Lumbar disc prolapse
Lumbar disc prolapse is when a spinal disc's inner soft gel-like material protrudes through a tear in its outer layer. This condition is also referred to as a slipped disc or herniated disc. Spinal discs act as cushions between the vertebrae of the spine, enabling flexibility and movement of the spine.
Disc prolapse can exert pressure on nerves or the spinal cord located in the vicinity, resulting in discomfort, tingling, and/or reduced strength in the back, buttocks, legs, or feet. The severity of the symptoms varies depending on the prolapse's size and location, ranging from moderate to severe.
What causes the lumbar disc to prolapse?
Lumbar disc prolapse is a common condition and can be asymptomatic. Men and women are at equal risk of developing sciatica following lumbar disc prolapse.
Several risk factors are associated with lumbar disc prolapse, including.
- Age - As people age, the spinal discs become less flexible and more susceptible to tears and prolapses.
- Genetics - Disc prolapse may have a genetic component, as some people are born with weaker spinal discs.
- Occupation - Jobs that involve heavy lifting, twisting, and bending increase the risk of disc prolapse.
- Obesity - Being overweight or obese can put extra pressure on the spinal discs and increase the risk of prolapse.
- Poor posture - Sitting or standing with poor posture can strain the spinal discs and increase the risk of prolapse.
- Trauma - Injuries to the spine, such as falls or car accidents, can cause the disc to prolapse.
- Smoking - Smoking has been linked to an increased risk of disc prolapse.
It's important to note that having one or more risk factors doesn't necessarily mean a person will develop lumbar disc prolapse, but it increases the likelihood.
How does lumbar disc prolapse present?
Lumbar disc prolapse can manifest differently depending on the severity, location, and size of the prolapse. Nevertheless, typical symptoms of lumbar disc prolapse include:
- Low back pain: This is the most common symptom that can vary from mild to severe, intermittent, or constant.
- Sciatica: When the prolapse compresses a nerve root in the lower back, it can cause sciatica, characterized by pain, tingling, or numbness that spreads down one or both legs. The pain may intensify when sitting, coughing, sneezing, or straining.
- Muscle weakness: Prolapsed discs can result in muscle weakness in the legs or feet, leading to difficulty lifting the foot, standing on tiptoe, or walking on the toes.
- Loss of bladder or bowel control: In severe instances, lumbar disc prolapse can cause bladder or bowel control loss, a medical emergency requiring immediate medical attention.
It is crucial to recognize that not all individuals with lumbar disc prolapse encounter symptoms, and some may not experience any symptoms at all. Furthermore, the symptoms of lumbar disc prolapse can overlap with other conditions, emphasizing the importance of seeking a medical diagnosis for appropriate treatment.
Get immediate care for sciatica if:
- Have sciatica on both sides.
- Have weakness or numbness in both legs that are severe and getting worse.
- Have numbness around or under your genitals or around your bottom (anus).
- It is hard to start peeing, cannot pee or control when you pee – and this is not normal for you.
- Sexual dysfunction.
- Do not notice when you need to poo or cannot control when you poo – which is not normal for you.
These could be symptoms of a serious back problem that needs to be treated in the hospital as soon as possible.
Diagnosis of lumbar disc prolapse.
Diagnosing lumbar disc prolapse typically involves a combination of a patient's medical history, physical examination, and imaging tests.
During the physical examination, the healthcare provider will check for any weakness or loss of sensation in the legs and assess reflexes. They may also ask the patient to perform certain movements to determine the range of motion and any associated pain or discomfort.
Imaging tests such as MRI scans (or CT) can help confirm the diagnosis of lumbar disc prolapse and determine the location and severity of the prolapse. The MRI scan is usually the preferred imaging test for diagnosing lumbar disc prolapse, as it can provide detailed images of the spinal cord and the surrounding soft tissues.
In some cases, further tests such as electromyography (EMG) or nerve conduction studies (NCS) may be required to evaluate nerve function and determine the extent of nerve damage caused by the prolapse.
Treatment of lumbar disc prolapse.
The treatment of lumbar disc prolapse depends on the severity of the symptoms and the extent of nerve involvement.
In most cases, conservative treatments are initially recommended, and surgery is considered if symptoms persist or worsen despite non-surgical treatments.
Conservative treatments for lumbar disc prolapse may include:
- Rest: Avoiding activities that exacerbate the pain and taking a break from work or other physical activities can help reduce symptoms. However, staying active is still recommended. Limit bed rest to avoid muscle deconditioning.
- Pain relief: Over-the-counter pain medications, such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs), may be prescribed to alleviate pain and inflammation.
- Physical therapy: Specific exercises and stretches can help relieve pain and improve flexibility and range of motion.
- Steroid injections: Corticosteroid injections may be administered directly into the affected area to reduce inflammation and alleviate pain.
- Alternative therapies: There's some evidence that manual therapies, like osteopathy, can help ease lower back pain.
Surgery may be recommended if conservative treatments fail to relieve symptoms or if the patient experiences severe nerve damage. The most common surgical procedure for lumbar disc prolapses is a discectomy, in which the prolapsed disc is removed to relieve pressure on the nerves.
Explore procedures for Lumbar Disc Prolapse:
Lumbar Discectomy: Surgery to remove the disc material that is pressing on nerves.
Lumbar Laminectomy: A procedure to create space by removing the back part of the vertebra that covers the spinal canal.
Explore more related spinal conditions:
Cervical Disc Prolapse: The nature of cervical disc displacement and its potential treatments.
Cervical Disc Myelopathy: The compression of the spinal cord in the cervical spine and its neurological implications.
Arm Pain (Cervical Radiculopathy): Understand the nerve compression in the cervical spine causing pain and numbness in the arms.