Lumbar Disk Disease (Herniated Disc)
A herniated disc is a bulging of one of the small, round discs between the bones of the spine. A disc that bulges from its proper place puts pressure on spinal nerves. It can cause pain and weakness in limbs. Problems are more common in the lower spine.
|Herniated Lumbar Disc|
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Common causes are:
- The natural aging process (most common cause)
- Poor posture and body mechanics
- Too much pressure on the spine, such as from an inactive lifestyle
- Recent trauma, such as a fall or motor vehicle accident
This problem is more common in older adults. Other things that may raise the risk are:
- A history of low back pain
- Long periods of standing and bending forward
- Strenuous activities, such as heavy lifting
- Genetic problems related to discs
The main symptom is pain that may:
- Be sharp, dull, piercing, aching, burning, or throbbing
- May spread over the back, buttocks, down the back of one thigh, and into the calf or through shoulders and arms
- Be in one leg or both legs or arms
Other problems may be:
- Numbness, tingling, or weakness in the legs, feet, or in one or both arms
- A sudden aching or twisted neck that cannot be straightened without feeling pain
- Numbness in the groin (rare)
- Bowel or bladder changes (rare)
The doctor will ask about symptoms and past health. A physical exam will be done. It will focus on the spine. Images may be taken of the spine. This can be done with:
Most people start to feel better in a few days or weeks. Staying active may be better than full rest. The goal of treatment is to manage symptoms. Choices are:
- Supportive care, such as not sitting for long periods of time, avoiding things that cause pain, and using cold or warm compresses
- Physical therapy to promote strength, flexibility, and range of motion
- Medicines, such as:
- Over-the-counter or prescription pain relievers
- Steroid injections to ease pain and swelling
People who are not helped by these methods may need surgery. Choices are:
- Laminectomy to remove some of the bone over the spine and problem disc
- Microdiscectomy to remove fragments of herniated disc through a small incision
- Spinal fusion to fuse vertebrae together with bone grafts or metal rods (rare)
Exercise and improved strength may help some prevent herniated discs.
- Deyo RA, Mirza SK. CLINICAL PRACTICE. Herniated Lumbar Intervertebral Disk. N Engl J Med. 2016 May 5;374(18):1763-1772.
- Herniated disk in the lower back. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/herniated-disk-in-the-lower-back. Accessed February 17, 2021.
- Lumbar disk herniation. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/lumbar-disk-herniation. Accessed February 17, 2021.