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Lumbar Disc Herniation

A lumbar disc herniation occurs when the jelly-like material in the center of the disc (in the lower spine) is forced beyond the outer disc wall and into the area where your spinal nerves reside. Sometimes no symptoms result from a lumbar herniated disc, but intermittent or continuous back pain can result. You may also experience a wide variety of symptoms in different body parts like the legs and feet. Luckily, treatments are available that can help reduce or even eliminate your lower back pain.

About Lumbar Disc Herniation

As mentioned above, lumbar disc herniation occurs when the nucleus pulposus (gel-like substance) gets pushed from the outer disc area of the lower-back vertebrae and into your nerves. These discs provide cushioning between the bones of your back. There are numerous reasons this can occur, including degenerative disc disease or injury to the area. The pain and discomfort you may experience are caused by the pressure the ruptured disc is placing on the nerves in your spinal cord.

Common Symptoms of Lumbar Disc Herniation

There are several common symptoms that can accompany a lumbar disc herniation. The most prominent symptom is back pain, that can either come in spurts or be constant. This can be experienced as dull, aching or sharp, stabbing pains in the lower back. Another common symptom with lumbar disc herniation is severe, shooting pain in the buttock, leg, and or foot pain known medically as “radiculopathy” and known commonly as “sciatica.” This comes from compression of a spinal nerve and may also be associated with numbness, tingling, or weakness. You may notice that bending, twisting, coughing or even sneezing can cause the pain to worsen.

Diagnosis of Lumbar Disc Herniation

Symptoms of a lumbar disc herniation can mimic symptoms of other conditions, making a correct diagnosis important. Your doctor will give you a physical exam and perform a basic neurological exam. Diagnosis of a lumbar disc herniation usually requires an MRI. MRI is the only non-invasive test that can definitively rule out the presence of a herniated disc, although sometimes well defined herniated discs can be seen well enough on a CT scan to make a diagnosis. In some cases instances, when a patient is unable to get an MRI, a test called a myelogram may be used. A myelogram is a CT scan performed after injection of dye into the spinal canal.

Treatment Options for Lumbar Disc Herniation

Most lumbar disc herniations are treated without surgery, as your body has the capacity to heal these on its own.  This will take time, however, and treatment is directed towards reducing symptoms while waiting for improvement. Nonsurgical options include rest, activity modification, physical therapy, and anti-inflammatory and pain medications. Steroid spinal injections, or “epidurals”, are very useful for this problem and can be effective at reducing pain when other measures fail.

For more severe cases that don’t respond to the above treatments, surgical intervention may be necessary. If pain does not subside within 6-12 weeks or if neurological deficits are present, surgery is typically recommended. The most commonly performed surgery is a microdiscectomy. This involves the removal of herniated portion of the disc, allowing for the pressure on the spinal nerve to be relieved.