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Lumbar Disc Herniation

WHAT YOU NEED TO KNOW:

What is lumbar disc herniation?

Lumbar disc herniation occurs when a disc in your lumbar spine (lower back) bulges out. Lumbar discs are spongy cushions between the vertebrae (bones) in your spine. The herniated disc may press on your nerves or spinal cord.

What increases my risk for lumbar disc herniation?

Aging increases your risk for a herniated disc because your discs weaken and shrink as you get older. This causes the disc to lose its cushion and bulge out between your vertebrae. The following also increase your risk for a herniated disc:

  • Back strain caused by heavy lifting
  • Repetitive activities that strain your back, such as jobs that require pulling, bending, or twisting
  • Frequent driving
  • Being overweight
  • Not getting regular physical activity

What are the signs and symptoms of lumbar disc herniation?

Mild lumbar disc herniation may not cause any signs or symptoms. You may have any of the following if the herniated disc presses against your nerves or spinal cord:

  • Pain in your lower back, buttocks, groin, or legs
  • Burning, stabbing, or tingling pain that shoots down one or both of your legs
  • Numbness or weakness in one leg
  • Trouble walking or moving your feet or toes

How is lumbar disc herniation diagnosed?

Your healthcare provider will ask you about your symptoms and any health problems you may have. He or she may examine your spine for any abnormal areas. Tell him or her if any area on your spine is painful when touched. Your provider may also check the reflexes in your ankles and knees. You may also need any of the following tests:

  • A straight leg raise test is done to check if your disc is pressing against your nerves or spinal cord. Your healthcare provider will ask you to lie flat on your back, with your legs straight. He or she will then raise each leg as far as possible. Ask your provider to stop if this test causes you pain.
  • An MRI or a CT may show the bulging disc. You may be given contrast liquid to help the disc show up better in the pictures. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if you have any metal in or on your body.
  • A myelography is an x-ray or CT scan of your spinal cord. Dye will be given as an injection into the area around your spinal cord before the pictures are taken.

How is lumbar disc herniation treated?

Your healthcare provider may have you rest in bed for a few days. It is best to rest on your side with your knees bent. Put a cushion between your knees to help decrease the pressure on your spine and nerves. You may also need any of following:

  • NSAIDs , such as ibuprofen, help decrease swelling, pain, and fever. NSAIDs can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask your healthcare provider if NSAIDs are safe for you. Always read the medicine label and follow directions.
  • Prescription pain medicine may be given. Ask how to take this medicine safely.
  • Muscle relaxers decrease pain and muscle spasms.
  • A steroid injection may be given to reduce inflammation. Steroid medicine is injected into the epidural space. The epidural space is between your spinal cord and vertebrae. You may be given pain medicine along with the steroids.
  • Physical therapy may be recommended by your healthcare provider. A physical therapist teaches you exercises to help improve movement and strength, and to decrease pain. A physical therapist can teach you safe ways to bend, lift, sit, and stand to help relieve back pain.
  • Surgery may be needed to fix your herniated disc if other treatments have failed. Surgery may be done to remove your herniated disc and make your spine stronger. Surgery may also be done to decrease pressure on your nerves and spinal cord.

How can I manage pain from a lumbar disc herniation?

  • Apply heat on your lower back for 20 to 30 minutes every 2 hours for as many days as directed. Heat helps decrease pain and muscle spasms.
  • Do low-stress exercise and activity. Exercises that do not stress your back muscles may help decrease your pain. Examples of low-stress exercises are walking, swimming, and biking. Avoid heavy lifting while your back is healing. Try not to sit for long periods of time. Talk to your healthcare provider before you start any new exercise program.

When should I seek immediate care?

  • You cannot control when you urinate or have a bowel movement.
  • You are unable to move one or both of your legs.
  • You lose feeling in your groin or buttocks.

When should I contact my healthcare provider?

  • You have numbness in one or both of your legs.
  • You have low back pain while resting.
  • You have trouble moving one or both of your legs.
  • You begin leaking urine or bowel movement.
  • Your pain gets worse, even after you take medicine.
  • You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2017 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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