Herniated lumbar disc is a common spinal condition that involves a bulging of the disc, or rupture of the outer layer of the disc with displacement of a fragment of the disc material. The disc material has moved and is now compressing one or more nerves. This can result in severe pain and be a very distressing condition.
Most of the time when you suffer this condition, you will experience some back pain initially, but leg pain is usually the symptom that troubles most. While both legs may have some pain, the disc bulge is usually to one side of the spine and therefore causes one sided leg pain to be more severe.
If this should happen to you or your loved one, it can be very distressing, and most people are not sure what is happening to them or what to do next. The initial care for a lumbar disc herniation is short term (no more than four days) of bed rest with simple pain killers like Panadol and non-steroidal anti-inflammatories such as Ibuprofen. The one exception to this is if you have cauda equina syndrome – this is an emergency – you need to seek urgent medical attention for this condition.
If your symptoms are persisting despite these simple measures your doctor will order a CT scan or MRI to confirm the diagnosis of a lumbar disc herniation and determine the exact extent to which your lumbar disc is injured, and your nerves are affected. Your doctor may also prescribe stronger medication or nerve specific medication.
You should try to take part in gentle activities at this point, such as going for small walks. You should avoid prolonged sitting, standing or any heavy lifting. You should avoid twisting movement and should bend at the knees, not at the hips.
The good news is that this is a treatable reversible condition. The natural history (in other words if we did nothing) for this condition is well known. People like you who have this problem do get better, but without help this can take many months.
If you are one of the unlucky patients who do not get better with simple measures as described above your doctor will send you to see a spine specialist. The spine specialist will take a history about the symptoms of your condition. They will perform a clinical examination to determine the extent to which your disc herniation is affecting the strength, sensation and other neurological functions of your legs.
They will look at your scans and may need to order more tests depending on your specific circumstances. They may advise ongoing conservative care, or they may refer you to the radiologist to perform a targeted cortisone (steroid) injection into your spine. A small number of patients may eventually require surgery for this condition.
The most common operation that is done for a lumbar disc herniation is a microdiscectomy. This is a common operation that has been performed for many years. The outcome in terms of improving leg pain and symptoms related to nerve compression is usually excellent with this operation. You are generally only in hospital for a few days and can be back at work in less than a month in most cases.
Almost everyone will make a near complete recovery from a lumbar disc herniation. It can take quite some time to recover naturally, but there are a number of things as described that we can do to speed this recovery process up.