Lumbar Disc Herniation happens when some of the central material, or nucleus, of the disc pushes through its containing ring, or annulus. This nucleus material irritates nerves both chemically and by direct pressure.
Most people with lumbar disc herniations have pain in the buttock or hip that radiates down the leg. Numbness and weakness may also be present. Most individuals with a disc herniation will have some degree of back pain, but buttock, thigh and/ or leg pain are generally the predominant symptoms.
Disc herniations are diagnosed based on the location and presentation of the symptoms and confirmed with imaging studies, usually an MRI or CT myelogram.
Treatment for lumbar disc herniation varies widely. Almost all treatments are highly effective – approximately 85% get better regardless of the treatment option chosen.
Exercise, physical therapy and chiropractic treatments can all provide relief of symptoms. Exercise should include low impact cardiovascular methods such as cycling or swimming for at least 30 minutes 3 to 5 days each week. Stretching is also beneficial as are formal exercise programs like yoga or pilates.
While narcotic pain medications are often given for disc herniation symptoms, rarely do these medicines provide more than short term relief of symptoms. Most of these medications are highly addictive in nature. Instead, anti-inflammatory medications like ibuprofen or naproxen can provide more long-term relief without the potential for addiction.
Epidural injections may also relieve pain from a herniated disc for periods of time. Often, injections are combined with other non- surgical treatments.
For patients with a progressive loss of function, or for those who are in so much pain that waiting for a few months would not be possible, surgery may alleviate their symptoms more rapidly. Surgery carries some risk, but most complications are rare. The biggest advantage of surgery is that most patients experience a quicker relief of symptoms when compared to nonsurgical treatments.