Herniated Disc
Expert Herniated Disc Treatment in Bergen County, New Jersey.
A herniated disc also commonly called a slipped disc, ruptured disc, or bulging disc occurs when the soft, gel-like center of a spinal disc pushes through a tear in its outer layer and presses against a nearby nerve or the spinal cord. This pressure on the nerve is what causes the radiating pain, numbness, and weakness that herniated disc patients experience often in the arms or legs depending on where in the spine the disc has herniated.
Herniated discs can occur in any region of the spine. A cervical herniated disc in the neck causes symptoms that radiate into the shoulders, arms, and hands. A lumbar herniated disc in the lower back causes symptoms that radiate into the buttocks, legs, and feet commonly known as sciatica. Thoracic herniated discs, which occur in the mid-back, are less common but can cause significant chest wall and abdominal symptoms.
The good news is that the majority of herniated disc cases respond well to non-surgical treatment. Rishi N. Sheth, MD at Spine Care New Jersey approaches every herniated disc diagnosis with a conservative-first philosophy exhausting all appropriate non-surgical options before a surgical recommendation is ever made.
SYMPTOMS How to Recognize the Signs of a Herniated Disc.
Herniated disc symptoms vary depending on which level of the spine is affected and which nerve roots are being compressed. Some patients experience severe, sudden pain others develop symptoms gradually over weeks or months. The following are the most common warning signs that a herniated disc may be the cause of your pain.
Cervical Herniated Disc Symptoms — Neck Region:
Sharp or burning pain in the neck that may radiate into the shoulder, arm, or hand on one side of the body. Numbness or tingling in the fingers or hand. Weakness in the arm or grip strength. Pain that worsens with certain head positions, such as looking down or turning to one side. In more advanced cases, difficulty with fine motor tasks such as buttoning a shirt or holding a pen.
Lumbar Herniated Disc Symptoms — Lower Back Region:
Aching or sharp lower back pain, often one-sided. Pain that radiates down the buttock, thigh, calf, or foot on one side commonly known as sciatica. Numbness or tingling in the leg or foot. Weakness in the leg, foot drop, or difficulty walking normally. Pain that worsens with sitting, bending, coughing, or sneezing. Relief when lying flat or in certain positions.
Warning Signs That Require Immediate Medical Attention:
Loss of bladder or bowel control, severe progressive weakness in both legs, numbness in the groin or inner thighs, or sudden inability to walk. These symptoms may indicate cauda equina syndrome a rare but serious neurological emergency that requires immediate surgical evaluation. If you experience these symptoms, seek emergency care immediately.
Not all back pain is caused by a herniated disc, and not all herniated discs cause pain. An accurate diagnosis based on your symptoms, physical examination, and MRI imaging is essential before any treatment decision is made. Rishi N. Sheth, MD offers a free MRI review for patients who have existing imaging and want an expert evaluation of their diagnosis.
DIAGNOSIS Getting to the Right Diagnosis Accurately and Efficiently.
Accurate diagnosis is the foundation of effective herniated disc treatment. At Spine Care New Jersey, every new patient evaluation begins with a thorough review of your medical history, a detailed account of your symptoms, and a comprehensive physical and neurological examination conducted personally by Rishi N. Sheth, MD.
Diagnostic Process:
Medical History & Symptom Review
Rishi N. Sheth, MD will discuss the onset, location, nature, and progression of your symptoms including any factors that worsen or relieve your pain. Understanding your history in detail is essential to distinguishing a herniated disc from other conditions that can produce similar symptoms, such as spinal stenosis, facet joint disease, or sacroiliac joint dysfunction.
Physical & Neurological Examination
A systematic examination of your spine, reflexes, muscle strength, and sensation patterns helps identify which nerve root or spinal cord level is being affected. This information guides the interpretation of imaging findings and the selection of the most appropriate treatment approach.
MRI Imaging — The Gold Standard for Herniated Disc Diagnosis
Magnetic resonance imaging (MRI) provides the most detailed view of the spinal discs, nerve roots, and spinal cord available without surgery. An MRI can confirm the presence and location of a herniated disc, the degree of nerve compression, and whether surrounding structures such as the spinal canal or foramen are narrowed. If you have already had an MRI performed, Rishi N. Sheth, MD will review it as part of your consultation or you can submit your imaging in advance through the free MRI review program.
Additional Imaging When Indicated
In some cases, X-rays are used to evaluate spinal alignment, bone quality, and the degree of disc space narrowing. CT scans may be ordered to assess bony anatomy in patients who cannot undergo MRI. Nerve conduction studies or electromyography (EMG) may be recommended to confirm the extent of nerve involvement.
TREATMENTS From Conservative Care to Minimally Invasive Surgery Every Option, Personally Evaluated.
The appropriate treatment for a herniated disc depends on the severity of your symptoms, the degree of nerve compression on your MRI, how long you have been experiencing symptoms, and how significantly your condition is affecting your daily life. Rishi N. Sheth, MD evaluates all of these factors together before making any treatment recommendation.
NON-SURGICAL TREATMENT ALWAYS THE FIRST STEP
The majority of herniated disc patients experience significant improvement with non-surgical treatment. Rishi N. Sheth, MD is committed to exhausting every appropriate conservative option before surgical intervention is discussed.
Physical Therapy & Rehabilitation
A structured physical therapy program is one of the most effective first-line treatments for herniated disc pain. Targeted exercises improve core strength, reduce pressure on the affected disc, restore flexibility, and correct movement patterns that may be aggravating the condition. Physical therapy is often combined with other non-surgical treatments for faster and more complete recovery.
Epidural Steroid Injections
Epidural steroid injections deliver powerful anti-inflammatory medication directly into the epidural space surrounding the affected nerve root. This reduces swelling and inflammation around the compressed nerve, providing significant pain relief that allows patients to participate more effectively in physical therapy and daily activities. The procedure is performed in-office and most patients return to normal activities the same day.
Transforaminal Injections
A more targeted form of epidural injection, transforaminal injections deliver anti-inflammatory medication directly to the specific nerve root being compressed by the herniated disc. This precision delivery can provide more effective relief for patients with clearly localized nerve root pain.
Medial Branch Blocks & Facet Joint Injections
In patients where herniated disc pain is accompanied by facet joint irritation, targeted injections to the facet joints or their nerve supply may be used as part of a comprehensive pain management plan.
Conservative Pain Management
Anti-inflammatory medications, muscle relaxants, and nerve pain medications prescribed by your primary care physician may provide meaningful short-term
relief while the disc heals naturally or while awaiting evaluation. Rishi N. Sheth, MD will review your current medications and make appropriate recommendations during your consultation.
SURGICAL TREATMENT WHEN CONSERVATIVE CARE IS NOT ENOUGH
Surgical treatment for a herniated disc is considered when non-surgical treatments have been tried for an appropriate period without adequate relief, when symptoms are severe or worsening despite conservative care, when there is significant neurological compromise such as progressive weakness, foot drop, or loss of bladder or bowel control.
Microdiscectomy
Microdiscectomy is the most commonly performed and most effective surgical treatment for a lumbar herniated disc causing sciatica. Using a small incision and a surgical microscope, Rishi N. Sheth, MD removes the portion of the herniated disc that is pressing on the nerve root. The procedure is typically performed on an outpatient basis, meaning patients go home the same day.
Minimally Invasive Spine Surgery
For appropriate candidates, Rishi N. Sheth, MD performs all herniated disc procedures using minimally invasive techniques smaller incisions, less muscle disruption, reduced blood loss, lower infection risk, and faster return to daily activities compared to conventional open surgery.
Anterior Cervical Discectomy & Fusion (ACDF)
For cervical herniated disc causing significant arm pain, weakness, or myelopathy that has not responded to conservative treatment, ACDF involves removing the damaged cervical disc and fusing the adjacent vertebrae to eliminate nerve compression and stabilize the spine.
Cervical Artificial Disc Replacement
In carefully selected patients with cervical herniated disc, artificial disc replacement with the ProDisc-C system preserves natural neck movement while relieving nerve compression — avoiding the limitations associated with cervical fusion.
Rishi N. Sheth, MD is ProDisc-C certified, one of a limited number of surgeons in New Jersey with this specific certification.
Robotic Spine Surgery
When surgical complexity or patient anatomy warrants it, Rishi N. Sheth, MD utilizes Mazor robotic spine surgery technology for enhanced precision, reduced operative risk, and improved surgical outcomes.
Foraminotomy
Foraminotomy is a minimally invasive surgical procedure designed to relieve pressure on spinal nerves caused by narrowing of the foramina the small openings where nerve roots exit the spine. This condition, often resulting from herniated discs, bone spurs, or spinal degeneration, can lead to pain, numbness, or weakness in the neck, back, arms, or legs.
Bergen County's Most Credentialed Spine Neurosurgeon for Herniated Disc Care.
When you choose Spine Care New Jersey for your herniated disc treatment, you are choosing a surgeon whose entire practice his training, his research, his certifications, and his clinical focus is dedicated exclusively to the spine. Rishi N. Sheth, MD has treated hundreds of herniated disc patients across the full spectrum of severity, from mild disc bulges managed conservatively to complex multi-level herniations requiring advanced robotic surgical intervention.
What Sets Rishi N. Sheth, MD Apart:
Fellowship-Trained at Memorial Sloan Kettering Cancer Center: The depth of surgical training Rishi N. Sheth, MD brings to every herniated disc case including complex presentations, recurrent herniations, and cases where prior surgery has failed reflects fellowship training at the most demanding surgical institution in the country.
You Always See the Surgeon: Every consultation, every injection procedure, every surgical discussion, and every follow-up visit at Spine Care New Jersey is conducted personally by Rishi N. Sheth, MD. You will never be evaluated by a physician assistant and then handed off to a surgeon you have never met.
Conservative First. Always: Rishi N. Sheth, MD will never recommend surgery when a non-surgical approach is appropriate and has not yet been given a genuine chance to work. His honest, patient-centered approach to herniated disc treatment is one of the most consistent pieces of feedback from patients who have previously been told surgery was their only option.
Mazor Robotic Surgical Precision: When surgery is necessary, patients benefit from the added precision and safety of Mazor robotic spine surgery technology available at Spine Care New Jersey in Maywood, Bergen County.
Common Questions About Herniated Disc Treatment at Spine Care New Jersey.
The most effective non-surgical herniated disc treatments available at Spine Care New Jersey in Bergen County include epidural steroid injections, transforaminal nerve root injections, physical therapy and rehabilitation, medial branch blocks, and conservative pain management. For many patients, a combination of targeted injections to reduce nerve inflammation and a structured physical therapy program to strengthen the supporting muscles is sufficient to achieve lasting relief without surgery. Rishi N. Sheth, MD evaluates every herniated disc patient for the full range of non-surgical options before any surgical recommendation is made. A free MRI review is available for patients who want an expert assessment of their diagnosis and which non-surgical treatments are most appropriate for their specific herniation.
When looking for a clinic specializing in minimally invasive herniated disc surgery in New Jersey, look for a spine neurosurgeon who is specifically fellowship-trained in minimally invasive techniques, has demonstrated experience with microdiscectomy and endoscopic spine surgery, and performs all procedures personally without delegating to associates. Spine Care New Jersey in Maywood, Bergen County NJ is a dedicated boutique spine neurosurgery practice where Rishi N. Sheth, MD performs all herniated disc procedures personally using minimally invasive techniques. His dual fellowship training in spine surgery and neurosurgical oncology, combined with Mazor robotic surgery certification, provides patients with a level of minimally invasive surgical expertise typically found only at major academic spine centers.
Yes, the majority of herniated disc cases improve significantly without surgery. Studies consistently show that a herniated disc can shrink or retract naturally over time as the body reabsorbs the displaced disc material. Non-surgical treatments including physical therapy, epidural steroid injections, and anti-inflammatory medications are effective in relieving
symptoms for most patients within six to twelve weeks. Surgery becomes necessary when symptoms are severe or worsening despite conservative care, when there is significant neurological compromise such as progressive weakness or loss of bladder and bowel control, or when imaging confirms that conservative treatment is unlikely to produce adequate relief given the degree of nerve compression. Rishi N. Sheth, MD will give you an honest assessment of whether your herniation is likely to respond to conservative treatment or whether surgical evaluation is warranted.
Recovery time for minimally invasive herniated disc surgery varies depending on the specific procedure performed and the level of the spine involved. For lumbar microdiscectomy the most common surgery for a herniated disc causing sciatica most patients are discharged the same day and can return to light activity within one to two weeks. Return to desk work typically occurs within two to four weeks, and more physically demanding activities within six to eight weeks. Cervical disc procedures such as ACDF or cervical disc replacement have a slightly longer recovery period but most patients return to normal activities within four to six weeks. Rishi N. Sheth, MD will discuss your specific expected recovery timeline in detail during your consultation based on your individual diagnosis and the procedure recommended.
Most PPO insurance plans cover herniated disc treatments including epidural steroid injections, physical therapy, and surgery when medically necessary and properly documented. Spine Care New Jersey is an out-of-network practice, which means patients with PPO insurance plans are eligible to use their out-of-network benefits to cover a meaningful portion of their care. Prior to your first visit, our team verifies your specific out-of-network benefits so you have a clear picture of your financial responsibility before making any treatment decisions. There are no surprises. Patients with HMO plans or who are uninsured are encouraged to contact the office directly to discuss their options. For patients considering spinal injections for herniated disc pain, the cost varies depending on the type and number of injections all of which will be discussed in detail during your consultation with Rishi N. Sheth, MD