Herniated Disc Lower Back Pain
When it is bad, herniated disc lower back pain is probably the most painful thing that could ever happen to you! The level of pain can become debilitating. And it might not be just limited to your back. The pain can be shooting down your leg in severe cases (known as sciatica).
Fortunately, these sorts of severe cases are not that common. But most herniated discs in the lower back (the L4-L5 spinal level is the most common) are going to be uncomfortable.
The spinal discs are often described as being like a jelly doughnut. The discs have a tough outer layer (annulus fibrosus) and a softer, jelly like centre (nucleus pulposus). A herniation occurs when some of the softer centre pushes out through tears or cracks in the annulus fibrosus. These cracks and tears can form as part of the degenerative process, or as a result of injury to the disc.
You can actually have a herniated disc in your spine without even knowing about it. They can even show up on spinal scans of people that have no back pain at all. However, if the ruptured disc is pressing on or irritating the spinal nerves, the disc herniation is likely to cause pain and possibly other symptoms.
The most common signs and symptoms of a herniated disc in the lower back are:
Lower back and/or leg pain.
Depending on the size of the herniation, you may have a dull low back ache if there is only a small herniation (that can be hard to differentiate from Degenerative Disc Disease), through to intense shooting pain into the buttocks and leg. Pain down the leg is due to the herniated disc pressing on the nerves from the spine that run down the leg, it is usually referred to as sciatica.
Numbness or tingling.
Nerve compression as a result of a disc herniation can alter the nerve signals, resulting in a change of sensation such as numbness or tingling.
Muscles that are supplied by a nerve that is being compressed tend to become weak due to a loss of proper nerve messages. This may cause you to stumble or trip, and you may have difficulty getting out of a chair.
If the disc herniation is extremely large, it can compress the nerves enough to cause a loss of sensation in the groin/saddle area, and bowel and bladder problems (for example, incontinence). This is known as Cauda Equina Syndrome. It is a medical emergency and you should seek medical attention immediately.
Correct diagnosis of a herniated disc requires spinal imaging. X-rays show bone, but do not show the soft discs. So either a CT Scan or an MRI is required. This will allow your doctor to see whether you have a herniated disc, and exactly where it is in your spine.
Initially, your doctor should take a careful medical history to find out where you are feeling the pain, what the pain feels like, and how long you have been suffering. Your doctor should also ask how the pain started. Was there an injury or some kind of twisting, bending or reaching movement. They wil want to know if you have any weakness, numbness or tingling.
Neurological examination is also helpful, and you may have your reflexes, strength and ability to feel light touches, pinpricks or vibration.
Treatment For a Herniated Disc.
If it is determined that you have a herniated disc, you will have some choices regarding possible treatment strategies. Most herniated discs will resolve themselves over time, but this can take several months.
In severe cases where the herniated disc is compressing nerves, spinal surgery may eventually be an option. A Discectomy (removing the disc, or, usually, a small portion of it) can be performed to take the pressure off the nerves. However, all surgery is risky, and should only be performed in exceptional cases where all other options have been exhausted.
Medications such as pain killers, anti-inflammatories, or steroids (such as Cortisone) can relieve the pain, but do not fix the underlying problem.
Chiropractic manipulation can increase spinal range of motion, relieve nerve pressure, restore blood flow and reduce muscle tension. It is low risk and has a very good success rate.
Ultrasound and massage can help to restore blood flow and reduce muscle tension. Hot and cold therapy, losing weight and quitting smoking are all known to be beneficial as well.
A specific exercise program designed to progressively stabilise the spine and increase flexibility, such as the Total Back Pain Solution, is often the only way to achieve long-term healing for most sufferers of a bulging spinal disc.
Most people with a herniated disc can make a full recovery with the right help. Unfortunately, there is not usually a quick fix. Recovery periods vary from several days to several months, depending on the severity and other factors such as age, weight, whether or not you are a smoker, commitment to a treatment program, etc.
It is important to understand what causes the discs to wear and tear in the first place. You can read more about that by reading What Causes Back Pain?
The vast majority of treatments for herniated disc lower back pain are solely focused on pain relief. Whilst critical at the start, a more long term approach to rehabilitating and stabilising the spine is the only solution to prevent a recurrence.
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