The lumbar spine (low back) is made of five vertebrae (bones) separated by cartilaginous discs. These discs are shock absorbers. They cushion the bones and increase flexibility of the lower back. Lumbar disc syndrome is a group of symptoms related to disorders of these lumbar discs. Degenerative changes or trauma may burst the annulus fibrosus. The annulus fibrosus is the tough band of cartilage around each disc. Disc material may bulge (herniate) into the spinal canal or nerve root canal and cause pain.
Degenerative changes in discs are due to normal aging. Poor posture and strenuous work with poor lifting methods may make these changes worse. Discs slowly become worn, less plump, and flat. When disc spaces become so narrow that vertebrae rub together, vertebrae edges have wear-and-tear changes. Then bone spurs develop that may press on the spinal cord or nerve roots. As the nerve is irritated, back and leg pain, tingling, and numbness or weakness in the legs or feet can occur. Rarely, with very large, sudden disc bulges, bladder and bowel control may be lost.
Pain in the back or tingling and numbness may reach the buttocks, hips, groin, or legs. Pain from a bulging disc is worse while moving, coughing, laughing, or straining when having a bowel movement. Some people also have weakness, clumsiness, foot-drop, or trouble walking.
The health care provider will obtain a medical history and do an examination. X-rays may also be done. One or more of the following tests may also be done for persistent pain or if surgery is being considered: computed tomography (CT), magnetic resonance imaging (MRI), combined myelography/CT, and electromyography/nerve conduction velocity test (EMG/NCV).
A trained physical therapist will use conservative treatments, such as physical therapy, ultrasound, localized heat, and special exercises. Injection of steroids and an anesthetic drug into the spinal canal may help pain. Surgery is usually the final option if other treatments don’t work.
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