,” he says. That said, you can also get a herniated disc anywhere along your spine, including in your neck (cervical spine) and chest/mid-back (thoracic spine).
3. A herniated disc can cause a lot of pain…or no symptoms at all.
File this under random: Many people with a herniated disc don’t have any symptoms, according to the Mayo Clinic. “Sometimes it just shows up on [an imaging test],” Dr. Asghar says.
Whether or not you have symptoms depends on if the disc is pushing against a nerve, Santhosh Thomas, D.O., a spine specialist at Cleveland Clinic, tells SELF. The more the disc compresses the nerve, the more intense your symptoms may be—and the location of this action dictates where in your body the signs show up.
If your herniated disc is in your lower back, you may experience intense pain, numbness, tingling, and muscle weakness in your butt, thighs, calves, and even your feet, according to the Mayo Clinic. This is sometimes what’s behind sciatica, which is typically when you experience pain going from your lower back, down your butt, and into one of your legs (though it can affect other parts of your body, too).
If the herniation is in your neck, shoulder and arm pain might be your signal. You can also experience a herniated disc in your chest or mid-back area, but the symptoms are a little harder to pin down, according to the Cleveland Clinic. The pain, numbness, tingling, and weakness can extend from your upper back to your lower back and into your arms and legs.
No matter where you’re experiencing pain from a herniated disc, it can feel like it’s “shooting” into your extremeities whenever you cough, sneeze, shift your body into certain positions, or make other sudden movements, the Mayo Clinic says.
4. Anybody can get a herniated disc, but some people are more susceptible than others.
Risk factors include having excess body weight, which can put extra pressure on the discs in your lower back, as well as having a physically demanding job that requires you to make repetitive motions such as lifting, pulling, pushing, and bending, the Mayo Clinic says. It’s even possible to have a genetic predisposition to getting a herniated disc.
5. Your doctor should be able to diagnose a herniated disc pretty easily with questions and a physical exam, but they may run imaging tests as well.
Sometimes, your doctor will just do a physical exam to see which body parts hurt and how moving in certain ways affects the pain, according to the Mayo Clinic. They might also test your reflexes, muscle strength, walking ability, and capacity to feel certain sensations. Between those simple exams and your explanation of your symptoms, they might have enough information to make a diagnosis.
But if they want to gather more information, they may order imaging tests like an X-ray, CT scan, MRI, or myelogram, which uses dye and X-rays to detect pressure on your spine or nerves, according to the Mayo Clinic.
6. Having a herniated disc doesn’t mean you need surgery. Usually, various pain medications will be your first step.
The misconception that herniated discs automatically require surgery keeps some people from seeking help when they need it, Dr. Murray says. For most people, conservative treatment is enough. This includes over-the-counter pain medication, anticonvulsants (which can treat radiating nerve pain), muscle relaxers (to help combat muscle spasms), cortisone injections (which can help fight inflammation), and even a short course of narcotics for really severe pain, the Mayo Clinic says. If none of those does the trick after a few weeks, your doctor may recommend physical therapy to help minimize the pain.
If all else fails, yes, you could need surgery to remove the part of the disc that’s sticking out, Dr. Thomas says. But again, this isn’t common. “This will be required for very few people with this spinal condition,” Dr. Anand says. Usually, this is only recommended if your symptoms don’t get better after six weeks and you’re having other issues like intense numbness or weakness, difficulty standing or walking, or reduced bowel or bladder control.
7. Let’s wrap this up on a good note: There are a few things you can do to lower the odds you’ll get a herniated disc, like maintaining good posture.
Trying to achieve ballet dancer-level posture is a pretty easy way to reduce the pressure on your lower back, the Mayo Clinic explains. It’s all about aligning your body the right way—check out the Cleveland Clinic’s guide on good posture for some tips, including on how to lift heavy objects in the safest way for your back.
Also, your core muscles help you have a healthy, stable spine, Dr. Murray explains. Regularly strengthening these muscles can help you prevent a herniation in the future. And, hey, look at that—we happen to have a whole treasure trove of exercise to strengthen your core right here.