CNY Orthopedic Sports Medicine, PC: Injury: Lumbar Disc Herniation

Injuries and Conditions: Back & Spine: Lumbar Disc Herniation

Overview
The herniation or rupture of a lumbar disc occurs when the center or soft part of the disc (the nucleus palpasus) bulges or ruptures through the peripheral or fibrous portion of the disc (the annulus). Also known as a ruptured disc, herniated nucleus pulposus (HNP), or a slipped disc, this injury may occur when the ligaments surrounding the intervertebral disc become damaged or are weakened due to injury or from advancing age of the spine.

The injury can result from a from a sudden strenuous movement, trauma, or after degenerative changes in the spine. The result is a herniated disc that may compress, irritate or even permanently damage the nerve root. The severity and level of the lumbar disc herniation determines the type of signs and symptoms experienced by the patient.

  • Lumbar Disc herniations are seen in all age groups, but are most prevalent in men between the ages of 35 and 45.
  • The severity of symptoms of a disc herniation can vary from mild discomfort to disabling pain and nerve dysfunction.
  • The pain associated with a lumbar disc herniation is characterized by a sharp, burning, or stabbing sensation, which radiates down one or both legs. The symptoms associated with a herniated disc are sometimes referred to and confused with the condition of sciatica.
  • Initial treatment is non-surgical dependent on symptoms. Surgery is required to remove the herniated disc material, when symptoms of pain and/or nerve or when non-surgical therapies have failed.
  • Both non-surgical and surgical treatment options result in good outcomes.


  • Signs and Symptoms
  • The onset low back pain is usually sudden and severe.
  • Weakness, numbness, or a tingling sensation may be present in one or both legs.
  • Pain running from one buttock to the lower leg or foot.
  • Pain that worsens with sitting, bending, lifting, coughing or straining.
  • Severe nerve compression may cause changes in bowel and bladder functions (immediate medical care is essential in these cases).
  • The pain of a herniated disc is usually worse with movement.
     
  • Contact the Doctor if ...
  • If any signs and symptoms of a lumbar disc herniation are present, an evaluation by an orthopaedic specialist is recommended.
  • If severe pain, weakness and/or bowel and bladder dysfunction are present at any time.
  • If the pain following the injury, has not been relieved through rest and medication.


  • Common Causes of Injury
  • A lumbar disc herniation can occur when normal degenerative changes (wear and tear arthritis) of the spine have weakened the ligament, which surround and support the discs within the spinal column, the lack of support results in collapse and compression of the disc. The increased pressure causes the disc to be squeezed out from between two vertebrae.
  • A lumbar disc herniation can result from a sudden impact to or twisting motion of the spine.
  • The risk of disc herniation increases when the patient lifts heavy objects with poor posture, or participates in an occupation where excess strain and twisting are placed on the spine.
  • Participation in sports such as diving, weightlifting, golf, are examples of recreational activities that may increase the risk for lumbar disc herniation.


  • Expectations of Recovery
  • With proper medical care and rehabilitation, recovery utilizing non-surgical therapy can be expected within three to six months of the injury.
  • Surgery is required in only 10% of the patients who are diagnosed with a disc herniation.


     

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