Lumbar herniated disc

Lumbar herniated disc

A lumbar herniated disc is a ruptured disc in the lower back. Discs are the shock-absorbing cushions between vertebrae that prevent the vertebrae from rubbing against one another. A normal disc has a tough outer layer and a softer, jelly-like center. When a disc becomes compressed due to injury or disease, it bulges out from its normal position and comes in contact with nerves. Most herniated discs occur in the lumbar or lower section of the back. Symptoms of a lumbar herniated disc range from intermittent pain to severe pain in the back and legs and even changes in bladder or bowel function.

Symptoms

The symptoms of a lumbar herniated disc vary depending on which disc has ruptured and the specific nerve root it presses. The following are the most common symptoms of a lumbar herniated disc:

  • Intermittent or continuous back pain – This may be made worse by movement, coughing, sneezing, sitting or standing for long periods of time
  • Spasms – In the lower back muscles can suggest a lumbar herniated disc
  • Sciatica – Pain that starts near the back or buttocks and travels down the leg to the calf or into the foot
  • Muscle weakness – In the legs or lower back
  • Numbness – Usually involves the leg or foot
  • Decreased reflexes – The knees or ankles are affected, due to a herniated disc in the lumbar section
  • Changes in bladder or bowel function – Incontinence of urine or stool can occur in severe cases and is considered a serious condition requiring rapid evaluation and treatment.

The symptoms of a lumbar herniated disc may resemble other conditions or medical problems. Always consult your physician for a diagnosis.

Causes

The primary causes of a lumbar herniated disk are:

  • Aging – With aging, our spinal discs slowly degenerate. They begin to dry up and lose some of the elasticity that keeps them flexible and cushion-like. When a disc dries out, the normal structure of the disc weakens and bulging and rupture of the disc can occur. 
  • Trauma – Direct trauma to the spine can crack or tear the disc due to:
    • Sudden increased pressure or heavy strain to the lower back
    • Sudden twisting movements
    • Sports-related injuries
    • Poor lifting habits
    • Repetitive activities
    • Prolonged exposure to vibration

Diagnosis

In addition to a complete medical history and physical examination, diagnostic procedures for a lumbar herniated disc may include the following:

  • X-ray – Invisible electromagnetic energy beams produce images of bones on film. These are very useful to see the overall alignment of the vertebrae and to look for arthritic changes.
  • Magnetic resonance imaging (MRI) – A combination of large magnets, radiofrequencies and a computer produces detailed images of the spine, including discs and nerves that are not seen on X-ray images.
  • Myelogram – Uses dye injected into the spinal canal to make the nerves more clearly visible on X-rays.
  • Computed tomography scan (CT or CAT scan) – Uses a combination of X-rays and computer technology to produce horizontal (axial) images of the body. A CT scan shows detailed images of any part of the body including bones, muscles, fat and organs. CT scans are more detailed than general X-rays but cause a lot more radiation exposure than regular X-rays.
  • Electromyography (EMG) – Measures muscle response or electrical activity in response to a nerve’s stimulation of the muscle. This test is useful to look for any problems with nerve or muscle function.

Treatment

Nonsurgical treatments for lumbar herniated discs usually consist of limited bed rest, back support and therapy. Most people suffering from a lumbar herniated disc do not need surgery. About 90 percent will recover within a month with nonsurgical treatments, and only 10 percent may eventually require surgery.

The multidisciplinary team of spine experts at Northwell Health Orthopaedic Institute treats lumbar herniated discs as well as a broad range of spine conditions that can occur at any stage of life.

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