Villanueva Institute of Pain and Spine
Herniated Disc Treatment in Burbank, CA
A herniated disc can make pain feel like it is moving through your body instead of staying in one place.
Some patients feel a sudden sharp pain after bending, lifting, twisting, coughing, or working out, while others may not remember one clear moment. The pain simply starts, then becomes harder to ignore when sitting, driving, walking, sleeping, exercising, or getting through a normal workday.
My name is Dr. John Villanueva, and I’m a physician, double board-certified in PM&R and interventional pain management at Villanueva Institute of Pain and Spine (VIPS). When I evaluate a herniated disc, I pinpoint where the pain starts, where it travels, whether nerves are involved, what your imaging shows when needed, and how much your symptoms affect your daily life.
A herniated disc does not always require surgery, and many patients improve with the right nonsurgical plan. The important step is understanding whether the disc is actually irritating a nerve, which nerve pathway is involved, and which treatment options make sense for your body.
If you are looking for herniated disc treatment in Burbank, CA, call VIPS at (818) 669-8895 or request an appointment online. We are located in Burbank and see patients from Glendale, Pasadena, Van Nuys, Toluca Lake, Studio City, Sherman Oaks, North Hollywood, Sun Valley, La Cañada, La Crescenta, Los Feliz, Atwater Village, Silver Lake, Echo Park, and communities throughout the San Fernando Valley and greater Los Angeles area.
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What Is a Herniated Disc?
A herniated disc happens when the softer inner material of a spinal disc pushes through or bulges against the outer layer of the disc. Some people call this a slipped disc, ruptured disc, bulging disc, or disc herniation.
Spinal discs sit between the bones of the spine, and they help cushion movement and absorb pressure. When part of a disc pushes outward, it can irritate nearby nerves or create inflammation around a nerve root.
A herniated disc can happen in the neck, mid-back, or lower back, although it is most common in the lumbar spine. Some herniated discs cause little or no pain. Others can cause intense symptoms, especially when a nearby nerve is inflamed or compressed.
What a Herniated Disc Can Feel Like
A herniated disc can cause back or neck pain, but many patients notice the radiating pain first. That means the pain travels away from the spine along the path of an irritated nerve.
Patients often describe:
- Low back pain that travels into the buttock, hip, leg, calf, or foot
- Neck pain that travels into the shoulder, arm, hand, or fingers
- Sharp, shooting, burning, electric, or stabbing pain
- Numbness or tingling
- Weakness in the leg, foot, arm, or hand
- Pain that worsens with sitting, bending, lifting, twisting, coughing, or sneezing
- Pain that makes driving difficult
- Pain that interrupts sleep
- Muscle spasms or guarding
- Trouble walking, standing, exercising, gripping, or lifting
Symptom location can tell us a lot. Pain on the outside of the calf may point to a different nerve than pain into the front of the thigh, and numbness in certain fingers may suggest a different cervical nerve level than pain near the shoulder blade. I use those details to connect the story, exam, and imaging.
Herniated Disc vs. Bulging Disc
Patients are often told they have a bulging disc or herniated disc and are left wondering how serious it is.
- A bulging disc usually means the disc is extending outward more broadly.
- A herniated disc usually means part of the inner disc material has pushed out more focally.
Either one can irritate a nerve, but either one can also appear on imaging without being the main cause of pain. That is why I do not treat the MRI report by itself. I look at whether the disc finding fits your symptoms. If your MRI shows a herniated disc on the right side and your pain travels down the right leg in the matching nerve pattern, that finding may be important. If the imaging and symptoms do not match, we need to keep looking.
Lumbar Herniated Disc
A lumbar herniated disc affects the lower back. This is one of the most common causes of sciatica and lumbar radiculopathy.
Pain may start in the low back or buttock and travel into the thigh, calf, ankle, foot, or toes. Some patients feel mostly leg pain and very little back pain. Others feel both. The pain may feel sharp, burning, electric, or deep, and it may worsen with sitting, bending forward, lifting, coughing, or sneezing.
Lumbar disc herniations can irritate different nerve roots depending on the level. That is why the exam includes strength, reflexes, sensation, nerve tension signs, gait, and sometimes EMG/NCS testing when the pattern needs more clarification.
Cervical Herniated Disc
A cervical herniated disc affects the neck. When it irritates a nerve root, pain may travel into the shoulder, arm, hand, or fingers. Patients may also notice numbness, tingling, burning, weakness, changes in grip strength, pain between the shoulder blades, or pain running down one arm.
Turning the head, looking down, working at a computer, driving, or sleeping in certain positions may make symptoms worse.
Cervical disc problems need careful evaluation because neck pain, shoulder pain, muscle tension, arthritis, and nerve symptoms can overlap. If there are signs of spinal cord involvement, such as balance changes, hand clumsiness, or trouble walking, the evaluation becomes more urgent.
Common Causes and Risk Factors
A herniated disc can happen after a sudden movement, but it can also develop over time as the disc weakens or degenerates. Sometimes patients blame themselves for one movement, such as picking up a laundry basket or turning the wrong way. In reality, the disc may have been vulnerable before that moment. The movement may have been the final trigger, not the whole cause.
Common contributors include:
Bending, lifting, or twisting under load
- Repetitive physical work
- Prolonged sitting or driving
- Disc degeneration over time
- Prior back or neck injury
- Genetics
- Smoking history
- Excess stress on the spine
- Poor conditioning or deconditioning
- Sports, workouts, or sudden increases in activity
- Prior disc herniation
When a Herniated Disc Needs Prompt Medical Attention
Some symptoms should be evaluated urgently. Seek emergency care if you develop new loss of bowel or bladder control, numbness in the groin or saddle area, rapidly worsening weakness, foot drop, trouble walking, fever with severe spine pain, severe pain after major trauma, or symptoms that are suddenly getting worse.
For neck symptoms, seek prompt care if you notice worsening arm or hand weakness, loss of coordination, balance problems, trouble using your hands, or difficulty walking.
Most herniated disc symptoms are not emergencies, but weakness, progressive numbness, and bowel or bladder changes should never be ignored.
How a Herniated Disc Is Diagnosed
Diagnosing a herniated disc starts with the story; I want to know where the pain began, where it travels, how long it has been present, what positions make it worse, and whether numbness, tingling, weakness, or balance changes are present.
During the exam, I may check posture, gait, range of motion, strength, reflexes, sensation, nerve tension signs, neck or back motion, hip or shoulder involvement, and how symptoms change with movement.
Testing may include X-rays, MRI, CT scan, or EMG/NCS testing depending on your symptoms. MRI is often useful when symptoms persist, nerve findings are present, or an injection or surgery referral is being considered. X-rays do not show the disc itself, but they can help evaluate alignment, arthritis, instability, or other bony issues. EMG and nerve conduction studies can help when numbness, tingling, weakness, or nerve injury needs clarification.
Whenever possible, I prefer to review the actual images, not only the written report. Reports are helpful, but the images often show details that affect the treatment plan.
How I Evaluate You Before Recommending Treatment
Before recommending treatment, I want to understand the disc herniation in context. A disc finding on MRI matters most when it matches the way your symptoms behave.
Two patients can both have a herniated disc on MRI and still need very different treatment plans. One patient may have severe sciatica because the disc is irritating a nerve root. Another may have a disc finding on MRI, but the main source of pain may be something else, such as facet arthritis, sacroiliac joint pain, hip pain, or peripheral neuropathy. That is why I look at the symptoms, exam, and imaging together before recommending treatment.
During your consultation, I will review your history, examine your spine and nerves, study imaging when available, and ask how symptoms are affecting your life. That may mean sitting through a workday, driving across Los Angeles, walking without leg pain, sleeping without waking up, using your hand normally, or getting back to exercise.
The goal is to make the diagnosis useful. Once we know which structure is causing the pain and how serious the nerve involvement is, the treatment plan becomes clearer.
Herniated Disc Treatment Options
Treatment depends on the location of the herniated disc, the nerve involved, the severity of symptoms, and how much the pain is limiting your life. A patient with mild leg pain and no weakness needs a different plan than someone with severe arm pain, progressive weakness, or symptoms that have not improved over time.
Physical Therapy and Rehabilitation
Physical therapy can help reduce nerve irritation, improve mobility, build strength, and restore confidence with movement. The plan may include gentle mobility work, core strengthening, hip or shoulder mechanics, nerve glides, posture training, body mechanics, walking progression, or gradual return to activity.
As a PM&R physician, I look closely at what the pain has changed. Can you sit? Drive? Sleep? Walk? Work? Exercise? Pick up your child or grandchild? The rehabilitation plan should support the activities you are trying to get back to, not just check off generic exercises.
Epidural Steroid Injections
An epidural steroid injection may help when a herniated disc is irritating or inflaming a spinal nerve. The injection places anti-inflammatory medication near the affected nerve area.
For a lumbar herniated disc, this may help pain traveling into the buttock, leg, or foot. For a cervical herniated disc, it may help pain traveling into the shoulder, arm, or hand.
While the injection does not remove the disc herniation, it reduces inflammation around the nerve so pain may improve and movement becomes more manageable. Your response can also help confirm how much nerve inflammation is contributing to the pain pattern.
Selective Nerve Root Blocks
A selective nerve root block targets a specific spinal nerve. This can be useful when symptoms and imaging suggest that one nerve root is responsible for pain traveling into an arm or leg.
The response can provide both relief and diagnostic information. If your familiar pain improves after the block, that helps confirm the nerve pathway involved.
Treatment for Muscle Spasm and Guarding
A herniated disc can cause the surrounding muscles to tighten and guard. Sometimes the muscles become painful enough that they add their own layer of symptoms.
Treatment may include medication review, physical therapy, gentle mobility work, trigger point injections, heat or ice strategies, posture changes, and activity pacing. Calming the muscle guarding can make it easier to move while the nerve pain is being addressed.
Treatment for Chronic Nerve Pain
Some patients continue to have nerve pain after the acute disc irritation has improved, especially if symptoms have been present for a long time or if there has been prior spine surgery.
In those cases, the plan may include medication management, EMG/NCS testing, updated imaging, rehabilitation, nerve blocks, or spinal cord stimulation evaluation in selected patients with chronic nerve-related pain that has not responded well enough to other care.
Medication Management
Medication can be useful when a herniated disc is making it difficult to sleep, sit, walk, work, drive, or participate in therapy. Depending on your symptoms, we may discuss options to calm nerve-related pain, reduce inflammation, ease muscle spasm, or make daily activity more tolerable.
I choose medication carefully based on your diagnosis, health history, current prescriptions, and how you have responded to treatment in the past. Medication often works best as part of a larger plan while the nerve irritation settles or while another treatment begins to work.
Surgical Referral
Some herniated discs may need surgical evaluation. This may apply when there is progressive weakness, severe nerve compression, foot drop, spinal cord compression, cauda equina symptoms, or pain that remains severe despite appropriate nonsurgical care.
If surgery should be considered, I will explain why and help guide the next step. For many patients, the first step is still a careful nonsurgical plan, but the decision should be based on your symptoms, exam, imaging, and safety.
How I Evaluate You Before Recommending Intracept®
You may benefit from a herniated disc evaluation if neck, back, arm, or leg symptoms are affecting your daily life. You do not need to know which nerve is involved before your visit. The consultation is where we connect the symptoms, exam, imaging, and goals.
Patients often come in with:
- Low back pain that travels into the buttock, leg, calf, foot, or toes
- Neck pain that travels into the shoulder, arm, hand, or fingers
- Sciatica or lumbar radiculopathy
- Cervical radiculopathy
- Burning, tingling, numbness, electric pain, or weakness
- Pain that worsens with sitting, bending, lifting, coughing, or sneezing
- Pain that interrupts sleep, driving, work, exercise, or daily routines
- MRI findings showing a herniated disc, bulging disc, or nerve compression
- Symptoms that have not improved enough with rest, medication, or physical therapy
- A need for a clearer explanation before deciding what to do next
Why Choose VIPS for Herniated Disc Treatment?
Double board-certified expertise
I am double board-certified in PM&R and interventional pain management. My PM&R training helps me evaluate movement, nerve symptoms, strength, rehabilitation, and function. My interventional training allows me to perform targeted spine procedures when they fit the diagnosis. As a double-board-certified physician and Certified Life Care Planner, I bring additional specialized training in evaluating the long-term needs of individuals with complex injuries and disabilities. This includes assessing future medical care, rehabilitation, and other ongoing needs that may be relevant in a medical-legal setting.
Careful image review
A herniated disc on MRI needs to be connected to your symptoms. I review imaging when available and explain which findings appear meaningful.
A full view of radiating pain
Arm or leg pain can come from a herniated disc, spinal stenosis, foraminal narrowing, arthritis, neuropathy, or another condition. I take time to understand which pattern fits.
Image guided procedures
Epidural steroid injections, selective nerve root blocks, and other spine procedures may be performed with fluoroscopy or ultrasound guidance depending on the target, anatomy, and clinical need.
A function-focused plan
I want to know whether pain is limiting sleep, work, sitting, driving, walking, exercise, lifting, parenting, or independence. Those details help define what success should look like.
Clear guidance about next steps
I will explain why a treatment option fits your symptoms. If the best next step is therapy, medication, an injection, nerve testing, updated imaging, or surgical referral, we will talk through it directly.
A warm, unhurried experience in Burbank
Disc pain can be frightening, especially when symptoms travel into the arm or leg. I want you to leave with a clearer understanding of what may be happening and what we can do next.
What Happens During Herniated Disc Treatment?
Your treatment depends on the disc location and nerve pattern.
For a lumbar herniated disc with sciatica, treatment may include medication management, physical therapy, an epidural steroid injection, or a selective nerve root block. For a cervical herniated disc with arm symptoms, the plan may include neck-focused rehabilitation, medication, cervical epidural steroid injection, selective nerve root block, or surgical referral when neurological findings are concerning.
Before any procedure, I explain what we are targeting, why that target fits your symptoms, what to expect afterward, and how we will judge your response.
Some patients need treatment in stages. We may start by calming the irritated nerve, then build the rest of the plan around movement, strength, posture, activity tolerance, and prevention of repeated flares.
What Should You Expect After Treatment?
Your response depends on the severity of nerve irritation, how long symptoms have been present, and which treatment is performed.
Some patients improve gradually with time, medication, activity changes, and rehabilitation. Some feel quicker relief after an injection because of the local anesthetic, while the anti-inflammatory effect may take several days to develop. When nerve symptoms have been present for a long time, numbness or weakness can take longer to improve than pain.
After treatment, I want you to track practical life changes, as these details tell us whether the plan is helping your life, not just changing a pain score.
Herniated Disc Treatment in Burbank, CA
VIPS is located in Burbank, CA, in the Magnolia Park neighborhood. The office is designed to feel welcoming and personal, with comfortable seating, warm finishes, and original artwork from patients who are working artists.
This is a place where spine and nerve pain stories have time to be heard. I live and work in Burbank, and I care about building a practice where patients feel known, respected, and well informed.
We see patients from Burbank, Glendale, Pasadena, Van Nuys, Toluca Lake, Studio City, Sherman Oaks, North Hollywood, Sun Valley, La Cañada, La Crescenta, Los Feliz, Atwater Village, Silver Lake, Echo Park, and communities throughout the San Fernando Valley and greater Los Angeles area.
Burbank Herniated Disc FAQs
To schedule a herniated disc consultation in Burbank, CA, call (818) 669-8895 or contact VIPS online today. The right plan may help calm nerve irritation, protect your function, and help you move forward with more confidence.
What does a herniated disc feel like?
A herniated disc may cause sharp, burning, electric, shooting, or radiating pain. A lumbar herniated disc may send pain into the buttock, leg, calf, or foot. A cervical herniated disc may send pain into the shoulder, arm, hand, or fingers.
Can a herniated disc cause sciatica?
Yes. A lumbar herniated disc can irritate a nerve root in the low back and cause sciatica. This pain often travels from the low back or buttock into the leg and may feel sharp, burning, electric, numb, or tingling.
Can a herniated disc in the neck cause arm pain?
Yes. A cervical herniated disc can irritate a nerve in the neck and cause pain that travels into the shoulder, arm, hand, or fingers. It may also cause numbness, tingling, burning, weakness, or changes in grip strength.
Can a herniated disc heal without surgery?
Many herniated disc symptoms improve without surgery. Treatment may include activity modification, medication management, physical therapy, epidural steroid injections, or selective nerve root blocks. Surgery may be considered when symptoms are severe, progressive, or not improving with appropriate care.
When should I see a doctor for a herniated disc?
You should consider an evaluation if pain travels into the arm or leg, symptoms last more than a short period, numbness or tingling is present, pain interrupts sleep or activity, or symptoms have not improved enough with rest, medication, or physical therapy.
What herniated disc symptoms are urgent?
Seek urgent care for new loss of bowel or bladder control, numbness in the groin or saddle area, rapidly worsening weakness, foot drop, trouble walking, fever with severe spine pain, severe pain after major trauma, or worsening arm or leg weakness.
Do I need an MRI for a herniated disc?
Not every patient needs an immediate MRI. MRI may be recommended when symptoms persist, include nerve signs, are severe, worsen despite conservative care, or when an injection or surgical referral is being considered.
Can epidural steroid injections help a herniated disc?
Epidural steroid injections may help when a herniated disc is inflaming or irritating a spinal nerve. The medication is placed near the affected nerve to reduce inflammation and improve comfort with movement.
What is a selective nerve root block?
A selective nerve root block targets a specific spinal nerve. It may be useful when symptoms and imaging suggest that one nerve root is responsible for pain traveling into the arm or leg.
Will I need surgery for a herniated disc?
Some patients need surgery, especially when there is progressive weakness, severe nerve compression, foot drop, spinal cord compression, cauda equina symptoms, or severe pain that does not improve with appropriate nonsurgical care. Many patients can begin with nonsurgical treatment.
How much does herniated disc treatment cost in Burbank, CA?
The cost of herniated disc treatment in Burbank can vary depending on the evaluation, imaging, medication plan, physical therapy, injections, EMG/NCS testing, advanced procedures, or specialist referrals involved. During your consultation, my team can help you understand what information may be needed for scheduling, authorization, and cost review.