Lumbar Disc Herniation
Overuse, degeneration or impact causes the shape of a lower back disc to break down.
Discs are round cartilage between the vertebrae, more elastic than ordinary cartilage, that spread and cushion shock and load. When a disc slips out, it is called a cervical disc herniation in the neck and a lumbar disc herniation in the lower back.
Common causes
01
Spinal canal narrowed by degeneration
02
A naturally small spinal canal
03
Holding poor posture for long periods
04
Disc degeneration
Signs to watch for
- Pain gets worse after using the back a lot
- Over time, radiating pain from the back down the leg
- Tingling, numbness and abnormal sensation in the leg; in severe cases, weakness that makes the foot drag
How we diagnose
X-ray
The basic first test. Further tests may be added for a definite diagnosis.
MRI
Shows soft tissue that X-ray cannot, such as muscles, ligaments, discs, cartilage, nerves and blood vessels.
How we treat it
More than 90% of disc patients improve with non-surgical treatment. If pain starts, don't ignore it; come in for an accurate diagnosis.
Nerve block (non-surgical)
A mix of medications, such as a steroid, local anesthetic, and anti-adhesion agents, is delivered through a long needle deep to the painful nerve. This removes adhesions and calms inflammation, relieving pain and helping prevent recurrence. It is done while watching a live monitor, so the medicine reaches the exact source of pain.
Radiofrequency disc decompression
A thin, long needle is placed into the herniated part of the disc and radiofrequency heat is applied, shrinking or firming the disc so it can recover. Like surgery, it can address the root cause.
Laminoplasty (surgery)
The lamina at the back of the vertebra is cut and reshaped to relieve pressure on the nerve, without removing or greatly changing the bone. It requires advanced surgical skill.
When surgery is consideredSurgery is done when pain continues despite conservative and non-surgical treatment, or when the disc has ruptured and cannot recover its shape.