HERNIATED DISC (CERVICAL AND LUMBAR)

A herniated disc occurs when the soft, gel-like center (nucleus pulposus) of a spinal disc pushes through a tear in the tough outer layer (annulus fibrosus), putting pressure on nearby spinal nerves or the spinal cord. This can happen in the cervical spine (neck) or the lumbar spine (lower back) and is one of the most common causes of neck, back, arm, and leg pain.

Cervical disc herniations cause neck pain that often radiates into the shoulder, arm, and hand. Patients may experience numbness, tingling, pain, or weakness in the arm or fingers. Lumbar disc herniations cause lower back pain that typically radiates down the buttock and leg — the classic pattern known as sciatica. Numbness, tingling, pain, and weakness in the leg or foot may accompany the pain.

Herniated discs are most common in adults between 35 and 55 years of age. They can result from a single injury such as heavy lifting with poor form or a sudden twisting motion, but more often they develop gradually as the disc degenerates with age. Risk factors include repetitive bending, lifting, prolonged sitting, excess weight, and smoking. While herniated discs can cause significant pain and disability, the good news is that most patients see improvement with herniated disc treatment within six to twelve weeks without surgery. If significant improvement does not occur during this time then surgery becomes a viable, predictable option.

Many herniated discs respond well to non-surgical care. Dr. Daniel Oh, our interventional pain management specialist, works closely with patients to develop an individualized treatment plan. Conservative treatment includes anti-inflammatory medications, a short period of activity modification, and a structured physical therapy program focused on core strengthening, flexibility, and proper body mechanics. Epidural steroid injections can provide significant pain relief by reducing inflammation around the compressed nerve, allowing patients to participate more effectively in therapy and helping determine whether the herniated disc may heal on its own.

Walking and gentle activity are encouraged — prolonged bed rest is not recommended and can actually delay recovery. Many patients experience meaningful improvement within four to six weeks and full resolution within three months.

When conservative treatment fails to provide adequate relief after six to twelve weeks, or when there is progressive neurological weakness, Dr. Chris Howe and Dr. Jason Thompson may recommend surgery. The most common procedure for a lumbar herniated disc is a microdiscectomy, a minimally invasive outpatient procedure that removes the herniated disc fragment and allows most patients to go home the same day. For cervical herniations, an anterior cervical discectomy and fusion (ACDF) or cervical disc replacement may be performed, also typically as an outpatient procedure. Both are performed at Proliance Surgery Center at Valley in Renton.

Recovery from microdiscectomy is typically rapid. Most patients go home the same day and notice significant improvement in leg or arm pain quickly. Return to desk work is usually possible within one to two weeks, and most patients resume normal activities within four to six weeks. Recovery from cervical surgery (ACDF or disc replacement) follows a similar timeline, with most patients returning to light activities within two to four weeks. Physical therapy after surgery aids in restoring strength, flexibility, and proper movement patterns.