A herniated disc in the lumbar spine is one of the most common causes of pain in the lower back. Not only can it cause pain in the lower back, but also in the legs (sciatica) because of the pressure it puts on nerve roots. According to the American Academy of Orthopaedic Surgeons (AAOS), 60-80% of us will experience lower back pain during our lifetimes. For many of us, the pain will be the result of a herniated lumbar disc.
In order to really understand lumbar disc herniation, a little spinal anatomy refresher course is in order …
What Are Spinal Discs?
Your spine is composed of a “stack” of 24 bones called vertebra. These bones connect and serve as a protective canal that surrounds the spinal cord. (The bottom 5 vertebrae make up the lumbar spine.) In between each of the vertebrae, is a flexible disc that act as shock absorbers when you walk, run or jump. End plates line the end of each of the vertebrae and serve to hold the discs in place. A tough outer ring called the annulus protects the gel-like substance called the nucleus pulposis, that’s inside of each of the disks.
If the annulus breaks open or cracks, the gel-like nucleus pulposus inside the disc begins to leak. (This can happen as the result of an injury, or just as a result of wear and tear or aging.) The gradual loss of the nucleus pulposus eventually causes the disc to lose its spongy quality, and to flatten and harden. Once that happens, the disc can put pressure on the nearby spinal nerve root, causing shooting pains in the lower back and often into the buttocks and down the leg*. (*The L4 L5 S1 S2 S3 spinal nerve roots join together to form the sciatic nerve, which can then radiate pain down its length through the buttocks and the leg down to the foot.)
Often a herniated or ruptured disc is referred to as a “slipped disc“, a term that’s a little misleading since it’s not the actual disc that slips, but rather the contents of the disc.
Non-Invasive Treatment for a Herniated Lumbar Disc
- Once a disc in the lumbar spine ruptures, the first 24-48 hours are a crucial time to take action with cold therapy — ice packs. Cold therapy helps in several ways. It decreases blood flow, which in turn reduces swelling and pain. To use and ice pack properly and safely, always wrap it in a towel and apply it for only 15 minutes at a time.
- You can also take any of the over-the-counter NSAIDs, which are non-steroidal and safe when used as directed. NSAIDs work by reducing inflammation, swelling and pain.
- The good news is that pain from a herniated disc is often short-lived, although it will recur from time to time. However, when the injury or irritation first occurs, the pain is sometimes severe, and your doctor may prescribe a muscle relaxant to calm spasms and a short-term pain medication that will relieve severe pain more effectively than NSAIDs can.
- After the initial 48-hours pass, it’s usually time to apply heat therapy. Heat increases blood flow to the area to warm and relax muscles and help flush away any accumulated toxins in the tissues. Just as with cold therapy, it’s important that you don’t apply the heat directly to your skin. Wrap it in a towel and warm the area for no more than 20 minutes.
- Physical Therapy is an important part of a successful treatment plan for a herniated lumbar disc. It usually consists of a combination of treatments designed to ease pain and promote healing of the disc. It may also include cold and heat therapies, gentle massage, core strengthening and stretching — your physical (PT) will always work with you to tailor your physical therapy to your specific needs and symptoms.
These types of non-invasive treatments, working together usually speed recovery, and most cases are resolved by using them. More rarely, you may need surgery to resolve whatever is causing your pain. Minimally invasive using small incisions and tiny instruments is often possible. Even so, it’s a good idea to get a second opinion about spine — or any — surgery, for that matter.
Is Prevention Possible?
Since lumbar disc herniation is often a natural side-effect to aging, you probably can’t always prevent it, but there are things you can do to take care of your spine health to improve your odds of avoiding a slipped (herniated) disc:
- Pay attention to your posture.
- Don’t smoke.
- Make healthier food choices.
- Get plenty of moderate exercise.
- Learn how to lift and bend properly.
Are You at Risk?
Besides age, there are a few other risk factors — some subject to control, and some not — including:
- Being male. Men between the ages of 35 and 40 are most likely to rupture a disc.
- Not lifting things correctly.
- Repetitive movements that strain your lower back. (Some jobs call for repeated bending and lifting that can wear discs out over time.)
- Being overweight.
- Being a driver (truck, cab, bus, etc.). Long periods in a seated position combined with the engine vibration can and often does, put pressure on your discs.
- Being a couch (or device) potato. Your body (and spine) need to move to remain healthy.
- Researchers believe that smoking damages your discs by lessening their supply of oxygen, which in turn leads to faster degeneration. So add “causes herniated discs”, to the myriad of other health problems that smoking tobacco causes.
If at some point you join the ranks of the many Americans that suffer a herniated lumbar disc sometime during your life, see your doctor and your physical therapist and follow their instructions. Above all, remember that it usually doesn’t take too long to get relief!
Want to find out how to tell if your pain is due to a disc herniation and how to heal without medications, injections, or surgery?
I’m hosting a Lower Back Pain and Sciatica Workshop coming up at both our Valparaiso and Crown Point locations.
Click the links below to register and hold your spot. We are only taking 20 attendees at each location.
‘Hope to see you there.