While a herniated disc (commonly referred to as a “slipped disc”) can happen anywhere along the spine, most cases occur in the lumbar (lower back) section. It is sometimes referred to as a bulging, protruding, or ruptured disc, and it’s one of the most common causes of lower back pain, as well as pain that radiates down the back of the legs (known as sciatica).
Herniated discs also occur in the neck (cervical spine) and, more rarely, in the upper back (thoracic spine).
Southwest Scoliosis Institute’s board-certified, fellowship-trained orthopedic physicians Richard Hostin, MD, Shyam Kishan, MD and Kathryn Wiesman, MD, have years of experience treating thousands of patients with complex spine conditions, including herniated lumbar discs.
A herniated lumbar disc normally happens due to aging, as the outer layer of tissue holding the disc in place can gradually degrade over time (a condition known as degenerative disc disease). A herniated lumbar disc may also be the result of a traumatic injury, but this is less common.
Symptoms of a herniated lumbar disc include:
Usually, the first (and by far the most common) symptom of a herniated lumbar disc is pain in the lower back. When a lumbar disc herniation presses on the nerves, it can lead to a condition known as sciatica, which, along with pain, may also cause numbness, tingling, or weakness in the buttocks and down the back of the legs.
When a herniated disc presses on nerve roots, it can cause pain, numbness and weakness in the area of the body where the nerve(s) travels. If it isn’t pressing on a nerve, you may only experience minor pain or even no pain at all.
In severe cases, this condition can lead to a loss of bladder or bowel control. While this is rare, it can be an indication of a serious condition known as cauda equina syndrome and requires immediate medical attention.
When you come to Southwest Scoliosis Institute, your physician will start by going over your medical history and performing a thorough physical examination, looking for any difficulty with walking or pain in the lower back. They may ask you to do a leg raise test to see if you are experiencing foot drop or other neurological symptoms.
The physician will confirm a diagnosis of lumbar disc herniation using X-ray imaging, computed tomography (CT) scans and/or magnetic resonance imaging (MRI). Because X-ray imaging can only show issues with the bones themselves and not the soft tissue, a CT or MRI scan may be necessary to confirm the condition.
Southwest Scoliosis Institute uses an advanced low dose radiation X-ray imaging system that takes high-quality images of patients in under a minute. It can also take X-rays of patients in multiple positions, and it’s conveniently located inside our Dallas location – which means that you and your physician can review the X-rays right after they are taken, during your appointment.
Most patients do not require surgery for a herniated lumbar disc and will improve with nonsurgical treatment over a period of days or weeks. In most cases, patients fully recover within 2-4 months, though the pain may return on and off while they recover.
At Southwest Scoliosis Institute, our physicians always try to take a conservative approach to treatment before considering surgery. The physician will consider all options, and treatment will depend largely on the patient’s age and overall health, as well as the severity of their injury.
Nonsurgical treatments for lumbar disc herniation include:
Surgery for Herniated Lumbar Disc
Only a small percentage (about 10-15%) of patients with lumbar disc herniation require surgery. Herniated disc surgery is typically recommended if nonsurgical treatment has not relieved painful symptoms.
Surgical treatment includes:
After the disc is removed through a discectomy, the spine may need to be stabilized via a spinal fusion procedure, which uses bone grafts and instrumentation (screws, rods, etc.) to hold the vertebrae in place while they fuse together and heal.
“At Southwest Scoliosis Institute, we treat disc herniations based on symptoms. The initial treatments are physical therapy and medications, the next set of treatments would be pain management injections, and ultimately, some people will require surgery to relieve the damaged disc and alleviate the nerve pain.” –Richard Hostin, MD
If you or a loved one suffers from spinal pain, you owe it to yourself to call Southwest Scoliosis Institute at 214-556-0565 to make an appointment.