PAIN AND ORTHOPAEDICS · Health guide
What Is a Lumbar Disc Herniation? Symptoms and Treatment Options
A patient guide to the symptoms of lumbar disc herniation, pain radiating into the leg, what MRI findings mean, and non-surgical treatment options.
Updated: · General information
What is a lumbar disc herniation, and who does it affect?
A lumbar disc herniation is displacement of the disc contents beyond the outer boundary of the disc between the vertebrae. Age-related changes or strain may contribute; it does not always begin with an identifiable injury. If a nerve is involved, leg symptoms may appear, but some disc changes cause no symptoms at all.
Symptoms and diagnosis
Low back pain may be accompanied by pain radiating into the leg, numbness or reduced muscle power. The positions that aggravate or relieve the pain differ from person to person. History-taking and neurological examination come first. MRI and, where needed, other investigations are requested according to clinical need and the contribution they will make to the treatment decision.
Treatment and points to watch
Individually appropriate activity, pain management and rehabilitation are among the non-surgical options. There is no universally applicable waiting period that determines the decision to operate. Assessment must not be delayed in the event of new problems controlling the bladder or bowels, loss of sensation around the groin, or progressive weakness. In other situations, the response to treatment and daily function are monitored regularly.
How are MRI results related to symptoms?
A change in the disc is not always the cause of the pain. The site of pain radiating into the leg, numbness, muscle strength and reflexes are interpreted together with the imaging. The terms used in an MRI report do not by themselves indicate a need for surgery. New or progressive loss of strength, however, does require reassessment.
Everyday movement and return to work
Rather than remaining completely immobile for long periods, the aim is graded movement appropriate to the assessment. The lifting, sitting or standing demands of your job are taken into account in the programme. In the event of new loss of bladder or bowel control, numbness around the groin or marked weakness in both legs, you should go to an emergency department without waiting for a routine appointment.
Your questions
Patient information
Does a lumbar disc herniation always require surgery?
No. Non-surgical approaches can be considered in many people. The decision to operate is taken together with the neurological findings, the loss of function and the response to treatment.
Can I do the disc-herniation exercises I find online?
The choice of movements should follow the examination and the symptoms. Any exercise that increases symptoms radiating into the leg or produces new weakness should be discontinued.
