Lumbar Disc Herniation
What is it?
A common cause of lower back pain is due to a lumbar disc herniation. There are five lumbar vertebrae. These are the bones in the lower back. They are commonly labeled L1-L5. In between each vertebra is a fibrous disc. These discs help absorb shock from the spine.
Lumbar Disc Herniation
Each disc is lined with a strong, tire like substance. This is called the annulus fibrosus. These discs are filled with a gel-like substance. This gel-like substance is known as the nucleus pulposus. A herniated disc is caused when the outer layer of the disc (annulus fibrosus) breaks open. This allows the gel-like substance (nucleus pulposus) to leak out. This can put pressure on the spinal nerves causing pain. Disc herniation is also known as bulging disc or ruptured disc.
Risk Factors
There are many factors that can increase the risk of lumbar disc herniation. One of them includes lifestyle choices. This means lack of adequate exercise, inadequate nutrition, and the use of tobacco products. Another reason for poor disc health is due to age. When the body ages the disc naturally begins to dry out. This can affect disc health and strength. Another risk factor is poor posture. The lack of proper body mechanics can put stress on the lumbar spine. This will decrease the ability of the lumbar spine to carry the body’s weight.
Symptoms
It is common for a lumbar disc herniation to press on a nerve causing pain to radiate. Some of the most noticeable symptoms are nerve pain. This can be described as a sharp, searing, piercing pain. Leg pain is also a common symptom of lumbar disc herniation. Sciatica is a common form of leg pain. This is when the pain radiates down the back of the leg.
One may also feel pain in the low back, buttock, and front of thigh, calf and toes. Location of the pain depends on which disc is herniated. It also depends on how severe the disc is herniated. One may also feel numbness or tingling in these areas. Drop foot is another symptom of lumber disc herniation. This is the inability to lift the foot when walking or standing.
Diagnosis
A physical exam is required when diagnosing lumbar disc herniation. The assessments include a neurological test. The doctor will check to see if there is loss of sensation, weakness, or numbness. A range of motion test will also be performed. This will check to see if there is any pain during certain movements. Another common assessment is a leg raise test. The doctor is looking for pain when the leg is raised between a 30-70 degree angles.
Imaging tests such as MRI, X-rays, CT, and EMG may be included in the visit to rule out anything more serious. Magnetic Resonance Imaging (MRI) provides the most accurate assessment of lumbar disc herniation. X-rays will rule out any broken bones, infections, or tumors. Electromyography can determine which nerve root is impacted.
Treatment
There are many different approaches when treating a lumbar herniated disc. There are a few options to control the pain initially. These include applying ice, heat, over the counter pain medications, and muscle relaxers. Bed rest is recommended for no more than two days. Too much rest could lead to more pain and stiffness. Therapy will also help with herniated discs. For example, physical therapy, acupuncture, massage therapy and chiropractic care. It is essential to talk to a doctor. They will provide proper treatment to meet each individual’s needs.
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