Herniated Disk: Causes, Symptoms, and Treatment
Medically reviewed by Sumiran Racherla, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Herniated Disk?
Most people with a herniated disk start with a primary care doctor. An orthopedic surgeon (a bone and joint doctor) or a neurosurgeon (a spine and nerve surgeon) treats cases that need a specialist. A physical therapist helps with recovery. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is a herniated disk?
Your spine is made of bones called vertebrae, with soft disks between them. A herniated disk happens when the soft, jelly-like center of a disk pushes through the tough outer ring. It is also called a slipped or ruptured disk. The disk can press on nearby nerves or the spinal cord.
The lower back is the most common place for a herniated disk. The neck disks are the second most common place.
Symptoms
The pain most often occurs on one side of the body.
- Lower back: sharp pain in one part of the leg, hip, or buttocks, with numbness in other parts.
- Sciatica: a sharp, often shooting pain that travels from the buttock down the back of one leg.
- Neck: pain when moving your neck, deep pain near or over the shoulder blade, or pain that moves to the upper arm, forearm, and fingers.
- Numbness or a tingling feeling in the leg or foot, or along the shoulder, elbow, forearm, and fingers.
- Weakness, such as trouble lifting a leg or arm.
Loss of bladder or bowel control is extremely rare but is an emergency, as explained below.
Causes and who gets it
A herniated disk is most often caused by natural, age-related wear and tear of the spine. As people age, disks lose water and become less flexible, which makes them more likely to tear or bulge. An injury, such as a fall, can also cause a herniated disk.
Herniated disks happen more often in middle-aged and older men. Other risk factors may include lifting heavy objects, being overweight, repeated bending or twisting, and long hours of sitting or standing in the same position. Smoking may also raise the risk.
How doctors diagnose it
A careful history and physical exam come first. Your provider checks for numbness or loss of feeling, muscle reflexes, and muscle strength. In the straight leg raise test, a doctor lifts your leg while the knee stays straight. Leg pain that travels below the knee is a strong sign of a herniated disk.
An MRI scan gives clear pictures of soft tissues, including the disks. A CT scan or a CT myelogram may be used if you cannot tolerate an MRI. An electromyography test (EMG) can find which spinal nerve is involved.
Treatment
Initial treatment is usually nonsurgical.
- Rest: One to 2 days of bed rest will usually help. Do not stay off your feet longer than that.
- Medicines: Anti-inflammatory drugs such as ibuprofen or naproxen can help relieve pain.
- Physical therapy: A therapist teaches you how to lift, walk, and strengthen the muscles that support your spine.
- Steroid injections: A shot near the nerve can reduce swelling and give short-term pain relief. The pain may return after weeks or months.
Only a small percentage of people with a herniated disk in the lower back need surgery. Surgery is usually recommended only after a period of nonsurgical treatment has not relieved painful symptoms. It may also be recommended for muscle weakness, difficulty walking, or loss of bladder or bowel control. The most common surgery for one herniated disk is a microdiskectomy, which removes the herniated part of the disk through a small incision. Surgery risks include nerve injury, infection, and a tear in the sac around the nerves. With either surgical or nonsurgical treatment, there is up to a 20 to 25% chance that the disk will herniate again in your lifetime.
When to see a doctor
Call 911 or go to the emergency room if you lose control of your bladder or bowels, or if you cannot urinate. Also go if you have numbness between your legs, over your buttocks, or in your inner thighs, or severe or worsening problems in your legs. These signs are rare, but they can mean cauda equina syndrome, a surgical emergency.
Contact your provider if you have severe back pain that does not go away, or any numbness, loss of movement, or weakness.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Such a doctor can examine you, order imaging, and help with pain care and follow-up. They can also refer you to a physical therapist or a spine specialist.
Common questions
Can a herniated disk heal on its own?
Yes, often. Most people feel better within a few weeks or months without surgery. In many cases, the herniation dissolves over time and is absorbed by the body.
Is a herniated disk the same as sciatica?
No, a herniated disk is a cause, and sciatica is a symptom. Sciatica is a sharp, often shooting pain that travels from the buttock down the back of one leg, caused by pressure on a spinal nerve.
Do I need surgery for a herniated disk?
No, most people do not need surgery.
Can a herniated disk come back?
Yes, it can. With surgical or nonsurgical treatment, there is up to a 20 to 25% chance that the disk will herniate again in your lifetime.
Sources
- MedlinePlus - Herniated disk (Medical Encyclopedia)
- American Academy of Orthopaedic Surgeons - OrthoInfo: Herniated Disk in the Lower Back
- American Academy of Orthopaedic Surgeons - OrthoInfo: Cauda Equina Syndrome
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
