Is Surgery Necessary for a Herniated Disc?

Approximately 39% of adults suffer from back pain, and each year nearly 7 million people in the U.S. experience a herniated disc. Also called ruptured or slipped discs, herniated discs are a leading cause of back, neck, arm and leg pain. Fortunately, most people with a herniated disc feel better with time, but in some cases surgery might be an option.

What is a herniated disc?

“A herniated disk is an injury of the spine, which is made up of a series of bones called vertebrae,” said Ghassan Bejjani, M.D., Chief of Neurosurgery at Penn Highlands Healthcare, who provides highly specialized care for neurosurgical conditions. “Between the vertebrae are round cushions called discs, which act as a buffer between the vertebrae, allowing them to bend. Inside the discs are a soft center called the nucleus, which is surrounded by a rubbery exterior called the annulus. A disc becomes herniated when the annulus rips and the nucleus bulges through, causing inflammation and compressing nearby nerves.”

He continued, “A herniated disk can occur in any part of the spine, although it most often occurs in the lower back. Disc herniation is usually the result of aging-related wear on the spine, called disc degeneration. As people age, the discs become less flexible and more prone to tearing.”

It can be difficult to determine the exact cause of a herniated disc, but lifting heavy objects using your back instead of legs or twisting and turning while lifting can cause a disc to herniate.

What are the symptoms?

Many people have no symptoms, and symptoms depend on where the disc is sitting and whether it is pressing on a nerve. If you have symptoms, they may include:

  • Pain in the lower back, buttocks, thigh and calf (if the herniated disc is in the back)

  • Sharp and burning pain in the shoulder and arm (if the herniated disc is in the neck)

  • Radiating numbness or tingling in the body part served by the affected nerves

  • Weakened muscles served by the affected nerves

Who is at risk for herniated discs?

Factors that can increase your risk include:

  • Excess weight, which can cause extra stress on the discs

  • Physically demanding jobs

  • Genetic predisposition

  • Smoking

  • Frequent driving

  • Sedentary lifestyle

Should I have surgery?

In most cases, your healthcare provider will likely recommend that you adjust your activities to refrain from movement that causes pain. They may also prescribe over-the-counter pain medication. This often relieves symptoms within a few days or weeks. If the pain does not subside, your provider may recommend physical therapy, which will teach you positions and exercises that minimize pain.

In a few cases, surgery may be necessary to remove the protruding portion of the disc. If your pain lasts for six weeks and does not respond to other treatments, your provider may recommend surgery. Surgery may relieve your pain faster than non-surgical treatments, but surgery has some risks, including infection and nerve damage.

Both surgical and non-surgical treatments can be effective to reduce pain. You can always explore surgical options if more conservative treatments do not help. Talk to your provider about which treatment options are best for your particular situation.

Penn Highlands Healthcare offers world-class spinal care throughout Pennsylvania. For more information, visit phhealthcare.org/spinecare.