Lumbar Disc Herniation
A lumbar disc herniation occurs in the lower back. A herniated disc is typically caused by an injury to the spine or daily wear and tear of the disc. The vertebrae (bones in the spine) are cushioned by small spongy discs, which help to absorb shock and keep the spine flexible. When these discs are damaged, it may bulge or break open causing a herniated disc. Most herniated discs affect the lower part of the spine, but can also affect the neck and upper back.
Common symptoms of a herniated disc include pain, numbness and weakness. Sciatica, a herniated disc in the lower back that causes pain and numbness in the buttock and down the leg, is the most common symptom of a herniated disc.
The spinal column has two distinct curves that allow for maximum flexibility and upright posture: the cervical and lumbar curves. While the cervical curve carries the weight of the head, it is the lumbar portion of the spine that supports the weight of the body. It is the largest section of the spine that is unsupported by neighboring bones. Only the abdominal muscles keep the lumbar curve intact and healthy.
The five heavy, dense vertebrae in this section are cushioned by jelly filled discs that are often subject to tremendous forces. When these discs are diseased, injured, or overused, they can break free of their membrane, or herniate, and cause pain in the lower back, hips, and legs.
Lumbar disc herniation is one of the most common back problems we see at BASIC Spine. Because the spine is unsupported in this area, it is most likely to experience injury, endure the stresses of the body, and ultimately generate pain. We have on site the means to diagnose and treat this type of herniation with state of the art radiographic and injection technologies. In extreme cases, our world class spinal surgeons can install cutting edge equipment into the spine to stabilize it and decrease pain. Of course, your comfort is our primary concern, and managing your pain is one of the charges we take seriously.
Many issues can cause a disc to herniate in the lumbar region. To make matters simpler, the general categories of injury, disease, and overuse apply to this condition. Injury to the lumbar region can take the form of traumatic forces, such as in a car accident or a fall. However, injuries can be subtler than that. Lifting incorrectly or twisting when carrying a weight is a prominent cause of lumbar disc herniation.
In fact, lifting and moving is one of the causes we see most frequently, and we teach proper mechanics in these potentially dangerous movements to prevent further back injury.
Disease sounds like a greater problem than it actually is, and it can be considered the normal deterioration of aging, such as in degenerative disc disease. Through the course of a person’s life, the discs can lose water, become brittle, and herniate from their proper places. Other diseases, such as osteoporosis, facet joint arthritis, and bone cancers can also affect the discs in the lumbar region. Finally, overuse causes of disc herniation can include the repetitive lifting of heavy objects, such as a factory worker may endure.
A great deal of lumbar pathology is caused by carrying excess body weight, and this can put undue pressure on the discs of the lower back. For this reason, weight loss is a vital component in treating lumbar disc herniation.
A lumbar disc can herniate and not cause any symptoms. This is because the symptoms do not arise from the herniation of the disc but from the surrounding structures that the bulging impacts. The area around the spinal column is rife with a network of nerves, blood vessels, and soft tissues. When a lumbar disc herniates, it usually presses on a nerve and causes nerve pain.
It is extremely unlikely that a herniated disc would cause anything other than nerve pain, and simple back pain is usually a result of a strained muscle or ligament rather than a bulging disc. The nerve root is the most likely culprit for pain in a herniated disc situation. This is the very start of the nerve that services a large portion of the body, such as the legs.
Nerve pain is generally described as shooting pain, numbness, tingling, and weakness along the track the nerve services. In lumbar disc herniation, the nerve most commonly affected is the sciatic nerve, and one on each side supplies sensation and movement to their corresponding legs.
In fact, herniation that presses on this nerve is often called sciatica, and the pain can sometimes extended as far as the foot. In rare circumstances, paralysis of this nerve may occur, and extreme cases can cause difficulties controlling the bowel or bladder. This is determined by which nerve the lumbar disc herniation impinges and how severe that impingement is.
Lumbar disc herniation is generally treated conservatively first. Non-steroidal anti-inflammatory drugs are the first line of treatment, and many less severe cases can resolve with these medications alone. Physical therapy is another important component of recovering from a herniation. This helps to build up the soft tissue support around the herniated disc, and you can learn ways to protect your back from further injury.
Chiropractic therapy can help to relieve pain, as well, by adjusting the vertebrae back into a more natural position. In some severe cases, more powerful pain medications are necessary. Anti-seizure drugs, such as gabapentin, are very helpful for nerve pain caused by impingement. Only in rare cases are opiate drugs used.
Slightly more aggressive treatment includes injecting a steroid into the area where the disc is bulging. This decreases swelling and helps to relieve the pressure on the nerve root. Some lumbar disc herniation does not respond well or completely to conservative measures, and this is where surgery may be necessary. New minimally invasive techniques can enter the spinal area and simply remove the part of the disc that is bulging.
When these surgical procedures do not work or are not recommended, spinal fusion may be necessary. High tech devices, such as the STALIF Midline device, can achieve fusion of the vertebrae, decrease movement of the lumbar spine, and resist fusion failure.
At BASIC Spine, we treat a great deal of lumbar disc herniation, and our philosophy centers around using the most conservative measures first. To that end, we have excellent chiropractic and pain management personnel on staff to fully exhaust these treatments. However, should you need surgery, our neurosurgeons are among the best in the country in surgical repair of lumbar disc issues.
You shouldn’t suffer with back pain, so contact us to make an appointment for a thorough assessment, diagnosis, and treatment.
- Back Pain
- Brachial Plexus Injuries
- Cervical Radiculopathy
- Lumbar Radiculopathy
- Compression Fractures
- Degenerative Disc Disease (Cervical and Lumbar)
- Facet Joint Syndrome
- Failed Back or Neck Syndrome
- Herniated Disc
- Lower Back Pain
- Nerve Impingement
- Spinal Infection
- Spinal Canal Stenosis (Cervical and Lumbar)
- Spinal Cord Compression
- Spina Bifida
- Cervical Neck Pain
- Lumbar Back Pain
- Lumbar Disc Herniation
- Anterior Cervical Discectomy and Fusion (ACDF)
- Posterior Lumbar Interbody Fusion (PLIF)
- Anterior Lumbar Interbody Fusion (ALIF)
- Artificial Disc Replacement
- Endoscopic Spine Surgery
- Posterior Cervical Foraminotomy
- Micro Endoscopic Lumbar Discectomy
- Micro Endoscopic Cervical Discectomy
- Extreme Lateral Interbody Fusion (XLIF®)
- Interlaminar Lumbar Instrumented Fusion (ILIF™)
- Facet Joint Injections
- Pain Pumps
- Spinal Cord Implants
- MILD Procedure (Minimally Invasive Lumbar Decompression)
- Ultra Minimally Invasive Endoscopic Spinal Surgery
- Compression Fracture (Cervical/Thoracic/Lumbar)
- Headaches (Migraines, Tension, Cluster)
- Heel Spur
- Medial Lateral Epicondylitis
- Myofacial Pain Syndrome
- Occipital Neuralgia
- Peripheral Neuropathy
- Plantar Fasciitis
- Postherpetic Neuralgia
- Sacroiliac Joint Disease
- Slipped Rib Syndrome
- Shoulder/Hip/Knee/Ankle/Wrist pain
- Trigeminal Neuralgia