Lumbar Disc Herniation
What is lumbar disc herniation?
The bones (vertebrae) that form the spine in your back are cushioned by small spongy discs. When these discs are healthy, they act as shock absorbers and keep the spine flexible. But when a disc is damaged, it may bulge or break open. This is called a herniated disc. It may also be called a slipped or ruptured disc.
You can have a herniated disc in any part of your spine, but most herniated discs affect the lower back (lumbar spine). Some happen in the neck (cervical spine) and more rarely in the upper back (thoracic spine).
What causes it?
There are two primary causes of a herniated disc:
Wear and tear – As you age, your discs dry out and loose flexibility.
Injury to the spine – This may cause tears or cracks in the hard outer layer of the disc. When this happens, the thick gel inside the disc can be forced out through the tears or cracks in the outer layer of the disc. This causes the disc to bulge or break open.
What are the symptoms?
When a herniated disc presses on nerve roots, it can cause pain, numbness and weakness in the area of the body where the nerve travels. A herniated disc in the lower back can cause pain and numbness in the buttock and down the leg. This is called sciatica, the most common symptom of a lumbar disc hernia.
If a herniated disc isn’t pressing on a nerve, you may have a backache or no pain at all.
What are the major risk factors?
Some risk factors you cannot change, like getting older, being male and having a history of back injury. However, there are some risk factors you can avoid:
- Long periods of sitting
- Being overweight
- Not exercising or exercising too strenuously after a long period of inactivity
- Smoking which keeps spinal discs from absorbing nutrients
- Lifting or pulling heavy objects
- Frequent bending or twisting of the back
- Heavy physical exertion
- Repetitive motions
- Exposure to constant vibration, such as driving
How is it diagnosed?
We first do a medical history and physical exam. If this suggests that you have a herniated disc, you probably won’t need other tests. However, if your medical history and physical exam suggest a more serious condition, we may order other tests to rule out other conditions.
How is it treated?
Only about 1 person out of 10 eventually has surgery.1Usually a herniated disc will heal on its own over time. About half of people with a herniated disc get better within 1 month, and most are better within 6 months. Here are some suggestions to help you recover:
- Stay active – Only rest when you have severe pain. Staying in bed for more than 1 or 2 days can weaken your muscles and make the problem worse. Walking and other light activity may help.
- Use a heating pad – on a low or medium setting for 15 to 20 minutes every 2 or 3 hours. Try a warm shower in place of one session with the heating pad. You can also buy single-use heat wraps that last up to 8 hours. You can also try an ice pack for 10 to 15 minutes every 2 to 3 hours.
- Exercise as prescribed – The exercises that your physical therapist suggests will help keep your back muscles strong and prevent another injury.
- Consider pain relievers – While it won't cure a herniated disc, it may help with pain and swelling.
Please note; if you have weakness or numbness in both legs along with loss of bladder or bowel control, seek immediate medical care. This could be a sign of a rare but serious condition called Cauda Equina syndrome.
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