Herniated Disk: Symptoms and Diagnosis

Medically Reviewed by Zilpah Sheikh, MD on April 05, 2024
7 min read

Back pain can sneak up on you when you least expect it. One minute you're sitting comfortably in front of the TV, and the next you try to stand up, and a sharp pain radiates through your lower back.

Could you have a slipped or herniated disk? You might.

The adult spine is made of 24 bones called vertebrae. Between the vertebrae are disks, which allow the spine to move and bend. Inside each disk is a soft, jelly-like center called the nucleus pulposus. The outer band is called the annulus fibrosus. In the case of a herniated disk, the outer band of your disk becomes torn or punctured, causing the inner nucleus to leak into the spinal canal.

Herniated disk vs. bulging disk

A herniated disk can often be confused with a bulging disk. While these conditions have some similar symptoms, they do differ. A herniated disk happens when the outer layer of the disk becomes ruptured, often during an acute, sudden injury. For bulging disks, it's possible to happen due to injury, but often it's because the soft center of each disk begins to wear down and deflate gradually as you age. Multiple disks can be affected at the same time and cause other spine-related issues.

Herniated and bulging disks share the following symptoms, depending on the location of the disk:

  • Pain in lower back, buttocks, leg (lumbar spine)
  • Pain in the neck, shoulder, arm (cervical spine)
  • Numbness, tingling, weakness

Some differences between the conditions include:

Herniated diskBulging disk
  • Acute, sudden injury
  • Disk covering has a hole or tear
  • May affect one spinal disk at a time
  • Usually happens to people ages 30 to 50, and it's more common in men
  • Progressive, degenerative condition
  • Disk decompresses and presses outward
  • Can happen to multiple disks at the same time
  • Generally happens around age 40 and older

If you have a herniated disk, you may not have any symptoms. Symptoms vary depending on the injury's severity and the disk's location. Symptoms include:

  • Numbness or tingling
  • Sharp, burning, or shooting pain in the lower back, buttocks, leg, calf, or foot (lower back herniated disk)
  • Sharp, burning, or shooting pain in the arm or shoulder (neck herniated disk)
  • Muscle weakness surrounding the area of pain
  • Symptoms located on one side of the body

If you don't have symptoms, your herniated disk may appear on a spinal image.

What does a herniated disk feel like?

Herniated disks can occur in any area of the spine, but they are most common in the lower back (the lumbar spine), just above the hips. The pain may spread from the back to the buttocks, thighs, and even your calves.

Herniated disks in the neck (the cervical spine) may extend to the shoulder and arm. Pain in the lumbar or cervical spine can feel sharp or burning. It's common to have numbness and tingling that affects the area of pain and then radiates through a nearby limb. You'll likely feel weakened muscles near the source of pain, too.

Discomfort from a herniated disk usually worsens when you're active and lessens when you're resting. Even coughing, sneezing, and sitting can worsen your symptoms because they put pressure on pinched nerves. 

Herniated disk emergency symptoms 

While a herniated disk can often be treated at home, there are occasions when you need to seek emergency medical care. If your pain becomes so severe you're unable to do daily activities, it’s time to see the doctor. Seek emergency care immediately if you experience any of the following after an injury:

  • Leg or arm weakness
  • Infection or fever
  • Loss of feeling in the rectum or genital area
  • Bladder or bowel dysfunction

If you have a history of metastatic cancer, it's also important to have your condition checked by a doctor. 

The best way to tell if you have a herniated disk is to see your doctor. They’ll likely do a physical exam to find the source of your pain, which is usually the only test you’ll need to confirm a diagnosis. Your doctor will check your back or neck for sore or painful spots. They may ask you to lie on your back and lift or move your legs or neck in various directions. 

They may also check:

  • Your reflexes at the knee and ankle(for lower back pain) or your arms and shoulders (for neck pain)
  • Your leg or arm strength, depending on the area of pain
  • How you walk on your heels and toes
  • Whether you can feel light touches or vibrations

If your doctor wants to rule out other sources of your pain or pinpoint specific nerves that are aggravated, they may do further testing, including:

X-rays. While a standard X-ray can't show if you have a herniated disk, it can show your doctor the outline of your spine and rule out whether your pain is caused by something else, such as a fracture or tumor.

Myelogram. This test uses dye injected into your spinal fluid and an X-ray to locate the pressure on the spinal cord.

CT scan. A computerized tomography (CT) scan takes several X-rays from different angles and combines them to create images of your spinal cord and the structures surrounding it.

MRI. Magnetic resonance imaging (MRI) uses radio waves, a magnetic field, and a computer to create detailed 3D images of the spinal cord and surrounding areas. MRI images can locate the position of the herniated disk, look inside it, and determine which nerves are affected.

Electromyogram (EMG). Your doctor might use these tests to see if any nerves are damaged or compressed. The EMG test uses a device to detect the tiny amount of electricity muscle cells make when stimulated by nerves connected to them. A needle electrode put into a muscle records its electrical activity and looks for anything that isn’t as it should be.

Nerve conduction studies (NCS). NCS  are often done simultaneously with the EMG. In this test, an electrode stimulates the nerves with tiny electrical impulses at one point on the body while other electrodes detect the impulses at a different point. The time it takes for the electrical impulses to travel between electrodes tells your doctor whether there is nerve damage.

A sudden injury can cause a herniated disk. Symptoms include sharp or burning pain at the point of injury, numbness, tingling, and weakness. A herniated disk in the lower back can trigger traveling pain into the buttocks, hip, and leg. A herniated disk in the neck can trigger pain in the shoulder and arm. Your doctor can help diagnose your herniated disk and may recommend treatment including rest, anti-inflammatory drugs, and physical therapy. Most cases of a herniated disk resolve within a few weeks or months. If your pain continues, talk to your doctor about further treatment. 

Do herniated disks heal on their own?

Typically, a herniated disk will heal with rest, time, and an occasional over-the-counter anti-inflammatory medicine. It's important to avoid triggering exercises and activities during your healing process. If the pain isn’t resolved within 6 months, your doctor may prescribe physical therapy. Surgery is typically not recommended unless your doctor detects spinal compression or your daily movement is severely restricted.

What is the fastest way to heal a herniated disk?

The fastest way to heal a herniated disk is to avoid triggering activities, to rest, and to take an over-the-counter anti-inflammatory medicine. During the initial onset, apply ice to help ease pain. In the days and weeks following, heat can help relax and soothe sore muscles. Try incorporating short walks, gentle stretches, and stabilizing exercises, but only if they help reduce pain, not worsen it. If your symptoms don’t get better within a few weeks, speak with your doctor.

How do I know if I have herniated my disk?

The only way to know if you have a herniated disk is to see your doctor for an examination and diagnosis. During your exam, your doctor will guide you through various movements to assess your range of motion and strength. 

Your doctor may also run diagnostic tests. An electromyogram (EMG) will help find the exact nerve root that is triggered. A myelogram can show the size and location of the herniated disk. An MRI or CT scan can show where the herniated disk is putting pressure on the spine. A nerve conduction test can reveal any possible nerve damage. A spinal X-ray may be used to see if other physical issues are connected to the herniated disk, although it won’t show a herniated disk alone.

Do you have a herniated disk for life?

Most people recover from a herniated disk within a few weeks or months. If the pain lingers, your doctor may prescribe pain relief medications and muscle relaxants or give you a steroid shot. Physical therapy can help reduce pain, build supportive muscles around the area of injury, and teach correct posture and alignment to reduce the chances of reinjuring the same disk. For the most serious cases, surgery is also an option.