Dr. M.J. Bazos, MD Patient Handout


About Your Diagnosis

Disk herniation usually refers to protrusion of the soft, rubbery material that sits between the vertebral bodies in the spinal column that act as shock absorbers. When they begin to bulge or protrude, the disks can apply pressure to the nerves as they exit the spinal cord. This can produce pain, numbness, and possibly weakness, extending down the arms and into the hands and fingers or down the leg and into the feet and toes. The causes of disk herniation are varied but most commonly are related to a degenerative, arthritis-like process. Improper bending and improper lifting technique can lead to disk herniation, particularly lifting of heavy objects. This is a relatively common condition and usually can be managed.

Living With Your Diagnosis
The signs and symptoms of disk herniation include pain somewhere along the spinal column, whether it be in the neck or back, with radiation of the pain into either the arms or legs. The pressure of the disk on the nerve can actually cause weakness in some muscles or paralysis.

Most disk protrusions can be treated with rest, medication, and time. Sometimes, however, disk herniation does not respond to conservative measures, and surgical intervention may be needed. Medications typically used for the new onset of back pain and pain down into the arms or legs include nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, and pain relievers. A concern with back pain that does not respond quickly to medical therapy is the potential for addiction to narcotics and other medications. These medications are to be used for short periods of time, and are generally not recommended for long-term use. The side effects of conservative treatment are generally related to the use of medications. Possible complications of surgical treatment include permanent damage to the nerve and wound infection. Relative rest is recommended until the pain begins to subside, which may take 2 weeks or more. Should the pain symptoms subside, treatment is directed at rehabilitation and re-education on proper lifting techniques (Fig 1). Many cities now have back centers that focus on rehabilitation and retraining in proper lifting techniques. For low back difficulties, including herniation, elastic low back supports may be of benefit.

The DOs
• Rest and take your medications as prescribed.
• Use proper lifting techniques.

The DON’Ts
• Avoid lifting heavy objects, particularly using inappropriate lifting techniques.

When to Call Your Doctor
• If you notice partial paralysis of muscles or loss of bowel or bladder control, this may represent a surgical emergency.