Lumbar Disc Herniation – Symptoms and Treatment

Posted on 30. Nov, 2010 by in Herniated Disc

What Is a Lumbar Disc Herniation?

To properly understand what a lumbar disc herniation is it is important to learn about the structure in question: the intervertebral spinal disc. Between each vertebrae pair in your spine there is a disc that acts as both a shock absorber and a stability mechanism. This disc is made up of a tough outer shell (annulus fibrosus ) and a softer gel-like inner substance (nucleus pulposus). As a disc degenerates, either through age or repeated stress / trauma, the outer shell may begin to weaken in an area allowing for some of the inner substance to bulge or even rupture through.

When the nucleus pulposus leaks through the outer shell of the disc, a disc herniation is formed. It is important to note that not all lumbar disc herniations are actually painful. Lumbar disc herniation symptoms will usually only begin to show if the leaked material comes in contact with a spinal nerve. The symptoms will either come from nerve irritation or from pressure being applied to the nerve. If the lumbar disc herniation puts direct pressure on the sciatic nerve, the patient will usually present symptoms of a condition known as sciatica. If you would like more information on sciatica please see our sciatica page by clicking here.

Common Lumbar Disc Herniation Symptoms

ninety percent of the time, a lumbar disc herniation occurs at either the L4-L5 or the L5-S1 segment, causing pain and symptoms in either the L5 or the S1 nerve.

Below are the lumbar disc herniation symptoms that you would feel when pressure is applied to these nerves.

L5 nerve impingement – Pressure on the L5 nerve could cause pain that radiates into the buttocks along with symptoms of weakness in the big toe and potential foot drop if the ankle is involved. You may also feel numbness and or pain on the top of your foot.

S1 nerve impingement – A patient with a S1 nerve impingement will have a loss of ankle reflexes mixed with weakness in that area. The patient will not be able to perform toe rises because of this loss of function. Other symptoms may include numbness or pain radiating along the sole or outside of the foot.

Lumbar Herniated Disc Treatment Options

Surgery for a lumbar disc herniation is rarely required; conservative treatment measures should be attempted before surgery is considered as long as the herniated disc is not considered to be an emergency. The majority of patients with lumbar disc herniations will notice considerable improvement within the first 6 weeks of treatment.

Listed below are several lumbar disc herniation treatment methods that should be attempted before surgery.

  • Physical Therapy
  • Chiropractic Manipulation
  • NSAID medicines (nonsteroidal anti-inflammatory drugs)
  • Oral steroids such as prednisone or methyprednisolone
  • Lumbar epidural spinal injections (cortisone shots)

Along with the above treatments narcotics may be prescribed to help the patient with pain. It is important to understand that pain narcotics are not an answer to lumbar disc herniation. Narcotics for pain are highly addictive and should be administered with extreme caution.

When considering how to treat your herniated disc, it is important to consult with a medical professional, whether it is your doctor or a physical therapist. An accurate diagnosis can only be made by reviewing your medical history and performing specific tests. Although there is a wealth of knowledge on the Internet, information on the Internet cannot replace the professional advice that a specialist can give you.

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