Disc Herniation (Lumbar)

Introduction

Intervertebral discs are positioned in between each vertebral body (the bones of the spine). Each disc is composed of a tough outer ring (the annulus) and a soft gel-like inner core (the nucleus).  Disc degeneration or acute injury can cause the nucleus to herniate into the spinal canal or the neural foramen.  The herniated disc material can irritate the nerve root (radiculitis), which can cause pain to radiate down the path of the nerve from the lower back through the buttocks and into the leg or even into the foot.

Symptoms

  • Sharp pain that travels into the buttocks and back of the leg (sciatica)
  • Burning, tingling, or numbness in the leg or foot
  • Muscle weakness in certain muscles of one or both legs*
  • Loss of reflexes in the leg*
  • Loss of bowel or bladder control*

* These symptoms may indicate a very serious condition, medical attention should be sought immediately

Treatment

Treatment for a lumbar disc herniation will largely depend on the length of time the patient has had symptoms and the severity of the pain. For most patients, symptoms from a lumbar disc herniation will go away over time.  Patients usually start with 3 to 6 months of conservative (non-surgical) treatments.  Surgery may be considered if a course of conservative treatment does not provide pain relief, or if the pain is too severe and the patient is having difficulty functioning.  Conservative treatments include:

  • Physical therapy, chiropractic manipulation, stretching programs
  • Ice or heat
  • Anti-inflammatory drugs (ibuprofen, naproxen, etc.)
  • Prescription pain medications
  • Lumbar epidural steroid injections
  • TENS