Out-of-state? Free MRI review + telehealth consult before you travel4.9 ★ · 619 Google reviewsBoard-certified — American Board of Orthopaedic SurgeryMinimally invasive, same-day spine surgery in Beverly HillsCall (424) 217-7463
Out-of-state? Free MRI review + telehealth consult before you travel4.9 ★ · 619 Google reviewsBoard-certified — American Board of Orthopaedic SurgeryMinimally invasive, same-day spine surgery in Beverly HillsCall (424) 217-7463
A spinal disc has a firm outer ring and a soft, gel-like center. A herniated disc happens when that inner material pushes through a tear in the outer wall, spilling into the space where the nerve roots and spinal cord travel. It is a more advanced stage than a simple bulge, and it is the tear plus the escaped material that tends to inflame and compress a nerve.
Herniations are most common in the lower back and the neck, where the spine bends and twists the most. The trouble usually is not the disc itself but the nerve it presses against, which is why the pain so often shows up in an arm or a leg rather than the back or neck alone.
Whether it’s a sudden twinge in your back or numbness in your leg, what might start as a minor discomfort can quickly develop into something more serious. Each year, over 3 million Americans are diagnosed with a herniated disc, and research shows that 28% of adults over 40 will experience some form of disc abnormality.
A herniated disc — sometimes called a slipped disc or ruptured disc — is a common spinal condition, affecting as many as 20 out of every 1,000 adults every year. It’s most common in people between the ages of 30 and 50, and men are nearly twice as likely to be affected.
In rare cases, the thoracic (upper back) region may be affected. While lower back herniations are most common, due to the daily demands placed on this area, disc problems in other regions can also lead to significant problems.
✓Sharp or burning pain that radiates into an arm or leg
✓Numbness or tingling along the path of the affected nerve
✓Muscle weakness in the arm, hand, leg, or foot
✓Pain that worsens with sitting, bending, coughing, or sneezing
✓Neck or low back pain that eases when lying down
✓In the neck, pain traveling into the shoulder or fingers
Depending on the exact location and severity of a disc herniation, the specific herniated disc symptoms can vary. Some people may have intense pain, while others may not have any noticeable symptoms at all. When symptoms do occur, they’re usually a result of the disc pressing on a nearby nerve.
You may also experience pain on one side of the body or sharp pain in a part of the leg, hips, or buttocks. Pain or numbness on the back of the calf or the sole of the foot is also common.
The specific part of the spine that is affected by the herniated disc can influence what type of symptoms you have and how they feel. For example:
Lumbar spine (lower back): Radiating leg pain, weakness, or numbness, especially on one side.
Cervical spine (neck): Pain in the neck, shoulders, and arms, often with tingling in the fingers. Some patients describe the pain as sharp or burning.
Thoracic spine (upper back): Pain, numbness, or weakness in one or both legs.
Genetics that make disc tissue more prone to tearing
Smoking, which speeds disc degeneration
Most cases result from a combination of age-related changes and physical stress placed on the spine.
Genetics, poor posture, and long periods of sitting or inactivity can increase the risk of getting a herniated disc. Other risk factors include:
Being overweight
Connective tissue disorders
Diabetes
Diagnosing a Herniated Disc
Dr. Melamed maps where the pain, numbness, and weakness travel, since each nerve root follows a predictable pattern that points to the exact level involved. An MRI confirms which disc has herniated and how far the material has migrated, while ruling out other sources. Matching the imaging to your symptoms is what makes a small, targeted procedure possible instead of a larger operation.
Accurate diagnosis is the first step toward determining the best course of herniated disc treatment. The process starts by taking a thorough medical history and physical examination. Your doctor will evaluate your posture, muscle strength, reflexes, and mobility. They’ll also ask about when your symptoms first began, what activities or movements trigger them, and whether pain is radiating to any other parts of your body.
If your doctor suspects you have a herniated disc, they’ll use imaging tests to confirm the diagnosis and assess its severity. These may include:
Magnetic resonance imaging (MRI): The most common and detailed scan for evaluating disc damage and nerve compression.
Computed tomography (CT) scan: Sometimes used when an MRI is not possible.
X-rays: Helpful for ruling out other spinal issues, but don’t show herniated discs directly.
Other diagnostic tests, such as electromyography (EMG), myelogram, or nerve conduction velocity tests, can also be used to assess how well the nerves function and determine which nerve root is affected.
Comprehensive Treatments for Herniated Discs in Beverly Hills
Most herniated discs settle without surgery, so the plan begins conservatively — targeted physical therapy, anti-inflammatory measures, activity changes, and sometimes an image-guided epidural injection to quiet an irritated nerve root. The escaped disc material often shrinks over time on its own, and Dr. Melamed gives that window a real, honest trial.
When leg or arm pain persists, is severe, or comes with progressive weakness, a small procedure is worth discussing. Rather than an open discectomy that strips muscle off the spine, Dr. Melamed typically uses biportal endoscopic surgery (BESS): two incisions under a centimeter, a high-definition endoscope, and no muscle cutting. The fragment pressing on the nerve is removed while your own disc and motion are preserved, and most patients go home the same day with far less pain and medication than traditional surgery requires.
Effective herniated disc treatment often begins with conservative, non-surgical methods. At The Spine Pro, Dr. Hooman Melamed emphasizes personalized care plans tailored to each patient’s unique needs and treatment goals. His treatment plans may integrate elements of chiropractic care, acupuncture, and other non-invasive therapies to address both the physical and lifestyle factors contributing to pain. Key behavioral changes, such as quitting smoking, can help prevent further disc degeneration.
Dr. Melamed also favors opioid-sparing pain management strategies, helping patients find relief without relying on habit-forming medications. This approach is supported by studies that show patients who were prescribed opioids for a herniated disc were significantly more likely to undergo surgery, and over three times as likely to still be using opioids 4 years later, compared to those who were not.
When conservative methods aren’t enough, Dr. Melamed offers ultra-minimally invasive surgical options for treating herniated discs. These include microlaminotomy, which creates space for the disc by removing a small portion of bone, and discectomy, where the herniated portion of the disc is removed. In cases of severe instability, spinal fusion may be recommended.
What is the difference between a herniated disc and a bulging disc?
A bulging disc is an earlier, milder stage where the disc broadens outward but its wall stays intact. A herniated disc is further along: the outer wall tears and the soft center pushes through. Because that escaped material sits right next to the nerves, a herniation is more likely to cause sharp, radiating pain.
Can a herniated disc heal without surgery?
Often, yes. The inflammation around a fresh herniation usually calms over several weeks, and the escaped disc material frequently shrinks on its own. Staying gently active and following a focused therapy plan helps. The signs it needs more than time are severe or worsening weakness, pain that isn't improving, or any change in bladder or bowel control.
Will I need a spinal fusion for a herniated disc?
Almost never. A herniation is a nerve-compression problem, not an instability problem, so the goal is simply to remove the fragment pressing on the nerve. A muscle-sparing endoscopic discectomy does exactly that while preserving your own disc and movement.
