Pioneer Spine and Sport Physicians, Spine Surgeons, East Longmeadow, Greenfield, Northampton, West Springfield, Lenox, MA » Spine » Spine Conditions » Lumbar Disc Herniation

Lumbar Disc Herniation

The lumbar intervertebral discs are flat and round, located present between the lumbar vertebrae and act as shock absorbers when you walk or run. There is a soft, gelatinous material in the center (nucleus pulposus) which is encased in strong elastic tissue forming a ring around it called annulus fibrosus.

Aging, injury or trauma may cause the annulus fibrosus to tear resulting in protrusion of the nucleus pulposus. This may compress the spinal nerves and/or spinal canal. The bulging disc may even break open releasing the gelatinous material, which is a chemical irritant, causing inflammation of the spinal nerves.

Obesity, sedentary lifestyle and smoking increase the risk of lumbar disc herniation.

Symptoms of Lumbar Disc Herniation

The symptoms of lumbar disc herniation include:

Mild to intense back pain, making it difficult to bend
Numbness and weakness in the leg or foot leading to the sensation of tingling
Leg and/or foot pain making it difficult to walk or stand
In rare cases, loss of bowel and bladder function (cauda equine syndrome) may occur. This condition requires immediate medical attention.

Diagnosis of Lumbar Disc Herniation

Diagnosis includes medical history coupled with a physical and neurological examination. Neurological examination is done to indicate any neurological injury and involves evaluation of reflexes and muscle weakness by various tests. To confirm the diagnosis, the doctor may order an MRI to evaluate changes in the disc and spinal nerves.

Treatment of Lumbar Disc Herniation

Non-surgical treatment

Non-surgical treatment is preferred over surgery and includes rest, activity modification, physical therapy and pain medication which include non-steroidal anti-inflammatory drugs and muscle relaxants.Various types of and epidural injections can be helpful if performed under X-ray guidance. Back braces are sometimes recommended for a few days to keep the lower back still and reduce mechanical pain due to movement. Physical therapy or acupuncture may be helpful in some cases.

Surgery for Lumbar Disc Herniation

Surgery is usually not needed except in cases with significant leg pain, muscle weakness and numbness that is unresolved after conservative treatment measures. Urgent surgery may be required if neurologic dysfunction-worsens or cauda equine syndrome occurs.