Lumbar Herniated Discs

A lumbar herniated disc, also known as a slipped disc or herniated nucleus pulposus (HNP), can cause a variety of signs and symptoms. These symptoms are typically related to the compression or irritation of nearby spinal nerves. Here are some common signs and symptoms associated with a lumbar herniated disc:

1. Lower back pain: The most common symptom is localized pain in the lower back, typically on one side. The pain may be sharp, shooting, or aching in nature.
2. Radiating pain: The pain may radiate from the lower back down into the buttocks, thighs, calves, and even the feet. The specific pattern of pain depends on the affected nerve root. For example, if the L5 nerve root is compressed, the pain may radiate to the outer side of the calf and top of the foot.
3. Numbness or tingling: There may be a sensation of numbness or tingling in the areas supplied by the affected nerve. This can include the buttocks, thighs, calves, and feet.
4. Muscle weakness: Weakness may occur in the muscles that are innervated by the compressed nerve. This weakness can affect various muscles in the leg and foot, leading to difficulties in walking, lifting the foot, or climbing stairs.
5. Loss of reflexes: Reflexes controlled by the affected nerve may be diminished or absent. For example, the knee jerk reflex (patellar reflex) may be reduced if the L4 nerve root is affected.
6. Changes in sensation: The affected nerve can cause alterations in sensation. This may manifest as a decreased ability to detect touch, temperature, or pinprick sensations in specific areas.
7. Pain exacerbation with certain activities: Certain movements or positions, such as bending, lifting, twisting, or prolonged sitting, may worsen the pain due to increased pressure on the herniated disc.

The treatment of a lumbar herniated disc depends on the severity of symptoms, the impact on daily activities, and the individual’s overall health. In most cases, conservative (non-surgical) treatments are recommended initially. Here are some common approaches to treating a lumbar herniated disc:

1. Rest and activity modification: Short-term rest and avoiding activities that worsen the symptoms can help alleviate pain and allow the disc to heal.
2. Medications: Over-the-counter pain relievers such as nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce pain and inflammation. In some cases, prescription medications like muscle relaxants or oral steroids may be prescribed for a short duration to manage pain and inflammation.
3. Physical therapy: A structured physical therapy program can help strengthen the muscles supporting the spine, improve flexibility, and promote proper posture and body mechanics. Therapeutic exercises and techniques, such as traction or spinal manipulation, may be employed to relieve symptoms and improve function.
4. Epidural steroid injections: Injections of corticosteroids into the epidural space around the affected nerve can provide temporary relief from pain and inflammation. These injections are typically performed under fluoroscopic guidance by a qualified healthcare professional.
5. Heat or cold therapy: Applying heat or cold to the affected area can help alleviate pain and reduce inflammation. Heat therapy, such as a warm shower or heating pad, may help relax muscles, while cold therapy, such as ice packs, can numb the area and reduce swelling.
6. Traction: Traction therapy involves gently stretching the spine to relieve pressure on the herniated disc and alleviate associated symptoms. It can be done manually or with the help of specialized equipment.
7. Lifestyle modifications: Maintaining a healthy weight, practicing good posture, using proper body mechanics during activities, and avoiding prolonged sitting or heavy lifting can all contribute to the prevention and management of lumbar herniated discs.

In cases where conservative treatments do not provide sufficient relief or if there is severe pain or progressive neurological symptoms, surgical intervention may be considered. Surgical options include discectomy (removal of the herniated portion of the disc) or spinal fusion (joining two or more vertebrae together to stabilize the spine). The decision to proceed with surgery is usually made on an individual basis after consultation with a spine specialist.

It’s important to consult with a healthcare professional for a proper diagnosis and to determine the most appropriate treatment plan for your specific condition. At Total Orthopedics and Sports Medicine we have a full team of specialists to evaluate and treat patients with lumbar disc herniations from conservative treatments to injections to minimally invasive surgery.