Herniated disc: the most common cause of sciatica.
The discs between your vertebrae have a soft center and a tougher outer ring. When the center pushes through a weak spot in the ring and presses on a nerve, that is a herniated disc. Most heal on their own; a minority need surgery.
Symptoms
Where the pain goes depends on which disc herniates. In the lower back (lumbar spine) the typical result is sciatica — pain, tingling, or numbness down one leg, sometimes with weakness in the foot. In the neck (cervical spine) it is pain that shoots into the shoulder, arm, or hand, often with tingling in specific fingers. Back or neck pain by itself, without pain traveling into a limb, is more often muscular or joint-related than a herniation.
Why discs herniate
Discs lose water content and elasticity with age — “degenerative” changes that are normal wear rather than disease. A weakened ring can then give way with a lift, a twist, or sometimes nothing in particular. Herniations are most common between the ages of 30 and 50. Smoking, heavy physical work, and prolonged sitting are associated with higher rates.
Diagnosis
The exam identifies which nerve root is involved. MRI is the test that shows the disc and the nerve it is touching; it is ordered when symptoms are severe, are lasting beyond a few weeks, or there is weakness. It is worth knowing that many people with no symptoms at all have disc bulges on MRI — so the picture is always read alongside the symptoms, never on its own.
Non-surgical treatment
The body reabsorbs most herniated disc material over weeks to months, and the nerve calms as it does. Treatment supports that process: staying active, a short course of anti-inflammatory medication, physical therapy, and — when leg or arm pain is severe — an epidural steroid injection. Roughly nine in ten people with a lumbar herniation avoid surgery.
Surgery for a herniated disc
A microdiscectomy removes the fragment pressing on the nerve through an incision an inch or so long, usually as a same-day or overnight procedure. It is among the most common and effective spine operations for leg or arm pain that has not settled. In the neck, the equivalent is usually an anterior cervical discectomy with fusion or, in selected patients, a total disc replacement that preserves motion. Dr. Mushlin has published research on lumbar disc herniation aimed at identifying which patients benefit most from surgery, and operates through the smallest approach that safely reaches the problem.
Where to be seen
Dr. Mushlin sees patients at the Stony Brook Spine Institute offices in Riverhead, Lake Grove, and Commack, across Suffolk County. A recent MRI is useful but not required for the first appointment.
Ready to have it looked at? Request an appointment or call 631-444-1213.
Can a herniated disc heal on its own?
Yes — most do. The herniated material is gradually reabsorbed and the irritated nerve settles over weeks to months. Surgery is reserved for pain that persists despite treatment, progressive weakness, or nerve-related bladder or bowel changes.
What is the difference between a bulging and a herniated disc?
A bulge is the disc's outer ring spreading slightly beyond its normal edge, which is common and often painless. A herniation is the inner material pushing through the ring. Either can press on a nerve; either can also be an incidental finding that causes nothing.
How long is recovery from a microdiscectomy?
Many people walk the same day and are back at desk work within one to two weeks; heavier lifting and sport are usually reintroduced over about six weeks, depending on the individual and the operation. Leg pain typically improves quickly; numbness can take longer to fade.
Which offices does Dr. Mushlin see disc patients at?
Riverhead, Lake Grove, and Commack — all three Stony Brook Spine Institute locations in Suffolk County.