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A herniated disc occurs when the soft inner core (the nucleus) of the intervertebral disc breaks out through a tear in the outer shell (the annulus), putting pressure on the spinal nerve root in the lower back. A herniated disc is often referred to as a slipped disc, a ruptured disc or a prolapsed disc. The result of the pressure on the nerve is often called sciatica - pain traveling down the leg in the location of the irritated nerve.
Typically the patient experiences pain, numbness and sometimes weakness in one or both legs. Back pain may or may not be present. The pain may be worse with sitting or standing and relieved by lying down.
The patient's medical history and examination will suggest a disc herniation, and an MRI is used to confirm the diagnosis. The MRI will show how severe the herniation is and how much pressure is being placed on the nerve.
Many herniated discs heal without surgical intervention. Rest, physical therapy, anti-inflammatory medication, and maybe an epidural steroid injection may alleviate the pain from the irritated nerve root.
Surgical treatment may be necessary if the symptoms do not improve with time or if significant weakness is present. A minimally invasive technique called microdiscectomy permits the surgeon to remove the pieces of the disc causing the pressure on the nerve. Pain relief is often immediate and the patient leaves the hospital the same day.