Herniated discs often occur in the lumbar region (lower back), and are among the most common causes of lower back pain. In many cases, herniated discs are caused by age-related wear and tear on the discs, which cause them to weaken over time. However, herniated discs can also be caused by a traumatic injury, such as a fall or a car accident.

What is a herniated disc?

The spine is made up of a series of connected bones called “vertebrae.” The discs in the spine help connect vertebrae together and act as a cushion between them. Discs are made of a tough outer layer called the “annulus fibrosus” and a gel-like center called the “nucleus pulposus.” A herniated disc occurs when the disc’s center (the nucleus) pushes through a crack in the outer layer.

A herniated lumbar disc can press on the nerves in the spine and may cause pain, numbness, tingling, or weakness of the leg. This collection of symptoms is called “sciatica.” A herniated lumbar disc may also cause back pain, although back pain alone (without leg pain) can be caused by several other conditions as well. An accurate diagnosis is important to determine the best way to treat the problem.

What treatments are available for herniated discs?

Most patients (80–90%) with a new or recent acute disc herniation will improve without surgery. In most cases, we will try nonsurgical treatments for the first few weeks to see if symptoms improve without more invasive treatment. If the pain still keeps you from your normal lifestyle after completing nonsurgical treatment, your doctor might recommend surgery.

Nonsurgical treatments for herniated disc

Your doctor may prescribe nonsurgical treatments, including:

  • A very short period of rest
  • Anti-inflammatory medications to reduce the swelling
  • Analgesic drugs to control the pain
  • Physical therapy
  • Epidural steroid injections

Some form of aerobic exercise is usually advised during the healing process, helping increase blood flow to the healing area. Most people can continue to work while they are being treated.


Most pain can be treated with nonprescription medications such as aspirin, ibuprofen, naproxen or acetaminophen. If you have severe persistent pain, your doctor might prescribe narcotics or muscle relaxants for a short time. However, taking these controlled substances do not actually help you recover faster, might cause unwanted side effects (such as constipation and drowsiness), and can result in dependency. All medication should be taken only as directed.

Other anti-inflammatory medications are available to help with herniated disc symptoms. Corticosteroid medications — either orally or by injection — are sometimes prescribed for more severe back and leg pain because of their very powerful anti-inflammatory effect. Corticosteroids, like NSAIDs, can have side effects. Risks and benefits of this medication should be discussed with your physician.

Epidural Injections

Epidural injections may be recommended if you have severe leg pain. These are injections of corticosteroid into the epidural space (the area around the spinal nerves), performed by a doctor with special training in this technique. The initial injection may be followed by one or two more injections at a later date, and should be done as part of a comprehensive rehabilitation and treatment program.

Surgery for herniated disc

Although surgery may not return leg strength to normal, it can stop your leg from getting weaker and relieve leg pain. Surgery is usually recommended for relief of leg pain, but can be less effective in relieving back pain.

The goal of surgery is to stop the herniated disc from pressing on and irritating the nerves, causing symptoms of pain and weakness. The most common procedure is called a “discectomy” or “partial discectomy,” in which part of the herniated disc is removed. In order to see the disc clearly, sometimes it is necessary to remove a small portion of the lamina, the bone behind the disc. A microscope is typically utilized during surgery for better visualization.

The herniated disc and any loose pieces are removed until they are no longer pressing on the nerve. Any bone spurs that are present are also taken out to make sure that the nerve is free of pressure. Usually, there is very little bleeding.

What can I expect after herniated disc surgery?

More than 90% of patients experience relief of leg pain after surgery. Relief of lower back pain, which is typically not caused by a simple disc herniation alone, is less reliable from a microscopic discectomy procedure.

Most patients will not have complications after a discectomy procedure, but it is possible you may have some bleeding, infection, tears of the protective lining of the spinal nerve roots (dura mater), or injury to the nerve. It is also possible that the disc will rupture again and cause symptoms. This occurs in about 5% of patients.

Your doctor will provide recommendations on postsurgical activity restrictions. Usually, you can get out of bed and walk around immediately after recovering from anesthesia. Most patients go home within 24 hours after surgery, often later the same day.

Once home, you should avoid driving, prolonged sitting, excessive lifting, and bending forward for the first four weeks. Some patients will benefit from a supervised rehabilitation program after surgery. Your doctor will advise on when it is safe to exercise to strengthen your back to prevent recurrence.

How do I know if I need emergency surgery?

Very rarely, a large disc herniation may press on the nerves that control the bladder and bowel, causing loss of bladder or bowel control. This is usually accompanied by numbness and tingling in the groin or genital area, and is one of the few indications that you need surgery immediately for a herniated lumbar disc. Call your doctor at once if this happens.

Herniated lumbar disc treatment in Austin, TX

Austin Spine offers a full range of treatment options, both surgical and nonsurgical, to treat conditions like herniated lumbar discs and alleviate symptoms that affect daily life. If you would like to learn more about our treatment options for herniated discs, or would like to schedule an appointment with one of our specialists, please contact our office at (512) 347-7463.