Lumbar Disc Herniation

Lumbar Disc Herniation

Are you suffering from moderate to severe back pain? Perhaps it comes and goes from time to time. You may think it is due to sleeping in a bad position or straining when you picked something up. It could be, or it could be a more severe condition that can worsen over time if you don’t seek out medical care. The good news is our team of back doctors in New Jersey can help you. This is especially true for a condition known as lumbar disc herniation. It’s a complex term for a condition that many people suffer from every day.

Do You Have Lumbar Disc Herniation?

This condition is not diagnosed on the symptoms alone, but many people who have it suffer from back pain in the lower area, right above the hips, as well as pain that seems to travel or spread into the hips and buttocks. You may also have pain that gets worse if you sneeze or cough. Many people experience spasms, conditions that worsen and improve over time. If these are the types of symptoms you have, it is time to come in to see our lumbar doctor in New Jersey.

Can You Really Improve Your Back Pain?

It is not uncommon for individuals to suffer from back pain, but that pain should never be ignored. In many situations, back pain is an indication of an underlying health problem. In this case, it is often due to a disc in your spinal column that is compressing against the spaces in between your vertebrae, the bones that protect the spinal cord. When this pinching occurs, it can send a tremendous amount of pain or just dull aches moving through your body and back. It’s painful and can often be debilitating especially if it is allowed to worsen. The good news is our team of doctors in New Jersey can help to address your lumbar disc herniation or any other complex condition you have and offer a solution to you. Contact us today to learn more about the options available to you.

Lumbar disc herniation is a low back disorder.  A brief review of key spinal anatomy can help answer ‘what is’ a herniated disc.

In between each of your five vertebral bones is an intervertebral disc.  The structure of a disc’s outer layer (annulus fibrosus) is made of strong fibrocartilage; it is constructed similar to a radial tire.   The annulus fibrosus encases a gel-like interior matter, the nucleus pulposus (Figure 1).  A disc herniates when the annulus fibrosus breaks open allowing some of the nucleus pulposus to leak out (Figure 2) into the spinal canal and/or onto spinal nerve roots.  Spinal canal and/or nerve compression (i.e., pinched nerve) causes pain and other symptoms.

Symptoms include:

  • Low back pain: mild, moderate, severe, or varying
  • Pain that travels (lumbar radiculopathy) into the lower back (sacrum), hips, and buttocks.
  • Sciatica: a symptom described as pain that radiates below the knee.  Terms describing sciatic pain include electric-like, stabbing, and throbbing.
  • Coughing or sneezing aggravates pain
  • Low back muscle spasms, cramping
  • Unusual sensations: tingling, numbness, pins and needles
  • Skin tenderness or sensations that follow the path of a lumbar nerve root.
  • Leg weakness or loss of leg function.

What can cause disc herniation?

Lumbar discs absorb and distribute external body forces during rest and activity.  The design and structure of ligaments, tendons and muscles help protect the spine by limiting excessive motion.  This is one reason why strong abdominal and spinal muscles (core muscles) are important.  However, even the strongest ligaments and muscles can succumb to sudden and extreme force, such as might happen when catching a heavy object.

Low back disc herniation usually happens gradually and involves a combination of factors.

  • Aging-related degenerative changes cause discs to be less hydrated, affecting shape and structure.
  • Smoking, leading a sedentary lifestyle, being overweight
  • Poor posture, incorrect body mechanics (i.e., ergonomics) and repetitive movements (i.e., lifting) create unnatural spinal stress.

Does my low back or leg pain require immediate medical care?

When back pain develops suddenly for no apparent reason or after an accident, it is normal to feel upset or scared.  It is your health, and that is important!  The list below can help you determine if your back pain requires urgent care.

  • Back pain after injury: a fall, car or industrial accident
  • Persistent back pain that doesn’t stop or worsens.
  • Pain moves into your leg(s)
  • Extremity numbness, tingling sensations, weakness
  • Buttock and/or genital area numbness, tingling
  • Back pain with a fever
  • Bowel or bladder dysfunction

Diagnostic examination

The purpose of a diagnostic examination is to learn about your general health, lifestyle, past medical history, and current back problem.  The information gathered by our staff during your exam is combined with imaging or other test results to confirm your diagnosis.

Questions our Doctors may ask include:

  • When did your back pain start?
  • Did a particular event precede back pain?
  • Has your pain improved or worsened?
  • Does lumbar pain radiate into another part of your body?
  • On a scale of zero (no pain) to 10 (agony), what is your current pain level?
  • Does pain affect your ability to work or perform ordinary activities of daily life?
  • Do pain and symptoms disrupt your sleep?
  • Other questions specifically related to you and your symptoms.

An MRI is performed to evaluate your lumbar spine.  Sometimes a plain x-ray is ordered.  Depending on the results of your examination we may conduct electrodiagnostic studies.

Interventional treatment

Seldom does lumbar disc herniation require spine surgery!  At Rehabilitation Medicine Center of New Jersey,  we may combine non-operative interventional treatments to resolve back and leg pain.  Interventional means to ‘intervene’ to stop and manage pain while you heal.

Treatments are administered in a step-wise way.  We believe less can be more, and we apply that philosophy to our treatment approach.  For example, a non-steroidal anti-inflammatory drug and passive physical therapy may be as effective as a narcotic painkiller, but with fewer side effects.  However, no two patients are alike, and your lumbar herniated disc may require more aggressive care.

Back pain treatments may include: