What is a Lumbar Herniated Disc?

A lumbar herniated disc occurs when a spinal disc in the lower back ruptures, or “herniates.”

Herniated discs can also occur in the mid-back (thoracic) or neck (cervical) regions of the spine. However, in patients between the ages of 25 – 55, 95% of all herniated discs affect the lumbar spine. And, in particular, the spinal discs between the L4/L5 and L5/S1 vertebrae are the most vulnerable to injury.

But, what causes a disc to rupture in the first place? Part of the answer lies in the very nature of the disc. Remember that your 23 spinal discs (6 in the neck, 12 in the mid-back, and 5 in the lumbar spine) serve as the spine’s system of shock absorbers. These rubbery cushions consist of an outer ring of flexible cartilage (called the annulus fibrosus) and an inner compartment filled with liquid (known as the nucleus pulposus).

Over time, these discs start to degenerate from simple wear and tear, a condition known as degenerative disc disease. (Although the word “degenerative” sounds dire, the condition is actually not progressive in the truest sense of the word. It’s just a fancy way of indicating that our discs have begun to break down from age… and depending upon your occupation, this is pretty natural.)

As annular tears begin to appear in the outer ring of the disc, the liquid inside the disc can begin to bulge unevenly on one side of the disc. This condition, known as a bulging disc, can lead to a ruptured or herniated disc if the pressure inside the disc becomes too intense.

Unfortunately, as we age, our spinal discs also begin to dehydrate. Although this seems like it would make a herniated nucleus pulposus less likely, the reverse is true. Dehydration causes more frequent (and severe) annular tearing.

What are the Risk Factors for a Herniated Lumbar Disc?

We’ve already alluded to at least one cause of a herniated lumbar disc: wear and tear. The other common cause usually relates to trauma. Certain types of injuries can cause a spinal disc to rupture upon impact. These injuries can include car accidents, unexpected falls, or sports collisions.

However, did you know that certain risk factors can also make you more likely to develop a herniated disc? These risk factors include:

• Age: Individuals between the ages of 35 – 55 develop lumbar herniated discs more often than any other demographic. This likely reflects a.) the effects of wear and tear on the spine, and b.) the fact that this age group is slightly more active than seniors, and hence, more likely to sustain injuries from heavy lifting.
• Gender: For reasons unknown, men develop lumbar herniated discs twice as often as women do. This may be because certain fields that require heavy lifting, like construction, are male-dominated.
• Occupation: On that note, occupations that involve repetitive lifting can lead to lumbar herniated discs. These “high risk” jobs include construction, nursing, and professional sports.
• Obesity: Being overweight places more day-to-day strain on the spine and also makes that sudden, wrong twist more damaging to your discs. In fact, overweight individuals are more than 10 times more likely to suffer from a second herniated disc following back surgery, a condition known as recurrent disc herniation.
• Smoking: Studies show that smoking speeds up the rate of disc dehydration and slows down the speed of disc healing. This makes annular tears more likely and prevents the body from absorbing herniated disc material (a natural process that can greatly reduce your need for surgery).

What are the Signs of a Lumbar Herniated Disc?

If you suffer from a lumbar herniated disc, then you may or may not exhibit symptoms. When symptoms do emerge, it’s usually because herniated disc material is pressing against a lumbar or sacral nerve… or the spinal cord itself. Keep a watchful eye out for the following symptoms of a lumbar herniated disc:

• Local Pain: Early signs of a lumbar herniated disc often include pain at the site of the injury. Pain can range from dull and throbbing to sharp and stabbing. You may also experience lower back spasms or icy-hot pain.
• Sciatica: Lumbar herniated discs are a common cause of sciatica, or compression of the sciatic nerve. Your sciatic nerve runs all the way from your lower back, along the backside of your legs, and down into your feet. When herniated disc material pinches this nerve, symptoms such as leg pain can shoot from the lower back into the buttocks, hamstrings, calves, and/or feet.
• Nerve Dysfunction: However, the sciatic nerve is not the only nerve that can become pinched from a lumbar herniated disc. Symptoms of nerve pain include burning or electric jolt-like sensations, numbness, or tingling in the lower body.
• Muscle Weakness: If your herniated disc presses against a nerve that controls muscle function (or the spinal cord itself), then you may develop weakness in your legs. If you notice numbness around your groin or rectum or develop incontinence, seek medical help as soon as possible. These are symptoms of cauda equina syndrome, a condition that can cause permanent paralysis in the lower body.
• Foot Drop: A lumbar herniated disc can cause a special type of muscle weakness, known as foot drop. This occurs when the muscles that control the front of the foot weaken from nerve impingement. When this happens, you may find it difficult to lift the ball of the foot off of the floor.

Seeking Help for a Lumbar Herniated Disc

If you suspect that you might have a lumbar herniated disc, then seek the medical advice of a doctor. Although 90% of lumbar herniated disc symptoms will go away after 6 months, your doctor can help you manage pain while you heal.

In addition, your doctor can prescribe imaging tests to help you determine the precise location of your herniated disc. With this information, your doctor can design a plan of attack that targets the specific nerves affected by your slipped disc. Your treatment plan may involve nonsurgical treatment options, like epidural steroid injections to soothe inflamed nerves or physical therapy.

If your pain does not fade after 6 months, then contact a board-certified orthopedist to discuss surgical treatment options for your condition. A board-certified spine surgeon, like Dr. George Naseef, can help you treat your condition with both conservative therapies and minimally invasive surgical interventions. To learn more about how an artificial disc replacement or microdiscectomy can benefit you, contact our award-winning specialists at The Advanced Spine Center!