Back pain seems to happen more and more as we get older. But how do you know if that nagging ache in your back is more serious?

“Pain is the most common indicator bringing people into the doctor’s office to have their back checked,” says Shirvinda Wijesekera, MD, an orthopedic spine surgeon at the Connecticut Orthopaedic Institute at MidState Medical Center.

Dr. Wijesekera shares three signs that you may have a herniated disc, why it causes so much pain, and the treatment options.

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Tell-tale signs of a herniated disc

Other symptoms he says to look for include:

  • Pain in arms, legs or buttocks, especially if the herniated disc is in your lower back. Pain can radiate down through the calf.
  • Numbness or tingling. Nerves affected by the slipped disc can cause this in your back, legs, arms or buttocks.
  • Weakness in an arm or leg.

> Related: 6 Common Causes of Lower Back Pain and Ways to Treat it Without Surgery

The science behind it

The spine is a series of bones with cushions, or discs, between them that allow us to move freely and without pain.

The discs between vertebrae in the spine are firm and rubbery on the outside and filled with a soft center, much like a jelly donut, Dr. Wijesekera says.

“We call them the shock absorbers of the spine,” he explains.

Accidents, overuse and, sometimes, the smallest twist or bend can cause a disc to herniate or slip out of place. Once herniated, the disc can hit nerves, causing pain, or the substance inside can leak out, putting pressure on nerves.

Treatment options

As debilitating as that sounds, up to 90% of people who suffer from herniated discs see their symptoms improve without surgery, Dr. Wijesekera notes.

“We want surgery to be the last resort,” he says.

First, he suggests such remedies as:

  • Rest
  • Physical therapy
  • Anti-inflammatory medication

“We like to see it wrap up in about six months because we don’t want the nerves to scar,” he says.

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When a doctor can help

If surgery is needed, options include removal of the part of the disc that’s hitting the nerve and causing pain, or inserting a replacement disc.

“Living with pain is not always the answer, we just have something to correct,” Dr. Wijesekera says. “The body is remarkable. It’s able to repair itself.”