A herniated or lumbar disc rupture or lumbar disc is one of the most common causes of lower back pain and leg cramps. A herniated disc can lead to dull or severe pain, muscle spasms or cramping, sciatica, weakness in the legs, and loss of leg function. This can intensify the pain by coughing, sneezing and bending.
Rarely does bowel or bladder control become lost. Seek medical attention immediately. **Sciatica** refers to a lumbar herniated disc. One or more nerves that connect to the sciatic nerve may be put under pressure. This can cause burning, tingling, pain, and numbness. It can extend from the buttock up into the leg, sometimes even into the foot. It is usually the affected side (left or right).
Anatomy: Normal Lumbar Intervertebral Disc
A brief overview of spine anatomy is necessary to better understand how lumbar herniated spinal discs can cause leg and lower back pain. A disc is a hard fibrous shock-absorbing padding that sits between the 5 lumbar vertebrae. The ends of each vertebra are lined with endplates which hold the individual discs in their place. Annulus Fibrosus is a tire-like outer layer that surrounds the disc and contains a gel-like substance (nucleus Pulposus).
When the annulus fibrous ruptures or cracks, disc herniation allows the nucleus of the nucleus to escape. This is also known as a herniated annulus pulposus or herniated disc. You may also have heard it called a ruptured or bulging disc.
If a disc ruptures, it can press against the spinal cord or nerves. Your spine is lined with nerves that branch from the spinal cord, and travel to various parts of your body (to help you feel and function). Nerves pass through small passageways that run between the vertebrae. If a herniated or bulging disc presses into this passageway, it can cause the nerve to compress (or “pinch”) itself. This can cause the discomfort associated with herniated discs.
Risk Factors for Lumbar Herniated Disc
Numerous factors increase the chance of disc herniation. Poor disc health can be caused by lifestyle choices, such as smoking and insufficient exercise. As our bodies age, biochemical changes can cause discs gradually to dry out. This can have a negative impact on disc strength and resilience. The aging process can affect the ability of your intervertebral Discs to absorb shocks from your movements. This is their primary job.
Bad posture, combined with poor body mechanics, stresses the lumbar spine. This reduces its capacity to support the body’s bulk. This is just a small part of the reasons discs can herniate. An example: incorrect lifting can increase disc pressure by several hundred pounds per square inch.
How a Disc Herniates Works
A herniation could occur suddenly or slowly over weeks or even months. There are four stages that can lead to a herniated disc:
- Disc Degeneration is caused by chemical changes in the body that are associated with aging. However, discs do not become weaker.
- Prolapse is when the disc becomes displaced by slight impingement in the spinal canal or spinal nerves. This stage is also known as a bulging disc, or a protruding disc.
- Extrusion: This is where the gel-like nucleus of pulposus penetrates the tire-like wall, annulus fibrosus, but remains in the disc.
- Sequestration, or Sequestered disc: The nucleus poplu breaks through the annulus Fibrosus and can then travel outside of the intervertebral disc.
Diagnosis for Lumbar Herniated Disc
However, symptoms may not be present in every herniated disc. Some people are able to see a bulging or herniated disc on x-rays. Most often, symptoms, including pain, will prompt the patient or their doctor to seek medical treatment. The doctor will usually perform a physical and neurological exam. Your medical history will be reviewed and questions asked about your past and current pain management efforts.
A x-ray may also be required to rule out other causes such as osteoarthritis or spondylosis. A CT or MRI scan is used to determine the extent and position of disc damage. Sometimes a myelogram will be required. A dye injection will be performed during that test. The dye will appear well on a CT scan and will allow your doctor to pinpoint problem areas more clearly.
Lumbar Disc Herniation Treatment that is Non-Surgical
Doctors may recommend cold therapy or medication after an injury has occurred. In the first 24 to 48 hour, cold therapy reduces swelling, muscle spasm and pain by decreasing blood flow. Apply cold or ice to the skin only once you have wrapped the towel in it. Some medications may contain an anti-inflammatory to reduce swelling and a muscle relaxant or pain-killer (acute pain) to ease intense, but brief-lasting pain.
Non-steroidal Anti-Inflammatory Drugs (NSAIDs), may be used for mild to moderate pain. These drugs relieve both pain and swelling. Discuss any of these medications with your doctor first. The majority of heat therapy can usually be used within 48 hours. To warm and relax the soft tissues, heat increases blood circulation. An increase in blood flow aids in flushing out irritating toxins. Don’t apply heat directly on the skin, as it is dangerous. Wrap the heat source with a towel for not more than 20 minutes.
Spinal Injection
An epidural steroid injection may be prescribed if severe leg pain is present or if there is a possibility of leg weakness. An epidural steroids injection is a procedure that injects anti-inflammatory medication into the area around the affected nerves of your lumbar spine. Before beginning treatment, you should talk with your doctor about this option and discuss potential side effects.
Physical Therapy
A doctor might recommend physical therapy. The prescription from the doctor is transmitted to the physical therapy. Physical therapy is a combination treatment that helps to reduce pain and improve flexibility. Your physical therapist can help you determine the best treatment for your pain and other symptoms. The good news? Most patients feel relief within four to six weeks.
Lumbar Herniated Disc Surgical Treatment
Spine surgery can be considered when non-surgical treatment fails to alleviate symptoms. A further evaluation is needed if you experience constant pain, weakness in your legs, or loss of functionality. Rarely does lumbar herniated dist cause bowel/bladder dysfunction or groin/genital pain. These conditions require immediate medical attention.
Ask about the purpose of surgery and the expected outcomes. Make sure you understand everything that is being suggested. Don’t be afraid to ask for a second opinion from a spine surgeon. It is a major decision that you don’t want made lightly.
A discectomy (removal or partial of the intervertebral disc) is usually performed to relieve nerve pressure and leg discomfort. A surgeon may also be required to access the herniated nerve by removing part of the bone surrounding it. This is known as a laminotomy. These procedures can often be performed using minimally invasive techniques. Minimally invasive spine surgery is not a complicated procedure. It involves small incisions and the use of specialized instruments such as an endoscope and microscope.
Is it possible to prevent a Lumbar Herniated Disc
In this article we mentioned that a common cause for a lumbar herniated spine is aging. We can’t change that. Do you think that you cannot prevent a lumbar herniated disc? You can’t. It is possible to control several things. You can exercise and take good care your spine by watching your posture and not smoking. Although you may not avoid a lumbar herniated, they can help to alleviate lower back pain.
Your Spine, Your Nerves
Between vertebrae, spinal discs act like shock absorbers. They are composed of an outer layer (the annulus fibrosus) that is hard and covers a soft, jelly-like center (the nucleus pilosus). If a disc becomes damaged, it can bulge out of its normal boundaries and cause irritation to nearby spinal cords. In more severe cases, an annulus fibrosis could weaken or tear allowing the nucleus material to leak out.
This can result in the spinal cord becoming compressed or nerves being paralysed. They might not function properly and abnormal signals can be sent from and to the brain. Five vertebrae are located near the base and lumbar regions of the spine are the most common locations for lower back herniations. A sciatic nerve irritation can lead to severe pain in this area of the spine. It runs from the lower spine down the legs. It is the largest nerve of the peripheral nervous systems, and connects the brain to the rest.
A variety of causes can lead to herniated discs. These include age-related degradation, obesity, trauma, excessive spin, and lack of conditioning.
Pain and other related symptoms
Due to nerve irritation, muscle spasms, inflammation, and lower back pain, the most common sign of herniation is lower back pain.
Radiculopathy is also a common condition that results in abnormal nerve signaling. These symptoms include:
- Electric shock pain: A nerve pressure can cause abnormal sensations that are often referred to as electric shock pains. Lumbar herniations: The shocks can be sent down one leg or both.
- Tingling//or numbness: Many patients experience unusual sensations, such as tingling, pins and needles, down one or both their legs, or numbness.
- Muscle weakness. The brain’s nerve signals may be disrupted, which could lead to lower-body muscle weakness.
- Bowel and bladder problems: These symptoms may indicate cauda-equina Syndrome, a rare condition that results from a herniated disc separating the L5 vertebrae from the first vertebrae.
You should immediately see a healthcare professional if your back/leg pain is accompanied with problems urinating, having bowel movements or numbness around the anus. This is considered a medical emergency.
Severe cases
A herniated disc can cause spinal cord compression.
- Balance and walking difficulties
- Apparent clumsiness/dropping of things
- Leg cramps or weakness
- Difficulty in handwriting, picking small objects up, or with other fine-motor tasks
- Bladder and bowel dysfunction
