Lumbar Disc Herniation: Symptoms, Causes, and Treatment

Our spine is a fascinating and complex structure that plays a crucial role in supporting our bodies and allowing us to move freely. To better understand how injuries to the discs occur, it's essential first to understand the anatomy and physiology of the spine.

Structure of the Spine

Our spine is made up of 33 vertebrae stacked on top of each other. These vertebrae are separated by intervertebral discs, which act as shock absorbers and provide flexibility to the spine.

Vertebrae

The vertebrae are the individual bones that make up the spine. They are divided into different regions: cervical, thoracic, lumbar, sacral, and coccygeal. Each vertebra is a uniquely shaped bone that provides support and stability to the spine. The vertebrae are connected by facet joints, allowing smooth and controlled movements. The vertebral column also serves as the protective canal for the spinal cord, which transmits signals between the brain and the rest of the body.

Intervertebral Discs

Intervertebral discs are the spongy, cartilaginous pads found between the vertebrae. They are composed of an outer fibrous ring called the annulus fibrosus and an inner gel-like substance called the nucleus pulposus.  

Functions of the Intervertebral Discs

Intervertebral discs play two primary roles in the overall function and health of the spine:

Shock Absorption

One of the primary functions of the intervertebral discs is to act as a shock absorber for the spine during everyday activities. This shock-absorbing capacity helps protect the vertebrae and prevent injuries. However, the discs can wear down over time, making them less effective at absorbing shock. This wear and tear can increase the risk of conditions like lumbar disc herniation.

Spinal Flexibility

 

What Is A Lumbar Disc Herniation?

A lumbar disc herniation occurs when the outer layer of an intervertebral disc tears, allowing the soft inner material to bulge or leak out. This can cause nerve compression and pain, numbness, or weakness. Here are the common causes:

Age-related Degeneration

As we age, the intervertebral discs lose some water content and become less flexible. This process, known as disc degeneration, can make the discs more susceptible to tearing and herniation. Age-related degeneration is a common cause of lumbar disc herniation, highlighting the significance of preserving a healthy spine throughout one's life.

Physical Trauma or Injury

Sudden physical trauma or injury, such as a fall, a car accident, or a sports injury, can cause damage to the intervertebral discs and lead to lumbar disc herniation. In these cases, prompt treatment is crucial to minimize long-term damage and prevent chronic pain. 

Genetic Predisposition

Some individuals may have a genetic predisposition to lumbar disc herniation, and research has found several inherited factors that affect intervertebral disc structure and strength. While you cannot change your genetics, understanding your family history can help you take proactive measures to protect your spine and reduce the risk of herniation.

Lifestyle Factors

Several lifestyle factors can contribute to lumbar disc herniation, including:

Sedentary Lifestyle

A sedentary lifestyle can weaken the muscles that support the spine. That lack of stabilizer strength increases pressure on the intervertebral discs, resulting in a higher risk of herniation. Physical activity and targeted exercises can help maintain a strong and healthy spine. 

Poor Posture

Poor posture can place additional stress on the intervertebral discs and increase the risk of herniation. It can be static (think sitting or standing) or dynamic (think how you lift things).

Obesity

Excess body weight can put extra pressure on the intervertebral discs, making them more prone to damage and herniation. Maintaining a healthy weight through diet and exercise can help reduce the risk of lumbar disc herniation. 

 

What Are The Symptoms Of Lumbar Disc Herniation?

A herniated nucleus propulsus can compress a nerve root as it exits the spinal canal. This mechanical compression can lead to irritation of the nerve root. The herniated disk can also leak inflammatory chemicals, causing chemical irritation of the nerve root. The medical term for this compression is "lumbar radiculopathy". As a result, herniations can manifest in various ways, affecting your daily life and overall well-being. Here are some of the most common symptoms associated with this condition:

Lower Back Pain

One of the primary symptoms of a lumbar herniated disc is lower back pain, which can range from mild to severe. The pain may worsen when sitting, bending, lifting, or twisting, making everyday tasks difficult.

Pain In Legs

Nerve roots send sensory signals from the body to the brain and motor signals from the brain to the body. When a nerve root gets compressed, the sensory signals relayed to the brain get interpreted as pain. The pattern in which you feel the pain correlates to a particular level of nerve root irritation. A common example of this compression is sciatica.

Numbness and Tingling

Nerve compression from a lumbar disc herniation can also cause numbness and tingling in the buttocks, hip, groin, or leg. Patients with lumbar disc injuries may describe this as "pins and needles." It's essential to address these symptoms promptly to prevent long-term nerve damage.

Weakness

Compression of a nerve root can disrupt the motor signal from the brain to the body. As a result, the muscles innervated by a given nerve root may become weaker. If left untreated, that weakness can progress to muscle atrophy. 

 

How Lumbar Herniated Discs Diagnosed?

To determine if a disc is herniated, healthcare professionals must assess the patient's condition and choose the best course of treatment. Here's what to expect during the diagnostic process:

Physical Examination

A thorough physical exam is the first step in diagnosing a lumbar spine disc injury. A doctor will assess your range of motion, muscle strength, and reflexes. They may also ask about your medical history, looking for details that could contribute to your symptoms. The Capital Sports Medicine Approach emphasizes a comprehensive evaluation to ensure the best possible treatment plan for each patient.

Imaging Techniques

If your healthcare provider suspects a disc injury, they may recommend imaging tests. Imaging studies can confirm the diagnosis and assess the severity of the condition. Standard imaging techniques include:

• X-rays: X-rays produce images of the bones of your body, not of soft tissues like intervertebral discs. However, they can help rule out other causes of back pain, such as fractures, infections, or tumors.
• MRI (Magnetic Resonance Imaging): MRI scans use a magnetic field to produce very clear images of the organs and structures inside your body. It is the "gold standard" for identifying disc herniation and potential nerve compression.
• CT (Computed Tomography) scans: CT scans combine X-ray technology with computer processing to create detailed cross-sectional images of the body. Although they are less detailed than an MRI, they are quicker and a less expensive alternative.

The use of these imaging techniques will depend on your specific situation and the healthcare provider's assessment. 

 

What Is The Treatment For Lumbar Disc Herniation?

There are a variety of approaches to consider when treating lumbar spine disc injuries. The approach will depend on the severity of the condition and the patient's individual needs. Here's a closer look at the different treatment options:

Conservative Treatments

Often, conservative treatments can help ease the symptoms of a herniated disc without the need for more invasive measures. Common non-invasive treatments include:

• Rest and activity modification: Avoiding activities that worsen your symptoms is a crucial first step. As mentioned in our blog post on why rest is not always the best, finding the right balance between rest and activity is essential for recovery.
• Medication: Medicine may be prescribed to manage pain, reduce inflammation, and relax muscle spasms. Be sure to consult with a healthcare professional before starting any new medication.
• Chiropractic care: Chiropractic adjustments can improve joint motion, allowing for better movement and less pain.
• Physical therapy: A low-level rehab or high-level rehab program guided by a professional can help improve strength, flexibility, and overall function.

Surgical Treatments

Surgery may be necessary in severe cases or when conservative treatments have not provided enough relief. Common surgical treatments for disc injuries include:

• Microdiscectomy: A minimally invasive procedure that removes a part of the herniated disc material, relieving pressure on the spinal nerves.
• Lumbar laminectomy: A procedure that removes a piece of the vertebrae (lamina) to create more space for the spinal nerves and ease pressure.
• Spinal fusion is a surgery that permanently joins two or more vertebrae to provide stability and reduce pain.

Ultimately, the best course of treatment will depend on your specific condition and the guidance of your healthcare professional. Be sure to consult with a specialist, such as the experts at Capital Sports Medicine, to determine the most effective treatment plan for your needs.

 

Can Lumbar Disc Herniations Be Prevented?

Caring for your spine is the best way to prevent lumbar disc herniation. Adopting a healthy lifestyle and being mindful of your body mechanics can reduce the risk of developing this condition. Here's what you can do:

Exercise and Strengthening

Regular physical activity and targeted exercises can help strengthen the muscles around your spine, providing support and reducing the risk of injury—our blog post on pro tips to keep your spinal discs healthy offers valuable insights.

Maintaining a Healthy Weight

Carrying excess weight can put your spine under unnecessary stress, increasing the risk of disc herniation. Maintaining a healthy weight through a balanced diet and regular exercise can help reduce strain on your spine and promote spinal health.

Proper Lifting Techniques

Proper lifting techniques are crucial to avoid putting excessive strain on your back. Here are some tips for lifting objects safely:

1. Plan ahead: Before lifting any object, take a moment to consider your task. Check the weight of the object, its shape, and any obstacles in your path. Decide the best way to lift, carry, and set down the object.
2. Bend at the knees, not at the waist: Squat down by bending your knees, not your waist. Keep your back straight and your head up while you squat.
3. Maintain good posture: Keep your shoulders back and your chest out while lifting. Avoid hunching or slouching.
4. Keep the object close to your body: Hold the object close to your body, with your feet shoulder-width apart and your knees bent. This will help distribute the weight evenly across your body.
5. Use your legs: As you lift the object, push up with your legs rather than your back. This will help avoid strain on your back muscles. We like to use a cue: "Think about squashing an orange underneath your shoelaces."
6. Lift with a partner: If an object is too heavy to lift by yourself, get help from a co-worker or friend. Make sure you and your partner are lifting in unison.
7. Avoid twisting: Avoid twisting your back while holding the object. Instead, turn your entire body, feet included, to change directions.

By following these proper lifting techniques, you can help prevent the type of strain that causes a disc to rupture.  

Ergonomics and Posture

Maintaining good posture is essential to reduce the stress on the spine's joints. Optimizing ergonomics at your workspace can also help reduce the risk of lumbar disc herniation.

Incorporating these preventative measures into your life can significantly decrease the risk of lumbar disc herniation and promote a healthier spine. Remember, prevention is always better than cure, and taking care of your spine today can help ensure a pain-free tomorrow.

Don't let a herniated lumbar disc hold you back. At Capital Sports Medicine, we're committed to helping you conquer your pain and live life to the fullest. Whether you're dealing with back pain, neck pain, shoulder pain, or hip pain, our expert team is here to support you every step of the way. Request an appointment today to begin your journey toward a pain-free life.