PT Tip of the Month Archive

Herniated Lumbar Disc

Spinal image of herniated disc.Spinal Anatomy

The human spine consists of several bones called vertebrae that are stacked on top of one another. In between each of these vertebrae is a disc that acts as a shock absorber and allows for movement at every level of the spine. The outer walls of these discs are made up of a thick tissue called the annulus fibrosis. Contained within the annulus fibrosis is a gel-filled center called the nucleus pulposus.

What is it?

A herniated disc, also known as a herniated nucleus pulposus (HNP), occurs when the gel-filled center of the disc protrudes through a tear in the annulus fibrosis. Disc herniations are found most often in the lower back (lumbar spine) due to the high level of compressive forces placed upon these discs and the lack of ligamentous structures supporting the vertebrae. There are five vertebrae present in your lower back (L1-L5) that rest upon a large triangular bone in your pelvis called the sacrum. Herniated discs occur most commonly in the lower lumbar spine between L4 –L5 and where L5 meets the sacrum (L5-S1).

Symptoms

Sciatic nerve painThe symptoms of a herniated lumbar disc can vary greatly depending on the location and severity of the herniation. Many individuals complain of lower back pain and muscle spasms. The nerves that travel from your spinal cord and into your legs can often get compressed by herniated discs where they exit between the lumbar vertebrae. This can cause pain to radiate into the back of one (or both) legs and may travel all the down to your feet. Numbness and tingling may accompany this pain as well.

Severe disc herniations may also cause weakness of the muscles in your legs, foot drop, and / or loss of bowel and bladder control. If you experience any of these symptoms, you should seek medical attention immediately.

Causes

Herniated discs can be caused by traumatic injury, lifting improperly, or can occur spontaneously without any known cause. Lifting heavy items with your back instead of your legs is a very common cause of lumbar disc herniations, especially if you are twisting at the same time. Please see our monthly tip on ergonomics to review proper lifting and shoveling techniques!

Aging is an important factor in the occurrence of disc herniations as well. As we age, the discs in our spine dry out and the annulus fibrosis tends to weaken. This increases the likelihood of a tear occurring in the disc wall that results in a herniated disc.

Treatment

One of our skilled physical therapists can determine the best possible course of treatment that will allow you to return to your prior level of function as soon as possible. Your treatment may include the use of many modalities and manual therapies to help alleviate your pain. We can instruct you on the proper cardiovascular, stretching, and strengthening exercises to help you return to full activity and prevent re-injury. Please contact one of our two locations to inquire about an evaluation for your pain and dysfunction.

Common pain sites

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