A herniated disk is a condition affecting one of the rubbery cushions, or disks, located between the stacked bones, or vertebrae, that make up your spine.
Each spinal disk has a tough, rubbery outer layer called the annulus, which surrounds a soft, jelly-like center known as the nucleus. A herniated disk, also referred to as a slipped or ruptured disk, occurs when part of the nucleus pushes out through a tear in the annulus.
While a herniated disk can occur anywhere along the spine, it most commonly affects the lower back. Depending on its location, a herniated disk can cause pain, numbness, or weakness in one or both arms or legs.
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Over-the-counter pain relievers: If your pain is mild to moderate, your doctor may recommend non-prescription analgesics such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin IB), or naproxen sodium (Aleve).
Neuropathic medications: These drugs help reduce pain by affecting nerve signals. Examples include venlafaxine (Effexor XR), pregabalin (Lyrica), duloxetine (Cymbalta, Drizalma Sprinkle), and gabapentin (Gralise, Horizant, Neurontin).
Muscle relaxants: If you experience muscle spasms, your doctor might prescribe muscle relaxants. Common side effects include dizziness and sedation.
Opioids: Many doctors are cautious about prescribing opioids for herniated disks due to the risk of addiction and adverse effects. However, if other medications don’t alleviate your pain, your doctor may recommend short-term use of opioids like codeine or a combination of oxycodone and acetaminophen. Possible side effects include sedation, nausea, confusion, and constipation.
Cortisone injections: If oral medications don’t provide enough relief, your doctor may suggest a corticosteroid injection in the area around the spinal nerves. This procedure is typically done using X-ray (fluoroscopy) guidance to ensure accuracy.
“If you’re experiencing pain, your doctor may recommend physical therapy. Your physical therapist can teach you specific exercises and postures designed to alleviate herniated disk pain.”
Very few patients with a ruptured disk require surgery. If you’ve been undergoing conservative treatment for six weeks without relief, especially if you continue to experience:
– Pain that isn’t effectively managed
– Weakness or numbness
– Difficulty walking or standing
– Loss of bladder or bowel control
Surgery might be considered. Surgeons typically remove only the protruding portion of the disk, not the entire disk. In some cases, a bone graft may be needed to fuse the vertebrae.
To ensure spinal stability during the bone fusion process, metal hardware is often inserted into the spine. In rare cases, your surgeon might suggest implanting a prosthetic disk.
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