Disc herniation‘s are one of the most common ailments in the general population. The spine is divided into three areas, cervical, thoracic, and lumbar. Disk injuries can occur to all segments of the spine, although injuries to the spinal disc in the lumbar region are most common.
My past blog titled causes of back pain goes into the anatomy of the spine, both diskogenic and vertebrogenic. In this article I will specifically discuss lumbar disk injuries. The function of the intravertebral discs are to cushion between the vertebral bodies. They add height, aid in movement and contribute to stability.
A disc herniation occurs when excessive forces are placed on the lumbar spine, causing the structures which contain the disk to rupture. The disc can then put pressure on either the spinal cord or exiting nerve roots. This will result in low back and/or leg pain.
Various treatments exist for lumbar disc herniation’s. Initial treatment should involve conservative therapy including medications, and a brief period of rest, followed by physical therapy (including exercises, traction etc.). If symptoms persist, a lumbar epidural steroid injection is standard of care and the most common treatment for this condition. Many patients will improve with one up to three such treatments. Other treatment options include a percutaneous distal compression and if necessary, microdiscectomy surgery.
As with all conditions, treatment should start with the most conservative slowly progressing to more aggressive interventions. When treating a patient with injection therapy, my goal is always to utilize the lease number of treatments and the least invasive modality. I try to avoid surgery as much as possible due to its increased risks and recuperate of time.
In conclusion, lumbar disc herniation‘s are extremely common. Surgery can be avoided in most cases. The goal of treatment is to alleviate the pain, improve function, and return the patient to their pre-existing state as soon as possible.