Lumbar Herniated Disc: What You Should Know (2024)

A herniated disc occurs when the inner gel-like core (nucleus pulposus) of a spinal disc pushes through a tear or weak point in the tough outer layer (annulus fibrosus). A lumbar disc herniation occurs in the lower back (lumbar spine), and most commonly develops at the L4-L5 and L5-S1 spinal motion segments, located toward the base of the lower back.1Al Qaraghli MI, De Jesus O. Lumbar Disc Herniation. [Updated 2023 Aug 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560878/,2Dydyk AM, Ngnitewe Massa R, Mesfin FB. Disc Herniation. [Updated 2023 Jan 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441822/

A herniated disc becomes a source of pain and discomfort if it irritates or compresses nearby structures, such as a spinal nerve root.

The size of the herniation does not always correlate with the intensity of symptoms. A small herniation might cause significant pain and neurologic symptoms if the nerve root is severely inflamed or compressed. Similarly, a large herniation may cause little to no pain if it does not affect a nerve root.

A lumbar herniated disc – also called a slipped disc, bulging disc, or disc bulge – is a common but complex condition that affects everyone differently.

In This Article:

  • Lumbar Herniated Disc: What You Should Know
  • Lumbar Herniated Disc Symptoms
  • Lumbar Herniated Disc: Causes and Risk Factors
  • Diagnosing a Lumbar Herniated Disc
  • Treatment for a Lumbar Herniated Disc
  • Lumbar Herniated Disc Video

What Causes a Lumbar Disc to Herniate

The most common cause of lumbar disc herniation is disc degeneration – a natural process that occurs with age – leading to dehydration and weakening of the spinal disc. These changes make the disc weak and reduce its ability to act as a shock absorber, making the outer ring more prone to tearing under pressure and the inner core more likely to progressively herniate over time.1Al Qaraghli MI, De Jesus O. Lumbar Disc Herniation. [Updated 2023 Aug 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560878/,2Dydyk AM, Ngnitewe Massa R, Mesfin FB. Disc Herniation. [Updated 2023 Jan 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441822/

The second most common cause of a lumbar herniated disc is a sudden injury to the disc, such as while lifting a heavy object or unnaturally twisting the lower back, which results in an immediate tear in the outer layer and herniation of the inner core.1Al Qaraghli MI, De Jesus O. Lumbar Disc Herniation. [Updated 2023 Aug 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560878/,2Dydyk AM, Ngnitewe Massa R, Mesfin FB. Disc Herniation. [Updated 2023 Jan 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441822/

advertisem*nt

How a Herniated Disc Causes Pain

A lumbar disc herniation causes pain in 2 ways:

  1. It inflames or compresses a nearby spinal nerve – causing pain and other symptoms to radiate along the path of the nerve.
  2. It presses on the posterior longitudinal ligament – a band of ligament that runs along the length of the spine between the discs and the spinal cord – causing localized pain in the lower back near the area of the herniation.

If the disc material inflames or irritates a nearby spinal nerve root, it causes burning pain, commonly called sciatica, which radiates from the lower back through the buttock and into the leg. Nerve root irritation is primarily caused by inflammatory proteins that leak out of the disc’s inner core and concentrate in the area around the nerve root.3Cosamalón-Gan I, Cosamalón-Gan T, Mattos-Piaggio G, Villar-Suárez V, García-Cosamalón J, Vega-Álvarez JA. Inflammation in the intervertebral disc herniation. Neurocirugía (English Edition). 2021;32(1):21-35. doi: 10.1016/j.neucie.2020.04.001The medical term for sciatica is radicular pain.

If the herniation mechanically compresses the nerve root, it may cause neurologic symptoms and signs, also called lumbar radiculopathy. Symptoms and signs of nerve root compression typically include numbness, a pins and needles sensation, and weakness in the leg and/or foot.Additionally, spinal nerve compression potentially leads to reduced blood flow to the nerve and swelling, further contributing to pain.1Al Qaraghli MI, De Jesus O. Lumbar Disc Herniation. [Updated 2023 Aug 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560878/

Watch Sciatica Causes and Symptoms Video

Some disc herniations that exert pressure on the posterior longitudinal ligament also affect the spinal cord or cauda equina – causing more serious symptoms such as loss of sensation in the lower body or problems with walking.

advertisem*nt

How Long It Takes to Recover from A Herniated Disc

Symptoms of a herniated disc are usually short-lived. In 90% of cases, a herniated disc in the lower back heals on its own within 6 to 12 weeks.1Al Qaraghli MI, De Jesus O. Lumbar Disc Herniation. [Updated 2023 Aug 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560878/

Individuals without neurological signs (radiculopathy) tend to recover sooner, sometimes as soon as 2 weeks.1Al Qaraghli MI, De Jesus O. Lumbar Disc Herniation. [Updated 2023 Aug 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560878/

Surgery may be considered if the symptoms and/or signs continue or progressively worsen despite several months of non-surgical treatments.4Schoenfeld AJ, Weiner BK. Treatment of lumbar disc herniation: Evidence-based practice.Int J Gen Med. 2010;3:209-214. Published 2010 Jul 21. doi:10.2147/ijgm.s12270In some cases, surgery may be considered sooner or may be an urgent medical necessity, such as in cauda equina syndrome.1Al Qaraghli MI, De Jesus O. Lumbar Disc Herniation. [Updated 2023 Aug 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560878/

When a Lumbar Herniated Disc Is a Medical Emergency

In rare cases, a herniated disc in the lower back compresses the spinal cord or cauda equina – the bundle of spinal nerves extending from the end of the spinal cord – and becomes a medical emergency requiring surgery to prevent permanent neurologic damage.5Kapetanakis S, Chaniotakis C, Kazakos C, Papathanasiou JV. Cauda Equina Syndrome Due to Lumbar Disc Herniation: a Review of Literature. Folia Medica. 2017;59(4):377-386. doi: 10.1515/folmed-2017-0038,6Endo F, Iizuka H, Iizuka Y, Kobayashi R, Mieda T, Takagishi K. Myelopathy due to lumbar disc herniation in the presence of a tethered cord.Spinal Cord. 2014;52(1):S11-S13. doi:10.1038/sc.2014.67

Symptoms and signs to watch for include7Bednar DA. Cauda equina syndrome from lumbar disc herniation. CMAJ. 2016;188(4):284. doi:10.1503/cmaj.150206:

  • Severe, disabling pain in both legs
  • Numbness in the inner thighs, the back of the legs, and the area around the rectum (saddle anesthesia)
  • Progressive weakness or motor deficits in the legs, ankles, or feet making it difficult to walk or stand
  • Bladder and/or bowel dysfunction
  • Sexual dysfunction (such as the inability to get or maintain an erection or loss of sensation in the genital area)

Paralysis and permanent nerve damage are possible if treatment is delayed. Emergency medical care is needed if these symptoms occur.5Kapetanakis S, Chaniotakis C, Kazakos C, Papathanasiou JV. Cauda Equina Syndrome Due to Lumbar Disc Herniation: a Review of Literature. Folia Medica. 2017;59(4):377-386. doi: 10.1515/folmed-2017-0038

Read more about Cauda Equina Syndrome Symptoms

advertisem*nt

Doctors Who Diagnose and Treat Herniated Discs

In addition to primary care physicians, specialists who diagnose and treat lumbar spine problems include:

  • Physiatrist (Physical Medicine and Rehabilitation specialist)
  • Orthopedic or neurological spine surgeon
  • Neurologist
  • Chiropractor
  • Physical therapist

A lumbar herniated disc does not always cause pain or serious complications. In fact, in up to 99% of cases, the injured disc does not cause symptoms, and the herniation is only discovered during imaging tests (such as magnetic resonance imaging) for unrelated medical problems.2Dydyk AM, Ngnitewe Massa R, Mesfin FB. Disc Herniation. [Updated 2023 Jan 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441822/

  • 1 Al Qaraghli MI, De Jesus O. Lumbar Disc Herniation. [Updated 2023 Aug 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560878/
  • 2 Dydyk AM, Ngnitewe Massa R, Mesfin FB. Disc Herniation. [Updated 2023 Jan 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441822/
  • 3 Cosamalón-Gan I, Cosamalón-Gan T, Mattos-Piaggio G, Villar-Suárez V, García-Cosamalón J, Vega-Álvarez JA. Inflammation in the intervertebral disc herniation. Neurocirugía (English Edition). 2021;32(1):21-35. doi: 10.1016/j.neucie.2020.04.001
  • 4 Schoenfeld AJ, Weiner BK. Treatment of lumbar disc herniation: Evidence-based practice.Int J Gen Med. 2010;3:209-214. Published 2010 Jul 21. doi:10.2147/ijgm.s12270
  • 5 Kapetanakis S, Chaniotakis C, Kazakos C, Papathanasiou JV. Cauda Equina Syndrome Due to Lumbar Disc Herniation: a Review of Literature. Folia Medica. 2017;59(4):377-386. doi: 10.1515/folmed-2017-0038
  • 6 Endo F, Iizuka H, Iizuka Y, Kobayashi R, Mieda T, Takagishi K. Myelopathy due to lumbar disc herniation in the presence of a tethered cord.Spinal Cord. 2014;52(1):S11-S13. doi:10.1038/sc.2014.67
  • 7 Bednar DA. Cauda equina syndrome from lumbar disc herniation. CMAJ. 2016;188(4):284. doi:10.1503/cmaj.150206

Dr. Roger Härtl is a neurosurgeon with more than 20 years of experience specializing in spine surgery and neurotrauma. He is the Director of the Weill Cornell Medicine Center for Comprehensive Spine Care in New York.

advertisem*nt

Editor’s Top Picks

  • Lumbar Herniated Disc Video

  • Herniated Disc Symptoms Animation

  • Lumbar Herniated Disc Treatment Video

  • Insights and Advice About Herniated Discs

  • What's a Herniated Disc, Pinched Nerve, Bulging Disc...?

  • Sciatica Causes and Symptoms Video

Lumbar Herniated Disc: What You Should Know (2024)

FAQs

What do you need to know about a herniated disc? ›

These discs are made up of a jelly-like substance and act as cushions for your spine. A herniated (or slipped) disc occurs when all or part of a disc is forced through a weakened part of the spine. This may place pressure on nearby nerves or the spinal cord. The lower back is most commonly affected by herniated discs.

What is the fastest way to heal a herniated disc? ›

Lifestyle and home remedies
  1. Applying heat or cold. At first, cold packs can be used to relieve pain and swelling. ...
  2. Avoiding too much bed rest. Staying in bed can lead to stiff joints and weak muscles — which can complicate your recovery. ...
  3. Resuming activity slowly. Let your pain guide you in resuming your activities.
Oct 24, 2023

What makes a lumbar herniated disc worse? ›

These are the most common symptoms of lumbar disk disease: Intermittent or continuous back pain. This may be made worse by movement, coughing, sneezing, or standing for long periods of time.

What is the best pain medication for a herniated disc? ›

Your doctor might also prescribe muscle relaxants to ease muscle spasms in your back. And nerve pain medicines, such as amitriptyline (Elavil, Vanatrip), duloxetine (Cymbalta), gabapentin (Neurontin), pregabalin (Lyrica), and tramadol (Ultram) are options to ease nerve-damage pain.

Is walking good for a herniated disc? ›

In addition to the exercises below, walking and swimming are also excellent options to build up your activity level after experiencing herniated disk pain. In severe cases, herniated disks can affect bowel or bladder control, urging immediate medical consultation.

What happens if you don't do anything about a herniated disc? ›

If untreated for an extended period of time, the pressure caused by inflammation can cause permanent damage to the surrounding tissues and nerves, leading to more severe forms of chronic pain such as neuropathy or radiculopathy. If not treated promptly, this damage can result in permanent disability in some cases.

Does a herniated disc ever fully go away? ›

Chances are good that your herniated disc symptoms will pass on their own, as is the case about 90% of the time when people have a disc rupture. The question as to whether a disc herniation fully heals is harder to answer. Spinal discs can heal, and they can also become asymptomatic without fully healing.

Is lying down good for herniated disc? ›

It is best to avoid prolonged sitting if you have an injured disc. This can place more strain upon your spinal discs. By moving about and standing, you can maintain your comfort. It is a good idea, if you want to let your ligaments and discs relax, to lay down as often as possible.

How long does it take for a herniated disc to reabsorb? ›

In most cases, pain from herniated discs will subside within two to 8 weeks. However, in some cases, your herniated disc might take up to six months to fully heal. Every patient is different, and so is their healing timeline. However, you can take steps to support your overall health and help your body heal.

What foods should you avoid with a herniated disc? ›

This can include items like refined sugars and carbohydrates, processed foods, and red meat. These types of foods can trigger an immune response in the body, leading to increased inflammation and pain. Limit Dairy Intake: Another category of foods to avoid with a herniated disc is high-fat dairy products.

Does a herniated disc hurt all the time? ›

Depending on where the herniated disk is, it can result in pain, numbness or weakness in an arm or a leg. Many people have no symptoms from a herniated disk. For people who do have symptoms, the symptoms tend to improve over time.

What aggravates a herniated lumbar disc? ›

While bending, twisting, and lifting movements trigger both cervical (neck) and lumbar (low back) herniated disc symptoms, most people experience a worsening of leg pain (sciatica) and lumbar radiculopathy symptoms from discs in the L4-L5 or L5-S1 spinal levels.

How can I get immediate relief from a herniated disc? ›

Common home remedies for pain from a herniated disc
  1. Heat therapy with a heating pad or hot compress to loosen tight muscles and improve blood flow.
  2. Cold therapy with ice packs to relieve pain and inflammation.
  3. Low-impact aerobic exercise, such as walking, stationary biking, or water therapy, to release endorphins.

What is the new treatment for herniated discs? ›

Along with a microdiscectomy, a new treatment for herniated discs involves hyaluronic acid (HA) gel and collagen gel. The HA gel re-inflates the disc, while the collagen gel seals the hole to prevent further prolapse. Ask your doctor about this treatment option with a microdiscectomy.

Will muscle relaxers help a herniated disc? ›

They cannot treat herniated or bulging discs, but they can reduce pain and allow you to do physical therapy.

Is a herniated disc something to worry about? ›

Rarely, disk herniation can compress the entire spinal canal, including all the nerves of the cauda equina. In rare instances, emergency surgery might be needed to avoid permanent weakness or paralysis. Seek emergency medical attention if you have: Worsening symptoms.

What are 3 symptoms of herniated disk? ›

A sudden injury can cause a herniated disk. Symptoms include sharp or burning pain at the point of injury, numbness, tingling, and weakness. A herniated disk in the lower back can trigger traveling pain into the buttocks, hip, and leg. A herniated disk in the neck can trigger pain in the shoulder and arm.

How long does it take for a herniated disc to heal? ›

As soon as you seek treatment for your herniated disc, you can start your healing journey. In most cases, pain from herniated discs will subside within two to 8 weeks. However, in some cases, your herniated disc might take up to six months to fully heal. Every patient is different, and so is their healing timeline.

Can a herniated disc heal on its own? ›

Herniated Disk (Slipped, Ruptured or Bulging Disk) A herniated disk is also known as a slipped, ruptured or bulging disk. It's one of the most common causes of neck, back and leg pain. Most of the time, herniated disks heal on their own or with simple home-care measures.

Top Articles
Latest Posts
Article information

Author: Errol Quitzon

Last Updated:

Views: 5423

Rating: 4.9 / 5 (59 voted)

Reviews: 82% of readers found this page helpful

Author information

Name: Errol Quitzon

Birthday: 1993-04-02

Address: 70604 Haley Lane, Port Weldonside, TN 99233-0942

Phone: +9665282866296

Job: Product Retail Agent

Hobby: Computer programming, Horseback riding, Hooping, Dance, Ice skating, Backpacking, Rafting

Introduction: My name is Errol Quitzon, I am a fair, cute, fancy, clean, attractive, sparkling, kind person who loves writing and wants to share my knowledge and understanding with you.