Herniated/Bulging Disc

A herniated disc — sometimes called a slipped disc or ruptured disc — occurs when the soft inner center of a spinal disc pushes through a crack or weak spot in the tough outer layer.
When this material presses on nearby nerves or the spinal cord, it can cause pain, numbness, tingling, or weakness in the back, neck, arms, or legs.

A bulging disc is a related but less severe condition where the outer wall of the disc weakens and extends outward, but the inner disc material hasn’t fully broken through.
Both conditions can irritate or compress nerves, leading to similar symptoms and may occur in either the cervical spine (neck) or lumbar spine (lower back).

Herniated or bulging discs often develop gradually, but they can also occur suddenly after an injury.
Common causes include:

• Age-related degeneration: discs lose water content over time, making them less flexible and more prone to tears.
• Repetitive stress: heavy lifting, bending, twisting, or physically demanding work.
• Sudden trauma or injury: such as car accidents, falls, or sports injuries.
• Poor posture or ergonomics: long periods of sitting or improper workstation setup.
• Genetic predisposition: some individuals are more prone to disc problems.
• Lifestyle factors: smoking, obesity, and lack of exercise can accelerate disc degeneration.

Symptoms vary depending on the location of the herniated or bulging disc and whether nerves are involved.

• Localized pain in the neck or lower back that may worsen with movement.
• Radiating nerve pain:
  • Cervical spine: pain travels into the shoulders, arms, and hands.
  • Lumbar spine: pain radiates down the buttocks, legs, or feet (sciatica).
• Numbness or tingling (“pins and needles”) in the affected arm or leg.
• Muscle weakness in the arms or legs, causing difficulty gripping, lifting, or walking.
• Pain that worsens with coughing, sneezing, or sitting for long periods.
• Severe or urgent symptoms: sudden weakness, trouble walking, or changes in bladder/bowel control require immediate medical attention.

Accurate diagnosis is essential to develop the right treatment plan.
Dr. Fried uses a comprehensive evaluation process to determine the cause of your symptoms.

• Medical history: reviewing symptoms, lifestyle, and previous injuries.
• Physical and neurological exam: assessing reflexes, strength, sensation, and mobility.
• Imaging studies:
  • MRI: best for visualizing discs, nerves, and soft tissues.
  • X-rays: reveal alignment issues, bone spurs, or degenerative changes.
  • CT scans: occasionally used for complex or surgical cases.
• Diagnostic injections: may help confirm the exact pain source.
   

Most herniated or bulging discs can be treated without surgery, especially in the early stages.
Dr. Fried focuses on conservative care first, turning to surgery only if symptoms persist or neurological problems worsen.