Lumbar Disc Herniation

A herniated disc, sometimes referred to as a slipped or ruptured disc, is a common cause of back pain. Discs are small, circular cushions between the bones (vertebrae) of the spine. A herniated disc occurs when a small portion of the disc pushes into the spinal canal. This often causes irritation of one or more nerves and results in pain, numbness or weakness in the back and legs.

Cause of injury

Disc herniation is most often the result of a gradual, aging-related wear-and-tear called degeneration of the discs. As an individual ages, his/her spinal discs lose water content.  When this occurs disc flexibility increases, making individuals more prone to a tear or rupture.  A herniated disc can occur as a result of a fall, an accident or without any specific movement.

Signs and Symptoms

Some individuals may be unaware they have a herniated disc.  Spinal images will often reveal a herniated or bulging disc even though an individual is not experiencing any symptoms. However, herniated discs can be very painful, causing numbness, tingling, pain, or weakness in one or both legs (often referred to as sciatica).

Diagnosis

A herniated disc is diagnosed though the completion of a comprehensive medical history and physical examination. Additional tests such as X-rays, MRI, or CT scan may be ordered to confirm the diagnosis.

Treatment

Depending on symptoms, a physician may recommend anti-inflammatory medication, pain relievers, corticosteroid injections, or physical therapy.  Often individuals experience improvement within a month or two with conservative treatment.  Imaging studies reveal that protruding or displaced portions of the disc can shrink over time.  This often correlates with an improvement in symptoms.  In severe cases, a surgical procedure may be required to repair or remove the portion of the disc causing pain. Proper rehabilitation is essential for return to normal function. A physical therapist can guide rehabilitation to ensure 100% return to activity safely. Therapy initially focuses on decreasing pain/swelling and increasing range of motion. Later stages of therapy shift toward strengthening and return to normal function.

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