Lumbar Herniated Disc

There are soft rubbery pads found between vertebrae called discs. These discs allow the back to flex or bend, as well as act as shock absorbers. A herniated disc occurs when your disc ruptures out through a tear typically due to natural wear and tear. If the disc rupture is in the lower back, it is a lumbar herniated disc, which can cause pain in the lower back, pelvis, and legs.

Cause

In addition to the gradual wear and tear that comes with aging, there are other factors that can increase the risk of lumbar disc herniation such as:

Repetitive activities that strain your spine

Improper lifting

Staying seated for a long time (such as frequent driving)

Poor posture

Being overweight or excessive drinking and smoking

Frequently wearing high heeled shoes

Symptoms

Pain in the lower back, pelvis, and legs

Numbness or tingling sensation in the hip, leg, and/or foot

Stiffness in the back

Pain in coughing, sneezing, or during bowel movement

Pain when seated

Description of the condition

Various risk factors described above can cause the degeneration and drying of the lumbar disc. This could result in the disc to bulge out and press on the nerve roots and cause pain, weakness, numbness, or changes in sensation. Depending on the location of the hernia, the location of your symptoms may be different. Initially you may experience pain only in the lower back, but that may spread to one leg, and then to the other leg. If your nerve is severely pressured, you may experience numbness and even paralysis.

Tests and Diagnosis

Straight leg raise test: In this test, you lie on your back and your doctor lifts your affected leg while your knee stays straight. If you feel pain down your leg and below the knee, you are strongly suspected to have lumbar disc herniation.

The doctor will also do a nerve examination where you lie on your stomach and lift your leg up so that your heel will touch your hip. If there is pain or any other abnormal changes, you may have lumbar disc herniation

To help confirm the diagnosis, an MRI is needed to see a clear and detailed image of your back.

Treatment

Conservative Treatment

If your condition is in the initial stages or not severe, rest, medication (anti-inflammatory and muscle relaxant), physical therapy, and massage therapy may be recommended.

Non-surgical Treatment

If conservative methods provide no relief, a non-surgical treatment option such as Epidural Decompression is available. Epidural injections (thickness of 1mm) are administered into the epidural space to reduce inflammation of the nerve and the disc.

Surgical Treatment

If your condition is severe, you may need surgery. Minimally Invasive Arthroscopic laminectomy is a surgery where a tiny incision is made and the ruptured disc is removed. This requires an overnight hospital stay of 2~3 days.