Lumbar Herniated Disc

• Degeneration or general wear-and-tear, which can break down the walls of the disc.
• Repetitive bending and twisting motions especially in combination. These motions places the most stress on the outer fibrous rings.
• Discs are most susceptible to injury in the sitting or bending position as the pressure on the disc is displaced to the front, pushing the contents of the disc posterior laterally toward the thinner and weaker annulus fibrosis.
• A sudden fall or trauma, like a motor vehicle accident.
• Genetic factors may contribute to the likelihood of intervertebral disc disease.
• Smokers are more susceptible to disc herniation and degeneration.

When a disc is herniated the symptoms will depend on the location of the herniation and what soft tissue structures are affected. Symptoms can vary from none at all or very mild if the disc is the only structure involved, or can be more severe. Other symptoms can include:

• Pain in the back or radicular to the buttock into the leg down to the foot if the disc presses on the nerve root.
• Sensory changes like numbness or tingling if the nerve is compromised.
• Weakness can occur if the motor portion of the nerve is effected by the disc’s condition. In severe cases paralysis may even occur.
• Diminished reflexes.
• Muscle spasms and changes in posture in response to the injury.
• Loss of motion including inability to bend or stand straight, and poor tolerance to sitting.
• Standing and walking can be difficult if the herniation is severe. Often the patient will present with a shifted posture and have difficulty finding a comfortable position

Please note: A patient with a herniation may be symptom free if the disc does not press on a sensitive soft tissue structure.

Treatment of a disc herniation or injury will depend on the severity of the condition. When treating acute disc or back problems treatment options include:

• Rest. Avoid the activities that produce the pain like bending, twisting, lifting and prolonged sitting.
• Anti-inflammatory drugs and other pain medications.
• Apply ice to the lumbar spine to help reduce pain and associated muscle spasms. Apply ice right away and then at intervals for about 20 minutes at a time. Do not apply directly to the skin.
• An exercise regiment designed specifically to address the cause of the symptoms.
• Physical therapy for back and disc problems must remain conservative at the beginning to avoid aggravating the condition. Your physical therapist should emphasize rest, reducing the inflammation and increasing the blood circulation for healing. Once the initial inflammation has been reduced, a program of stretching and strengthening will be initiated to restore flexibility to the joints and muscles involved, while improving strength and stability of the spine. Each program will be based on the structure causing the problem and symptoms. A program not tailored to the specific problem may aggravate symptoms.
• Bracing or the use of supports may be necessary to reduce stress on the disc, muscles and lumbar spine.

In the case of conditions that do not respond to conservative care, surgery may be recommended. If you continue to experience some of the following symptoms, your doctor may recommend you for a surgical procedure:

• Increase in radiating or radicular pain
• Pain or nerve damage that gets worse
• The development of increased weakness.
• An increase in numbness or tingling.
• Loss of bowel and bladder control

Injections like facet injections, nerve blocks or an epidural. These may involve the injection of corticosteroids to a specific structure to reduce local inflammation.

• Caudal Epidural Injections
• Facet Joint Injections
• Interlaminar Caudal Epidural Steroid Injections
• Transforaminal Epidural Injections
• Selective Nerve Root Blocks

• Endoscopic Decompression
• Endoscopic Foraminotomy
• Percutaneous Decompression
• IDET Intradiscal Electrothermal Therapy
• Selective Endoscopic Discectomy
• Spinal Cord Stimulator
• Epidural Lysis of Adhesions

Determining the correct diagnosis means you will get the correct pain care. Any doctor can treat your Lumbar Herniated Disc symptoms, but only an expert pain management physicians and best injury specialist like Dr. Freeman of NJ pain treatment clinic can pinpoint the reason for your Lumbar Herniated Disc pain and take steps to treat it at its source.