What we need to know about lumbar herniated discs

Top Doctors recently spoke to esteemed consultant orthopaedic and spinal surgeon, Mr Rohit Shetty, who, here in this article below, sheds some expert light on all things lumbar herniated discs.

What is a lumbar herniated disc, and what symptoms suggest it?

80 percent of our disc is made up of moisture. The loss of moisture in the spine in your 80s and 90s is an age-related process, but in some people, it is genetically disposed. Up to between 25 and 40 percent of people in their 20s and 30s though, although unaware, are walking around with a lumbar herniated disc that hasn’t produced any symptoms.

The main symptoms are pain going down either of the legs going all the way down to the feet, tingling, and pins and needles.

How is a lumbar herniated disc treated?

It is always important to know what happens to a slipped disc. The most predictable factor is that when people get pain down the leg, between 40 and 60 per cent of people notice that this will go away by itself after about four weeks.

Seeing a physiotherapist is usually very helpful. Painkillers are also highly effective. Unfortunately, each individual is different, so people might notice that their symptoms do not get better after four weeks.

A slipped disc occurs in 60 per cent of the population between the ages of 45 and 60. Individuals get referred to spinal surgeons in cases where their symptoms do not improve after four to six weeks. An MRI scan is then carried out.

A significant amount of people with a lumbar herniated disc will see their symptoms settle down by itself, allowing it to run its course. In cases of persistent pain, a steroid spinal injection is considered.

What are the risks of lumbar herniated disc surgery?

A lumbar disc operation has different techniques. The gold-standard is a microdiscectomy. The success rate is 85 per cent. 70 percent of people who undergo this operation will be pain free after it. The benefits outweigh the risks.

The chance of a slipped disc recurring after the operation is only seven per cent. The recovery time is about three months, after which people can return to their normal activities.

The risks are extremely small. There is a chance of spinal leakage and a damaged nerve, but these are incredibly minimal. There is also a minute chance of infection.

Usually, it is an overnight stay. The following day, a physiotherapist will come and guide you to do some activities.

The wound normally takes about 10 days to fully heal. The initial four to six weeks is just about recovering from the surgery, doing gentle exercises. At six weeks, you can get back to swimming, work, and driving.

Are there any red flags to watch out for in relation to lumbar herniated disc?

In people who have a large-sized herniated disc, it can press on the nerves responsible for bladder and bowel function. If you notice pain going down one or both legs, an inability to control your bladder, and if you feel numbness when you wipe your back passage, you should go to A&E as soon as possible.

Once there, an MRI scan will be carried out and then, if needed, surgery will be performed to preserve the function of the bladder and bowel. Also, if you notice you’re not able to put your foot up towards you, then I recommend you get seen between one to two weeks.

To consult with Mr Rohit Shetty today, head on over to his Top Doctors profile.