Low Back Pain Disc Bulges, Herniations, Protrusions

Posted by Dr. Podesta on March 17, 2011 with 51 Comments

Back pain is second only to the common cold as the most common reason for seeing a physician. Low back pain is a very common problem experienced by most individuals with 70 to 80% of the world’s population experiencing low back pain sometime during their lives. Younger individuals in their mid 30’s are at greatest risk for intervertebral disc herniations.

The intervertebral discs are small, circular cushions between the vertebral bones. The discs function as shock absorbers and cushions. Lumbar discs are made up of a gelatinous inner center or nucleous surrounded by a thick casing or annulus. The discs help to separate two vertebral bones while maintaining the spacing for the exiting spinal nerves.

Discs are damaged when the outer casing or annulus allows the inner nucleus to escape thought the outer layer. The disc can be damaged by a sudden strenuous action such as lifting a heavy object or twisting. The discs can also be damaged by a fall or accident, repeated straining of your back or most commonly by simply bending over and twisting.

The pain associated with disc herniations can range from localized pain in the low pack to pain radiating into the buttocks or legs. Lumbar disc herniations that are compressing or irritating a nerve root can cause an electric type pain down the legs, numbness and tingling in the legs or in more severe cases, weakness in the leg muscles and bowel and bladder abnormalities.

Disc herniations can be diagnosed after a thorough history, physical examination and imaging studies such as an MRI or CT scan have been performed.

The treatment for lumbar disc herniations will depend on the severity of the herniation itself and the associated symptoms created by the herniation. Conservative treatment may include relative rest, application of ice packs, physical therapy, core-strengthening exercises, oral medications such as anti-inflammatories, pain medication, muscle relaxants, and spinal injections including epidural steroids. If conservative treatment fails then surgical treatment may become necessary. However, the vast majority of disc herniations can be affectively treated non-surgically.

The key to treating low back pain from disc herniations is to prevent them from happening in the first place. Next month’s article will concentrate on prevention of back injuries for drummers.


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