Lumbar Disc Herniation

A significant number of lower back injuries are linked to the intervertebral disc. This disc sits between the vertebrae in our spine and is composed of a central nucleus pulpous surrounded by an annulus fibrosis. The picture below shows part of the lumbar spine with the spinous process removed. This view is from the rear of the spine. Shown is the posterior longitudinal ligament, this ligament helps provide support to the disc however you can see that it is unable to cover the entire disc. These areas are where we commonly see herniations.

Interestingly enough not all herniations produce symptoms. In fact, approximately only 35 % of herniations develop true sciatica. Most of these herniations occur at the L4-L5 and L5-S1 areas of the spine.

Herniations occur when the nucleus pulpous is forced thru tears in the annulus fibrous. This can lead to the extruding disc impinging the nerve root resulting in pain. Herniations may be the result of a severe trauma, strain or intervertebral joint degeneration. Symptoms of lumbar disc herniation are unilateral and include pain, which radiates into the lower extremities. In the early stages it can cause sensory or motor loss in the area innervated by the compressed nerve and in the later stages, weakness and muscle atrophy may occur.

Treatments

• Physiotherapy
• Chiropractic manipulation
• Heat and/or ice therapy
• Anti-inflammatory drugs

Surgical Treatments

• Microdiscectomy: Designed to take the pressure off the nerve root, usually only a small portion of the disc needs to be removed leading the majority of the disc to remain intact.

• Laminectomy: The removal to the lamina to decrease compression of the spinal nerve root. This surgery can lead to instability in the spine.

• Fusion: If there is recurrent herniations in the same area of the spine or if there is excessive instability a lumbar fusion surgery may be performed to stop motion at the disc level.

 

Management

Most herniations improve with conservative management. If you are experiencing low back pain, or symptoms of a herniation you should have your condition evaluated by a qualified medical professional. At Pure Body Balance both Dr.Fryer and Robert Jacobsen specialize in the treatment of low back pain. Having your condition properly assessed and beginning a treatment plan early on can shorten recovery times and help in preventing the condition from progressing. Following treatment Pure Integrated Training offers Post Rehabilitation Programs to help regain strength and stability.

 

Sincerely,

Keegan Marshall CPT, CES