Sciatica: An overview of lumbar herniated discs

A lumbar herniated disc, commonly known as a slipped or ruptured disc, can be a source of significant pain and discomfort. This condition affects the lower part of the spine, called the lumbar region, and understanding its causes, symptoms, and treatment options can help you manage and alleviate the associated pain. Leading pain medicine specialist Dr Mohammed Qureshi explains everything you need to know about the condition.

What is a lumbar herniated disc?

Your spine is made up of bones called vertebrae, which are cushioned by small, spongy discs. These discs act as shock absorbers, allowing flexibility and movement. A herniated disc occurs when the soft inner gel of the disc pushes through a crack in the tougher outer layer. This can irritate nearby nerves and cause pain, numbness, or weakness in the legs.

Causes and risk factors

Several factors can contribute to a lumbar herniated disc. Ageing is a primary factor, as the discs lose some of their water content and flexibility over time, making them more prone to tears and ruptures. Other risk factors include improper lifting techniques, sudden pressure on the spine, repetitive strenuous activities, and being overweight, which places additional stress on the lower back.

Symptoms to watch for

The symptoms of a lumbar herniated disc vary depending on the location of the herniation and the degree of nerve involvement. Common symptoms include:

• Lower back pain: This is usually the first symptom and can range from a dull ache to severe pain.
• Leg pain (sciatica): Pain that radiates down the leg, often described as sharp or burning.
• Numbness or tingling: Affected nerves can cause a sensation of numbness or tingling in the leg or foot.
• Weakness: Muscles served by the affected nerves may become weak, making it difficult to move or lift the foot.

Diagnosis and treatment options

Diagnosing a lumbar herniated disc typically involves a physical examination and a review of your medical history. Imaging tests such as MRI or CT scans may be used to confirm the diagnosis and pinpoint the exact location of the herniation.

Treatment options depend on the severity of the symptoms. Many patients find relief through conservative treatments, including

• Rest and activity modification: Avoid activities that exacerbate the pain, but remain as active as possible.
• Medications: Over-the-counter pain relievers such as ibuprofen or Paracetamol can help manage pain and inflammation. In some cases, stronger prescription medications may be required.
• Physical therapy: Exercises designed to strengthen the muscles supporting the spine and improve flexibility can be highly beneficial.
• Epidural steroid injections: These injections can reduce inflammation around the affected nerve, providing pain relief.

When surgery is necessary

Surgery is considered when conservative treatments fail to relieve symptoms, or if there is significant nerve compression causing severe pain, weakness, or loss of bladder or bowel control. The most common surgical procedure for a lumbar herniated disc is a discectomy, where the herniated portion of the disc is removed to relieve pressure on the nerve.

Understanding your condition and the available treatments can empower you to make informed decisions about your health. If you suspect you have a lumbar herniated disc, consult with a healthcare professional to determine the best course of action tailored to your specific needs.

If you would like to book a consultation with Dr Qureshi, do not hesitate to do so by visiting his Top Doctors profile today