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Herniated Disc (Lumbar Disc Herniation): Symptoms, Causes, and Treatment Options

What is a Herniated Disc?

A herniated disc (lumbar disc herniation) occurs when the intervertebral discs between the vertebrae become damaged or displaced, leading to pressure on the spinal nerves. This condition can cause lower back pain, radiating leg pain (sciatica), numbness, and muscle weakness.

Herniated discs are commonly seen in people with sedentary lifestyles, heavy lifting jobs, or prolonged inactivity. Early diagnosis and appropriate treatment are crucial in preventing disease progression.

Symptoms of a Herniated Disc

The symptoms of a herniated disc depend on the severity of the herniation, nerve compression, and disease progression. Common symptoms include:

Lower back pain: Often worsens with movement and prolonged sitting or standing.

Radiating leg pain (sciatica): Pain that starts in the lower back and extends down the leg to the foot due to nerve compression.

Numbness and tingling: May extend from the lower back to the legs and feet.

Muscle weakness: Loss of strength in the legs, ankles, or toes.

Balance issues and walking difficulties: Severe cases can lead to mobility restrictions.

Loss of bladder or bowel control: A rare but emergency symptom of cauda equina syndrome, requiring immediate medical attention.

Causes of a Herniated Disc

Several factors can contribute to the development of a herniated disc, including:

Poor posture and incorrect movements: Prolonged improper sitting or incorrect heavy lifting techniques.

Aging and degeneration: The discs lose their elasticity and wear down over time.

Heavy lifting: Lifting heavy objects with improper technique can strain the discs.

Lack of physical activity: Weak muscles provide inadequate spinal support.

Obesity: Excess weight increases stress on the lumbar spine, raising the risk of herniation.

Trauma: Accidents or sudden movements can damage the discs.

Genetic predisposition: A family history of herniated discs increases susceptibility.

How is a Herniated Disc Diagnosed?

Orthopedic and neurosurgery specialists diagnose herniated discs using physical examinations and imaging techniques, including:

Physical examination: Evaluates nerve reflexes, muscle strength, and sensory loss.

Magnetic Resonance Imaging (MRI): Provides detailed imaging of the disc herniation and its effect on the nerves.

Computed Tomography (CT): Used for a detailed assessment of the spine.

Electromyography (EMG): Tests nerve conduction to determine the severity of nerve compression.

Treatment Options for a Herniated Disc

The treatment for a herniated disc varies depending on the patient’s condition. Non-surgical methods are preferred for early-stage cases, while surgical intervention may be required in advanced cases.

1. Non-Surgical (Conservative) Treatment

For mild to moderate herniated disc cases, the following treatments may be applied:

Medication therapy: Nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, and nerve pain medications help reduce inflammation and pain.

Physical therapy and rehabilitation: Strengthening exercises for spinal stability, manual therapy, electrical stimulation, and heat/cold applications.

Exercise and lifestyle changes: Swimming, Pilates, and stretching exercises strengthen back muscles and improve flexibility.

Lumbar support brace: Provides temporary spinal support but should not be used for extended periods to prevent muscle weakening.

Epidural steroid injections: Reduce inflammation and nerve compression.

2. Surgical Treatment

Surgery is recommended for cases unresponsive to conservative treatments, especially when progressive muscle weakness or severe pain occurs. Common surgical procedures include:

Microdiscectomy: A minimally invasive procedure where the herniated portion of the disc is removed to relieve nerve pressure.

Lumbar discectomy: Removes the damaged disc to alleviate pain and nerve compression.

Spinal fusion: Used in advanced cases to stabilize the spine by fusing vertebrae together.

Artificial disc replacement: A damaged disc is replaced with an artificial disc to maintain spinal mobility.

Preventive Measures for a Herniated Disc

Maintain proper posture: Sit up straight and bend your knees when lifting heavy objects.

Engage in regular exercise: Strengthening the lower back muscles with activities like walking and swimming.

Maintain a healthy weight: Excess weight increases pressure on the spine, raising the risk of disc herniation.

Avoid sudden movements: Sudden bending or twisting can strain the discs.

Improve flexibility: Stretching exercises help maintain spinal health.

Expert Opinions on Herniated Discs

Orthopedic specialists Doç. Dr. Serhat Mutlu and Doç. Dr. Harun Mutlu emphasize that early diagnosis and proper treatment significantly improve patients’ quality of life. A thorough evaluation of cases requiring surgery and maximizing the benefits of conservative treatments are essential.

If you experience symptoms such as lower back pain, sciatica, or numbness, consulting an orthopedic specialist for a detailed assessment is highly recommended.