Jason E. Smith MD

Spine Surgeon with Baton Rouge Orthopaedic Clinic 

Call Us:  225-924-2424

There are many similarities between a Lumbar and Cervical herniated disc.  A lot of the information under the Lumbar section also applies to the Cervical region with a few additions.


What Are The Symptoms Of A Herniated Disc?

Usually, the main symptom is sharp, acute pain. This pain is usually described as a deep, sharp pain. The symptoms of a cervical herniated disc often resemble other disorders of the upper extremities such as carpal tunnel syndrome, rotator cuff impingement, and gout. In some patients, a cervical herniated disc can cause spinal cord compression where disc material pushes on the spinal cord. This is a much more serious condition and may require a more aggressive treatment plan. Spinal cord compression symptoms include a stumbling gait with possible frequent falls, difficulty with fine motor skills in the hands, and tingling sensations in the arms or legs.  The onset of pain with a herniated disc may occur suddenly or it may be preceded by a tearing or snapping sensation in the spine, which may be attributed to a sudden rupture in the annulus fibrosis.


How Is A Herniated Disc Diagnosed?


The diagnosis of a herniated disc begins with a complete physical exam of the neck, arms, and lower extremities.  This includes but is not limited to:

  • flexibility and range of motion of the neck
  • Signs of the herniation affecting your nerve roots or spinal cord with the strength of your muscles and checking reflexes
  • X-rays of the C-Spine (May appear normal because an xray does not show soft-tissue which is what the disc is composed of


If conservative therapy, such as medications and physical therapy, does not relieve symptoms then ultimately a CT scan or MRI scan is needed to determine if a herniated disc is present.  A CT scan is often used to evaluate the bony anatomy in the cervical spine, which can show how much space is available for the nerve roots and spinal cord within the spinal canal.  An MRI scan is very useful for determining where disc herniations have occurred and where the nerve roots or spinal cord are being compressed because of its ability to view soft-tissues.

How is a Herniated Disc Treated?


Surgery for cervical disc herniations is offered as an early option for people who have evidence of muscle weakness that is being caused by nerve root or spinal cord compression. This is because muscle weakness is a definite sign that the nerves are being injured (more seriously than when pain is the only symptom) and relieving the pressure on the nerves is more of an urgent priority. In other situations, surgery is offered after physical therapy, rest, and medications have failed to adequately relieve the symptoms of pain, numbness and tingling.


Surgery usually consists of Anterior Cervical Discectomy and Fusion.

MRI of Cervical Spine

Cervical Herniated Disc

MRI of Lumbar Spine

Lumbar Herniated Disc

What Are The Symptoms Of A Herniated Disc?

Usually, the main symptom is sharp, acute pain. This pain is usually described as a deep, sharp pain, which gets worse as it moves down the affected leg. The onset of pain with a herniated disc may occur suddenly or it may be preceded by a tearing or snapping sensation in the spine, which may be attributed to a sudden rupture in the annulus fibrosis.

How Is A Herniated Disc Diagnosed?

A patient with a herniated disc will usually complain of low back pain that may or may not radiate into different parts of the body, such as the leg. They will often demonstrate a limitation in range of motion when asked to bend forward or lean backwards, and they may lean to one side as they try to bend forward. Patients will sometimes walk with a painful gait, flexing the affected leg so as not to put too much weight on the side of the body that hurts. Straight leg raising may be a positive indication of tension on the nerve root.

Abnormalities in the strength and sensation of the legs that are found with a neurological examination performed by a doctor provide the most objective evidence of nerve root compression by the herniated disc. An MRI is the test of choice for diagnosis of a herniated disc.

How Is A Herniated Disc Treated?

Conservative Therapy involves Physical Therapy, Rest, Medications such as anti-inflammatories, analgesics, muscle relaxers, and nerve pain medicine.

Usually treatment will begin with a modification of activity such as limiting sitting, bending, lifting and twisting as these activities put added stress on the compressed nerves.  Followed by a gradual return to protected activities.


If conservative measures fail then an Epidural Steroid Injection (ESI) is normally ordered.  This is a minor procedure where anti-inflammatory medication is injected around the irritated nerve structure under Xray.  This procedure is used both for diagnostic and pain relief purposes.


Surgery is typically recommended only after physical therapy, rest, medications, and injections have failed to adequately relieve the symptoms of pain, numbness and weakness.


Microlumbar Discectomy is the typical Surgical treatment for a herniated disc that is centrally located.

The benefits of spine surgery, however, must be weighed against the risks. Your surgeon will be able to discuss the risks and benefits of surgery with you, and the likely results of operative versus non-operative treatment.

A herniated disc, also called a bulging disc, ruptured disc or slipped disc, occurs when the inner core of the spinal disc pushes out through the outer layer of the disc.

What Is A Herniated Disc?

Herniation describes an abnormality of the intervertebral disc that is also known as a "slipped," "ruptured" or "bulging" disc. This process occurs when the inner core (nucleus pulposus) of the intervertebral disc bulges out through the outer layer of ligaments that surround the disc (annulus fibrosis). This tear in the annulus fibrosis causes pain in the back at the point of herniation. If the protruding disc presses on a spinal nerve, the pain may spread to the area of the body that is served by that nerve.