Lumbar disc herniation is a common condition and affects 0.5-2% of the population at any given time. The primary cause of lumbar disc herniation is the degeneration of disc material, which can lead to the outer disc layer tearing and the inner gel-like nucleus pulposus extruding into the spinal canal. This bulging or rupture places pressure on adjacent nerves, leading to inflammation and a variety of symptoms.
What are the symptoms of lumbar disc herniation?
Common symptoms include nerve root pain or sciatica (pain radiating down the leg), numbness, tingling, and muscle weakness in the lower limb. There may also be some associated lower back pain. The symptoms tend to affect the area of the lower limb supplied by the particular spinal nerve root. In rare cases, compression of the nerves which supply bladder, bowel and sexual function may lead to loss of these functions, known as cauda equina syndrome, and this requires urgent surgical intervention.
How are lumbar disc herniations diagnosed?
Following a thorough clinical assessment, you will be referred for an MRI scan. The MRI will show the disc herniation and resulting nerve compression causing the symptoms.
What are the treatment options for lumbar disc herniation?
The majority of lumbar disc herniations do not require surgery, and symptoms settle, usually within around 3 months. Initial treatment typically involves anti – inflammatory and anti – neuropathic medications, physiotherapy, and may involve lifestyle modifications. Epidural steroid injections might be considered to reduce inflammation and pain.
Surgery (microdiscectomy) is generally reserved for severe cases where there is significant nerve compression causing persistent pain despite non-operative measures, or neurological compromise (e.g. weakness). The goal of surgery is to remove a portion of the herniated disc to relieve pressure on the spinal nerve leading to improved function and alleviation of symptoms.
