What are the other Names for this Condition? (Also known as/Synonyms)

• Lumbar Disc Disease
• Lumbar Disc Herniation

What is Herniated Disc in the Lower Back? (Definition/Background Information)

• Herniated discs are injuries that occur, when all or a part of the disc within the vertebrae of the spine, slip or rupture
• This injury may be caused by age-related degeneration (wear and tear) of the discs; any twisting, turning, bending injury resulting from lifting/carrying of heavy loads; any significant direct trauma/blow to the spine (in some rare cases); or due to an idiopathic (unknown) cause
• Herniated Disc in the Lower Back, also known as Lumbar Disc Herniation, is an injury that occurs within the lower back (lumbar) region of the spine
• A herniated disc may aggravate the surrounding nerves causing pain, numbness, or weakness, within an arm or leg; though, a high percentage of individuals do not experience any noticeable symptoms
• Most commonly a Herniated Disc occurs in the Lower Back; one of the main reasons why individuals develop pain in the lower back

Who gets Herniated Disc in the Lower Back? (Age and Sex Distribution)

• Herniated Discs in the Lower Back may occur in individuals of any age, race, ethnic group, or gender
• However, it is mostly seen in individuals between the ages of 35-55 years
• Men are more likely to develop the condition, than women

What are the Risk Factors for Herniated Disc in the Lower Back? (Predisposing Factors)

Risk factors associated with a Herniated Disc in the Lower Back include:

• Men between the ages of 35-55 years
• Excess body weight associated with obesity, which may abnormally increase pressure on the joints
• Participation in rough or high-impact sports; overuse (causing wear and tear) of spine associated with sports
• Certain occupations that require an excessive lifting of heavy objects
• Smoking

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Herniated Disc in the Lower Back? (Etiology)

Some of the causes of Herniated Discs in the Lower Back include:

• Individuals as they age slowly lose some of the watery substance within their spinal disk. A progression of this condition reduces the flexibility of the disk and increases the probability of causing a herniated disc
• Highly stressful activities that affect the spine and are related to sports
• Certain occupations that require a set of repetitive physical movements, over prolonged periods
• Increased and abnormal pressure on the spine, due to excess body weight (or obesity)

What are the Signs and Symptoms of Herniated Disc in the Lower Back?

A high percentage of individuals with Herniated Discs in the Lower Back have no symptoms.  However, in others, the following signs and symptoms may be present, which include:

• Lower back pain
• Muscle weakness due to nerve damage
• Numbness or tingling sensation associated with nerve damage of the extremity (leg)
• Pain in the leg

How is Herniated Disc in the Lower Back Diagnosed?

Diagnostic methods that a physician may use to help diagnose a Herniated Disc in the Lower Back include:

• Physical examination: The physician will perform a thorough physician examination to determine, if the individual has a Herniated Disc in the Lower Back. In addition to this, a complete medical history may aid in arriving at a definitive diagnosis
• X-ray: X-rays are not used to detect Herniated Discs, but will help rule out other possible causes associated with lower back pain, such as a broken bone, or an infectious tumor
• Computerized tomography (CT): A CT scan takes a series of x-ray images from several different angles, which are then merged to create cross-sectional images of bones and soft tissues of the body. This allows a physician to examine the spinal column and its surrounding structures
• Magnetic resonance imaging (MRI): An MRI is a more detailed scan that uses radio waves and a magnetic field to produce images, which allow a physician to view any damage to the bones and soft tissues of the spine
• Myelogram: A myelogram is a diagnostic imaging procedure in which a special dye is injected into the surrounding areas of the spinal cord. X-rays or CT scan images are then taken to help detect any spinal abnormalities
• Electromyography (EMG): An EMG shows the electrical activity of the muscle during rest and when they contract. The electrical activities are then studied, to observe any nerve damage resulting from a Herniated Disc
• Nerve conduction velocity (NCV): Nerve conduction velocity shows the speed at which electrical signals move through a nerve. A slow nerve conduction speed may indicate nerve damage

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Herniated Disc in the Lower Back?

Complications due to a Herniated Disc in the Lower Back may include:

• Worsening symptoms that cause pain, numbness, and weakness. This may decrease an individual’s ability to perform their normal daily/regular activities
• Cauda equina syndrome: A rare but serious neurological condition characterized by abnormal pressure and swelling of (the cauda equina) nerves around the spinal cord
• Saddle anesthesia: Loss of sensation to the buttocks and perineum, which is usually associated with cauda equina syndrome

How is Herniated Disc in the Lower Back Treated?

Mild or minor spinal disc herniation heals on its own. In other cases, the initial treatment provided for a Herniated Disc in the Lower Back is usually conservative. The primary focus is to relieve symptoms (if any) causing pain and stiffness.

Conservative, nonsurgical treatment measures include:

• Non-steroidal anti-inflammatory oral medications, such as ibuprofen, may be used to decrease the pain and swelling
• Stronger prescription medications, such as codeine or a combination of hydrocodone-acetaminophen, may be prescribed, if over-the-counter medications are unsuccessful in relieving pain
• Nerve pain medication can usually relieve pain associated with nerve damage
• Individuals, who experience muscular spasms, may be prescribed medications, such as diazepam or cyclobenzaprine, to relieve back pain
• Corticosteroid injections into the epidural space (region near the spine, inside the vertebral column) help provide temporary relief of symptoms, and in improving the range of motion. It is important to note that corticosteroid injections only give temporary relief. Prolonged episodes of such injections, may injure the joints in the long-run
• Physical therapy exercises to strengthen and improve flexibility of the back/lower back, which may help reduce the discomfort

A small percentage of individuals may require surgical treatment for a Herniated Disc in the Lower Back. Your physician may advise surgery, if traditional nonsurgical methods do not improve the symptoms; or if a damaged disc fragment within the spinal canal compresses a nerve causing progressive weaknesses; or if the individuals experience prolonged difficulties completing their normal activities. Surgical procedures usually performed to treat this condition include:

• Microlumbar disectomy (MLD): MLD is an advanced, minimally invasive surgical procedure for the lumbar region. It uses a specialized surgical instrument with an attached microscope to inspect the problem region. During the procedure, the part of the herniated disc that is damaged, and any bone fragments (causing abnormal pressure on the spinal nerves), are removed. MLD is one of the most common surgical procedures performed for this condition, by a spinal surgeon

How can Herniated Disc in the Lower Back be Prevented?

There are no known methods to help prevent a Herniated Disc in the Lower Back. However, certain techniques that may help decrease the possibility of this injury include:

• Maintain a healthy body weight, which can help to reduce unwanted stress on the spine joints
• Maintain correct posture while standing, sitting, or working at a desk (or on the computer). This  can help avoid unwanted pressure on the spine
• Quit smoking: Nicotine and other harmful toxins associated with tobacco smoke contribute to a herniated disc. These harmful substances can damage the disc, by decreasing the body’s ability to absorb key nutrients, necessary to maintain a healthy lifestyle
• Begin any new physical activity slowly, with a thorough stretching regimen and complete warm-up
• Begin any new physical activity slowly, with a thorough and complete warm-up. Individuals are advised to add low-impact activities to their exercise regimen to avoid repetitiveness

What is the Prognosis of Herniated Disc in the Lower Back? (Outcomes/Resolutions)

• A high percentage of individuals show improvement, when treated for a Herniated Disc in the Lower Back. However, the back pain may still exist, even after a comprehensive treatment
• A return to normal daily activities may take anywhere between several months to a year; for the lower back pain to subside
• In certain work environments, individuals involved in lifting/carrying heavy objects, may need to modify their occupational responsibilities, in order to avoid recurrence of the injury

Additional and Relevant Useful Information for Herniated Disc in the Lower Back:

Over 90% of spinal disc herniation occurs in the lumbar region, which is followed by the cervical (neck) region. The thoracic region accounts for only a very small percentage of all disc herniation.