Lumbar herniated disc: Causes, symptoms and treatment

A lumbar herniated disc, also known as a slipped or ruptured disc, occurs when the soft inner gel of a spinal disc in the lower back (lumbar region) protrudes through a tear in the tougher outer layer. This condition can cause significant pain and discomfort, as the herniated material can irritate nearby nerves. In her latest online article, renowned consultant neurosurgeon Mrs Anne Mitchener offers her expert insight into this condition, including the common causes, symptoms and treatment options.

Causes of a lumbar herniated disc

Several factors can contribute to the development of a lumbar herniated disc, including:

• Age-related degeneration: As we age, the spinal discs lose water content, becoming less flexible and more prone to tearing.
• Trauma or injury: Sudden physical trauma, such as a fall or an accident, can cause a disc to herniate.
• Repetitive strain: Jobs or activities that involve repetitive lifting, pulling, or twisting can place excessive stress on the lumbar spine.
• Genetic predisposition: A family history of herniated disc can increase the likelihood of developing this condition.
• Obesity: Excess body weight places additional stress on the spinal discs, particularly in the lower back.

Symptoms of a lumbar herniated disc

The symptoms of a lumbar herniated disc can vary depending on the severity of the herniation and the specific nerves affected. Common symptoms include:

• Lower back pain: Persistent or intermittent pain in the lower back, which may worsen with movement.
• Leg pain (Sciatica): Sharp, shooting pain that radiates from the lower back down one or both legs, often following the path of the sciatic nerve.
• Numbness or tingling: Sensations of numbness, tingling, or pins and needles in the legs or feet.
• Muscle weakness: Weakness in the muscles of the lower back, legs, or feet, which can affect mobility and balance.

Treatment options for lumbar herniated disc

Treatment for a lumbar herniated disc typically begins with conservative methods, progressing to more invasive procedures if necessary. Common treatments include:

• Rest and activity modification: Limiting activities that exacerbate symptoms while maintaining gentle movement to avoid stiffness.
• Medications: Over-the-counter pain relievers, nonsteroidal anti-inflammatory drugs (NSAIDs), and muscle relaxants can help manage pain and inflammation.
• Physical therapy: A physical therapist can design a personalised exercise program to strengthen the muscles supporting the spine and improve flexibility.
• Epidural steroid injections: Corticosteroid injections can reduce inflammation around the affected nerve, providing temporary relief from pain.
• Surgery: In severe cases, when conservative treatments fail, surgical options such as a microdiscectomy or laminectomy may be necessary to remove or repair the herniated portion of the disc.

Complications

While many individuals with a lumbar herniated disc recover with either conservative or surgical treatment, there are potential risks and complications associated with this condition, including:

• Chronic pain: Persistent pain that does not respond well to treatment.
• Nerve damage: Prolonged pressure on a nerve can lead to permanent damage and loss of function.
• Recurrence: Even after successful treatment, there is a risk of the disc herniating again in the future.
• Cauda equina syndrome: A rare but serious condition where severe compression of the spinal nerves leads to loss of bowel or bladder control and requires immediate medical attention.

Mrs Anne Mitchener is a renowned consultant neurosurgeon based in central London and Surrey. If you would like to book a consultation with Mrs Mitchener, you can do so today via her Top Doctors profile