Lumbar Disc Herniation

Intervertebral disc, means space between two consecutive discs of the spinal cord. A cushion, which is rubbery with a soft and jelly-like center fits in these disc spaces. When this jelly-like structure or nucleus is pushed out due to any reason or pressure it is called a herniated disc or slipped disc.

Commonly slip discs occur in the back (lower spinal bones) and cause low back pain and this pain can radiate to the thigh and legs.

Stages of the slip disc or disc herniation

Stage 1 – With age, the disc starts losing its elasticity and becomes rigid and breakable. This stage also called the degenerative stage
Stage 2 – With growing age and continuous stress, the disc fibers (outer layer) start damaging and the jelly structure or nucleus starts bulging out. Also called Disc Herniation and bulging
Stage 3- When the bulged nucleus breaks the outermost layer but still connected in the Disc is called extrusion
Stage 4 – When the bulged nucleus detached from the disc loose in the spinal canal called Sequestration

Causes

Aging, wear and tear
The weakness of the low back
Any trauma or injury
Heavy weight lifting
Sudden jerks on the back
Sudden twisting movement of the back

Risk factors

Extra weight exerts more pressure on the disc
Work involving weight lifting, pushing or pulling activities
Smoking may decrease the oxygen supply to the disc which causes quick degeneration

Slip disc Symptoms

Pain the buttocks, thigh, and legs
Numbness in the legs
Tingling sensation
Weakness in the lower limb
Back muscle spasm
Tenderness
Loss of bowel bladder control

Diagnosis

Physical examination by your doctor and your symptoms also reveal the diagnosis
Neurological examination in which your doctor will check for reflexes, muscular strength, walking pattern/ ability. The doctor will also test your sensations
X-ray is performed to check any bony abnormalities, fracture
CT scan and MRI are more specific investigation to diagnose the slip disc or herniation and the stage of herniation
Nerve conduction studies are also performed

Treatment

Conservative treatment for slip disc
- Medications to reduce the pain, cortisone injections. Muscle relaxants to reduce the muscle spasm
- Physiotherapy exercises to strengthen the back muscles
- Stop heavy weight lifting and take proper rest

Surgery
- - When disc herniation is in the severe stage and not manageable conservatively that required surgery
    - Removal of the herniated disc
    - Spinal bone fusion
    - Artificial disc implantation