Lumbar disc herniation is a painful lower back condition. It can occur after gradual “microtraumas” over an extended period of time. Or, it can occur after a single heavy load or traumatic event.
A herniated lumbar disc is also called a slipped disk or a ruptured disk. Herniated disks can occur anywhere on your spine. However, they’re particularly common on your lower back – your lumbar spine.
Approximately 4 in 5 Americans will experience lower back pain at some point in their lives. If you have low back pain combined with leg pain, then you may have a herniated disk.
How Does Lumbar Disc Herniation Occur?
Your spine is made up of 24 bones called vertebrae. These bones are stacked on top of one another: they connect together to form your spine. The bones also create a canal that protects your spinal cord. The five vertebrae in your lower back are called your lumbar spine.
Other crucial parts of your spine include your spinal cord and nerves, which are the “electrical cables” that travel through the spinal canal relaying signals between your brain and muscles.
There are also intervertebral discs, which are flexible “shock absorbers” that fit between your vertebrae. These discs are flat and around and about half an inch thick. They’re made from two components:
Annulus Fibrosus: The annulus fibrosus is the tough, flexible outer ring of the disk.
Nucleus Pulposus: The nucleus pulposus is the soft, jelly-like center of the disk.
Basically, the annulus fibrosus is the outer layer of the disc, while the nucleus pulposus is the center of the disc.
A disc “herniates” when the jelly-like nucleus pushes against the outer ring – the annulus fibrosus. Think of the annulus fibrosus as like the caramel in a chocolate: if you press down on it, it’s going to squeeze out the sides. This herniation can be caused by a sudden injury – like a heavy, unexpected load – or long-term microtraumas.
When the disc starts to herniate, you’re going to begin feeling lower back pain. If your disk is very worn or injured, then the jelly-like center may squeeze all the way through the outer ring. The center of the disk pushes through the outer layer. Once the nucleus breaks – or herniates – through the outer ring, you may actually notice an improvement in lower back pain. However, your leg pain may increase.
What Causes a Herniated Disk?
Herniated disks are more common in older adults. The majority of herniated disks are related to the natural aging of your spine. As you get older, your disks have less and less water content. Eventually, the disks dry out, weaken, and shrink. As they lose water content and shrink, the spaces between your vertebrae get narrower. This is a natural process called disk degeneration.
Are Certain People More at Risk of Herniated Disks?
There are a number of risk factors associated with herniated discs. In addition to aging, several other things can put you at risk of a herniated disk, including all of the following:
Gender: Men between the ages of 30 and 50 have a particularly high risk of developing a herniated disc.
Improper Lifting: Anyone who uses their back muscles instead of their legs to lift heavy objects is at risk of experiencing a herniated disc. Twisting while you lift can also increase your risk of injury. Make sure you practice proper lifting technique, lifting with your legs instead of your back, to reduce your chance of herniating a disc.
Obesity: Being overweight will put added stress on your entire body, including the disks in your lower back.
Repetitive Activities: Repetitive activities that strain your spine can add up over time. Even small stimuli – like typing or using a mouse with poor posture – can put pressure on your spine and disks. Over a long period of time, these “microtraumas” can cause a herniated disk.
Sedentary Lifestyle: Long-haul truck drivers and anyone else who stays seated for a long period of time will need to be particularly careful with their spinal health. Staying seated for a long period of time is a major risk factor in developing a herniated disk.
Smoking: Researchers don’t fully understand the connection between smoking and herniated disks. However, it’s believed that smoking reduces the oxygen supply to your discs, speeding up the degeneration process.
Symptoms of Lumbar Disc Herniation
Symptoms of a herniated lumbar disc appear in different ways. Sometimes, you’ll notice pain for a few days, and then the pain will disappear. Eventually, however, you’ll notice chronic pain in your lower back accompanied by numbness, pain or weakness in your leg. This pain can extend below the knee and even into your foot and ankle.
One of the easiest ways to spot a herniated lumbar disk is if you notice the pain moving from your lower back or buttocks down the leg into the foot.
Other symptoms of a herniated lumbar disc can include:
- Back pain
- Leg and/or foot pain (i.e. sciatica)
- Numbness or a tingling sensation in your legs or feet
- Weakness in your legs and feet
- In rare cases, loss of bowel or bladder control (if you exhibit these symptoms, you might have a more serious problem called cauda equina syndrome, which is caused by spinal nerve roots being compressed and requires immediate medical attention)
Please note that not all patients experience pain as their disk degenerates. Furthermore, not everyone who experiences lower back pain and leg pain has a herniated lumbar disk. Request a free consultation from Lakewood’s Renew Chiropractic to determine the best course of treatment for your pain.
How a Chiropractor Can Help
Doctors and chiropractors can conduct a number of tests to verify a herniated lumbar disk diagnosis, including:
Neurological Examination: The doctor might perform a neurological examination to detect weakness or sensory loss. The doctor will test muscle weakness by assessing how you walk on your heels and toes. The doctor may also test your thigh, ankle, and toe strength. Doctors can detect any loss of sensation by checking your sensitivity to light touches on the leg or foot. Doctors may also test reflexes at your knee and ankle.
Straight Leg Raise (SLR) Test: The doctor or chiropractor may request a straight leg test. You lie on your back while the doctor lifts your affected leg. Your leg stays straight while being raised. If you feel pain down your leg and below your knee during the test, then you likely have a herniated disk.
Imaging Test: Your doctor may recommend an MRI to create clear images of soft tissues like intervertebral discs. This can definitely show whether or not you’ve suffered disk degeneration or a herniated disk.
Treating a Bulging or Herniated Lumbar Disc in Lakewood
With treatment, a herniated lumbar disk can slowly improve over a period of several days or weeks. Typically, a patient is symptom-free within 3 to 4 months of beginning treatments. In some cases, patients may experience episodic pain after their treatment.
Broadly speaking, you can treat herniated lumbar disks in non-surgical ways – like physical therapy – or surgical ways – like a microdiscectomy.
Non-Surgical Treatments for Herniated Discs
Non-surgical treatment is the preferred course of action for most herniated disc treatments. Unless the patient is experiencing significant neurological issues, like muscle weakness, difficulty walking, or cauda equina syndrome, the doctor will likely recommend non-surgical treatment. Non-surgical methods can include all of the following:
Rest: Some patients can relieve herniated disc symptoms with 1 to 2 days of bed rest. Severe pain should subside within 24 to 48 hours. Avoid staying off your feet for longer: prolonged rest can lead to further disability.
Anti-Inflammatory Medicine: Medication like ibuprofen and other anti-inflammatories can relieve pain caused by a herniated lumbar disk.
Physical Therapy: A physical therapist or other medical professional may recommend specific exercises to strengthen your lower back and abdominal muscles. Strengthening your core can reduce stress on your back, reducing pain caused by a herniated lumbar disk.
Epidural Steroid Injection: An epidural steroid injection involves injecting steroids into your back to reduce local inflammation.
Out of all the above non-surgical herniated disc treatments, only epidural injections have bene proven to reduce pain and related symptoms. Most studies indicate that epidural injections improve symptoms in 45% to 55% of patients who have not been heled after 6 weeks of other non-surgical treatments (like rest).
Ultimately, the most popular non-surgical treatment methods for herniated disks involve a combination of anti-inflammatory drugs like ibuprofen and epidural injections. You get short-term pain relief and long-term improvement in conditions.
Surgical Treatments for Herniated Lumbar Discs
Surgical treatments for herniated lumbar discs are relatively rare. Only a small number of patients will require surgery to repair their herniated disc. Surgical treatments include:
Microdiscectomy: During a microdiscectomy, a surgeon will remove the herniated part of the disc and any surrounding fragments of the disc that are putting pressure on your spinal nerve.
Rehabilitation: Most patients do not require physical therapy after surgery. However, doctors may recommend a rehabilitation program – like an exercise program. Something as simple as walking 30 minutes a day at home, when combined with flexibility exercises for your leg and back, can put you on the path towards rehabilitation.
Ultimately, patient outcomes and treatments vary widely for patients with a herniated lumbar disc. There’s no single solution for herniated lumbar discs, nor is there a single accepted treatment method. Get a free consultation with a Lakewood, CO chiropractor today by calling Renew Chiropractic at 720-493-5885. Our friendly staff can answer any questions you might have about treating a herniated lumbar disc.