What is a herniated lumbar disc?
A herniated lumbar disc refers to the process by which the soft inner core of the disc pushes through the exterior hard covering and protrudes into the spinal canal. As a result, the damaged disc can produce low back pain. If the herniated disc compresses and pinches a nerve traveling in the spinal canal, it can produce pain, numbness, and weakness into the buttock and leg. Each nerve has a distinct pain pattern which helps the physician diagnose a symptomatic disc herniation. A herniated lumbar disc does not always cause pain. A herniated disc is also referred to as a “slipped disc”, “bulging disc”, “protruding disc”, or “ruptured disc”.
How is a herniated disc diagnosed?
A herniated lumbar disc is highly suspected when the patient complains of pain that radiates from the low back into the leg. Some patients can hear a “popping” sensation when the pain began which indicates that the disc has herniated. If the disc herniation is large, it can cause leg weakness or numbness in addition to pain. Typically, the pain from a herniated disc is made worse by flexion activities of the spine such as sitting or bending forward. An MRI is the best diagnostic test for a herniated disc as it will show the herniated disc compressing the nerve.
What is the treatment for a herniated lumbar disc?
Most patients with a herniated lumbar disc do not require surgery and will be treated conservatively (nonsurgical treatments). The treatments include rest, medications, physical therapy and injections. Common medications include anti-inflammatories (aspirin products), Tylenol, muscle relaxants and steroid. Physical therapy includes manual massage techniques, stretching, heat, and core muscle strengthening. An epidural injection may be helpful to deliver a steroid medication around the nerve to reduce local inflammation. If pain persists despite conservative treatments, then a surgical procedure known as a lumbar microdiscectomy is very effective to remove the portion of the herniated disc away from the nerve.