Lifting the wrong way, repetitive motions, or whiplash can trigger problems in your lower back and spine. A lot of times, general “wear and tear” or aging can also cause these problems. McLeod Spine Surgeon W.S. (Bill) Edwards, MD, explains treatment options for lumbar spine disc herniations:
Here are highlights of Dr. Edwards’ comments:
When patients come to my office and complain of symptoms that are suggestive of a disc herniation in their lower back, usually they’re having back pain predominantly in the lower part around the waist or down into the buttock region. The pain typically radiates into the back of the leg down into even as low as the calf and ankle. That usually means that when that disc bulges, or protrudes, out, it is pressing on the branch of the sciatic nerve going into the buttock and leg.
Patients will ask what causes discs to herniate. There are many different things that could cause this-mainly traumatic types of events like improper lifting maneuvers at work, or motor vehicle accidents. In some cases, patients don’t recall any specific event or injury-it’s something that just happens. Sometimes they wake up with a little pain in their back and it starts going into the buttock and into the leg, but most of the time in the low back region it relates to some type of a lifting, or some type of an injury or fall.
A disc herniates when the outer lining of that disc, which is like a fiber mesh, gets a weak spot in it (kind of like the weak area in a sidewall of a tire) and the disc material, or jelly-like cushioning part, pushes through that weak area.
When the disc protrudes, it pinches or presses on a nerve and causes pain. The conservative efforts are very important and most of the time will be the use of some medications such as muscle relaxers, or anti-inflammatory medications. Physical Therapy can restore lost function and strengthen the surrounding areas. We know that about 80 percent of disc herniations will not need surgery, so we explore conservative treatments and try to buy some time until the body’s natural healing can take place.
The surgical treatment for lumbar disc herniation is to remove the part of the disc that is ruptured. Unlike in the cervical spine where the disc really is not functional anymore and we have to remove it and do a fusion, removing the entire disc in the lumbar spine is rarely necessary. The disc in the lumbar spine, even when with a big herniation, is really only about 5-percent of the entire volume of the disc that herniates, so we remove the herniated part of the disc in a minimally invasive approach, with usually about a 1-inch incision. Basically, we’re just removing the part of the disc that’s ruptured. We’re leaving the rest of it in there because God put there for a reason—it’s there to provide cushioning and support for the spine, so we’re not going to do anything to disturb that. Usually there’s enough left behind to accomplish this.