Patrick Ranney at the Clinic with Dr. Dan Lieberman

Episode 2: Herniated Disc

Patric Ranney came to Dr. Dan Lieberman complaining of low back pain running like electricity down his left leg. Pat is well known to the Clinc, having undergone L5/S1 anterior lumbar interbody fusion surgery six years earlier. He reports that he was pain free until three weeks earlier.

Pat returned to walking for exercise after a couple of months break due to a knee issue. After the second day, he reported pain and numbness in his right leg. These are typical herniated disc symptoms. On physical examination, Pat had weakness lifting his left leg straight up. Magnetic resonance imaging showed a giant herniated disc in the lumbar spine.

Can a herniated disc heal itself?

Herniated discs normally heal by themselves, but the process is slow and sometimes it is either too painful or dangerous to wait. One of the peculiar things about the discs in your lower back is that they do not have their own blood supply. It is through the blood supply that your body recognizes what is part of ‘you’ and what is not. When a disc “herniates” the soft, inner part goes through a rip in the tough outer part.

Pat’s body did not “know” that the soft inner part is part of him. So, his body generated an inflammatory response.

The weird part is that it is the healing that causes herniated disc symptoms. On the show Patrick talked about feeling a “sharp pain” that “went right down my leg.” As his body tried to heal the disc herniation the inflammation spilled over and irritated the neighboring nerve root. That irritation of the nerve root causes the sense of pain going down the leg that people often call sciatica. It also caused a sense of numbness in his leg.

When a herniated disc is the problem the most common solution is to let the body heal itself. But there is a catch. Two of them, actually.

First, the inflammation that reabsorbs the herniated disc is damaging the nerve root. If the healing takes too long, that damage can cause permanent nerve damage.

Second, sometimes pain fibers grow into the scar that heals the annulus, and causes permanent low back pain to form the torn disc. This is called discogenic pain.

Learn more about Herniated Disc Phoenix Spine & Joint (phoenixspineandjoint.com)

Is a herniated disc serious?

Herniated discs are extremely common, and most get better on their own; however, some can be serious in two ways.

A herniated disc is serious when it causes problems with the neighboring nerve roots due to inflammation or direct pressure. Giant herniated discs, like Pat had, can actually cause damage to nerve roots making you paralyzed and unable to control your own urine:

If you experience herniated disc symptoms like severe weakness, numbness, or incontinence with back pain you may have a giant herniated disc that requires surgery on an emergency basis. If you have severe numbness, weakness, uncontrollable pain, or cannot pee with back pain then go to the nearest hospital that has a neurosurgeon on call. If a hospital is a trauma center, then there is a neurosurgeon on call there.

Second, a herniated disc can happen in conjunction with another serious problem. Infection, tumors, and fractures can all be associated with disc herniation.


Pat had been to the clinic before, so he contacted us. If you have a lot of pain the initial herniated disc treatment is moist heat, rest, and antiinflammatory medications. If your initial herniated disc treatment fails and you are not getting better, then see your doctor right away.

No matter what, if these herniated disc treatments fail and you are not improved after 12 weeks (about 3 months), then your doctor will refer you to an orthopedic surgeon who specializes in spine surgery or a neurosurgeon as appropriate.

What does it feel like to have a herniated disc? What are herniated disc symptoms?

Pat’s history of back pain, leg pain, numbness, and weakness are typical herniated disc symptoms. The details depend on which disc is the herniated disc. If the herniated disc causes compression of a nerve root, then you may feel symptoms such as pain, weakness, or numbness in the part of your body served by that nerve root.

Pat described a “sharp” pain going down his left leg. This is usually due to the inflammation your body generates to try and heal the herniated disc. He also noted numbness in the left leg. Pat's disc was so large that it affected more than one nerve root; he had numbness in the groin, thigh, and calf.

What is the best herniated disc treatment?

Most people with a herniated disc will get better on their own without the need for further specific herniated disc treatment over days to weeks. Pat had a history with the clinic, so he came to see us. But for most people the best herniated disc treatment for pain from a herniated disc depends on how long you have had it.