Lumbar disc disease also referred to as herniated disc, is an injury that affects the lumbar region of the spinal cord (backbone). The spinal cord consists of about 33 vertebrae, which is divided into five regions - cervical (7 vertebrae), thoracic (12 vertebrae), lumbar (5 vertebrae), sacral (5 vertebrae), and coccyx (4 vertebrae). Between the vertebrae, rubbery cushion-like structures called discs are located. These discs act as shock absorbers and help the spine bend and move around. About 2% of individuals are diagnosed with a herniated disc each year.
Types of Lumbar Disc
- The disc is composed of a soft centre called a nucleus surrounded by a tough exterior, annulus. In this condition, the annulus breaks down, causing the nucleus to bulge out.
Ruptured or herniated
- Continued disc breakdown causes the nucleus to rupture via the annulus leading to a ruptured or herniated disc.
Causes of Lumbar Disc
Lumbar disc disease can be caused due to-
- Severe injury
- Improper lifting of heavy objects and twists.
Signs and Symptoms of Lumbar Disc
The signs and symptoms of lumbar disc disease include-
- Back pain: Continuous or intermittent pain worsened during sneezing, coughing, movement, or standing for a prolonged period.
- Tingling or numbness in the leg or foot.
- Muscle weakness
- Bowel or bladder dysfunction
- Sciatica: A pain that begins from the buttock or back and radiates down the leg to the foot.
Risk Factors of Lumbar Disc
Factors that increase the risk of lumbar disc disease include-
- Smoking: Smoking is thought to interfere with oxygen supply to the disc. This accelerates the breakdown of the disc.
- Weight: Overweight can cause stress to the discs of the lower back.
- Occupation: Individuals involved in physically challenging jobs are at increased risk of developing lumbar disc disease. Repetitive movements like pulling, lifting, twisting, bending, etc., increase the risk of a herniated disc.
- Genetics: Some individuals have an inherited liability to develop lumbar disc disease.
Diagnosis and Tests of Lumbar Disc
The doctor would perform a thorough examination to assess the patient’s medical history, signs, symptoms, muscle strength, reflexes, etc. In addition, the doctor may also recommend the following tests-
X-ray scan: An X-ray test would be recommended to rule out other causes of pain
Computed Tomography (CT) scan: Uses a combination of X-rays and computer to create detailed slices of bones, muscles, etc.
Magnetic Resonance Imaging (MRI) scan: MRI is the most preferred test for diagnosing a herniated disk.
Myelogram: This test helps better visualise the spine in X-ray or CT scans. The procedure involves injecting a contrast material (dye) into the spinal canal.
Electromyography (EMG): This test helps identify the nerve affected by the herniated disc.
Doctors who treat lumbar disc disease are called orthopedic spine specialists.
Treatment and Care for Lumbar Disc
Depending upon the severity of the pain, the doctor may recommend the following treatment strategies:
Anti-inflammatory drugs, painkillers, and muscle relaxants are commonly prescribed for managing lumbar disc disease. Sometimes, steroids are directly injected into the spine.
Physical therapy improves circulation and loosens muscles.
In severe cases, surgery would be performed to remove the herniated disc.
The following lifestyle modifications can also be adopted to reduce the severity-
- Exercise regularly.
- Quit smoking.
- Ensure proper lifting of weights.
- Maintain proper body weight.
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