How a lumbar disc herniates
A tough outer ring called the annulus protects the gel-like interior of each disc, known as the nucleus pulposus.
Due to aging and general wear and tear, the discs lose some of the fluid that makes them pliable and spongy. As a result, the discs tend to become flatter and harder. This process—known as disc degeneration—starts fairly early in life, often showing up in imaging tests in early adulthood.
When pressure or stress is placed on the spine, the disc’s outer ring may bulge, crack, or tear. If this occurs in the lower back (the lumbar spine), the disc protrusion may push against the nearby spinal nerve root. Or the inflammatory material from the interior may irritate the nerve. The result is shooting pains into the buttock and down the leg.
A person with a herniated disc may be told by the doctor that degenerative disc disease led to the lumbar herniated disc. This term can be alarming and misleading. Degenerative disc disease is not a progressive disease per se, and it does not always cause chronic or persistent problems.
Lumbar herniated disc symptoms are usually short-lived
While a lumbar herniated disc can be extremely painful, for most people the symptoms are not long-lasting.
About 90% of people who experience a lumbar herniated disc will have no symptoms six weeks later, even if they have had no medical treatment.
Experts believe the symptoms from a lumbar herniated disc may resolve themselves for three reasons:
In general, it is thought that the symptoms get better because the smaller size of the herniated material reduces the likelihood it will irritate the nerve root.
Although a lumbar herniated disc usually triggers attention when it becomes painful, medical research has found it is common for people to have a lumbar disc herniation in their lumbar spine, but no associated pain or other symptoms.
It is for this reason that care must be taken in the diagnosis to be sure a herniated lumbar disc is causing the problem.
Other terms for herniated disc: slipped disc, ruptured disc
A herniated disc may be referred to by many names, such as a slipped disc, or a ruptured or bulging disc. The term slipped disc can cause confusion since spinal discs are firmly attached to the vertebrae and do not slip or move—rather, it is just the gel-like inner material of the disc "slips" out of the inside.
Another common term for a herniated disc is a pinched nerve. This term describes the effect the herniated disc material has on a nearby nerve as it compresses or "pinches" that nerve.
A lumbar herniated disc may also be described in reference to its main symptoms, such as sciatica, which is caused by the leaked disc material affecting the large sciatic nerve. When a nerve root in the lower back that runs into the large sciatic nerve is irritated, pain and symptoms may radiate along the path of the sciatic nerve: down the back of the leg and into the foot and toes.
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1.Slipped Disk: Overview, National Library of Medicine, PubMed Health. Oct. 9, 2014. www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072656/ .
2.Brinjikji W, Luetmer PH, Comstock B, et al. Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations. AJNR American journal of neuroradiology. 2015;36(4):811-816. doi:10.3174/ajnr.A4173.