Alternative names: Herniated Lumbar Disc, Slipped Lumbar Disc, Ruptured Lumbar Disc, Herniated Disc In Lower Back, Herniated Lumbar Intervertebral Disc.
A herniated disc in the spine is one in which the outer fluid has leaked out through a tear in the tough outer wall. When this occurs in the upper spine, it is called a Herniated Cervical Disc; when it occurs in the lower spine, it is called a Herniated Lumbar Disc.
Due to the increased stresses placed upon the lower spine, Herniated Lumbar Discs are 15 times more common than Herniated Cervical Discs. Herniation is rare (but possible) in the upper-to-middle back (thoracic) area.
Herniated discs are most common in those aged 30-50, but can occur in older people if they are involved in activity that puts excessive strain on the spine. About three-quarters of people experience low back pain at some point in their lives. Men are more often affected than women.
Disc bulging or herniation can occur for no obvious reason, or for reasons such as:
Various occupational or recreational activities that put excess stresses on the spine can lead to early disc degeneration. Problems often begin when lifting objects without bending at the knee, or twisting while lifting a heavy item.
The leaking material from within a herniated disc can touch or compress a nerve. When this occurs in the lower back, the resulting symptoms can include:
In severe cases, symptoms of a serious problem can include:
If you experience any of these serious symptoms, seek medical help immediately. Emergency surgery is often the only option in such cases.
A doctor will usually begin with discussing the patient's medical history. Patients with herniated discs can often recall a specific incident when their spine was under stress and there was a 'pop'.
During a physical exam, the doctor will test reflexes, muscle strength, range-of-motion, walking ability, and sensitivity to touch, as well as look for tender areas in the back.
Although X-rays alone cannot show herniated discs, other imaging techniques can identify precisely the affected discs and nerves. These techniques include MRI, CT scans, discogram, electromyography, and myelogram.
Lying flat on one's back with knees bent is often useful for reducing the pain because it relieves the pressure on the herniated disc.
Initial treatment includes a combination of:
If symptoms do not resolve (for 80% of people they do, within 6 weeks), then surgery is an option. This may involve removing the herniated portion of the disc, removing the disc completely, or replacing the disc with an artificial disc.
Ways to reduce your risk of developing herniated discs include:
Over time, a herniation tends to shrink and there may be partial or complete pain relief. If the pain is going to resolve by itself, it usually does so within 6 weeks.
In severe cases, a small piece of the herniated disc can become detached and lodge in the spinal canal.
Seek medical attention immediately if you experience severe symptoms such as loss of bowel or bladder control (incontinence).