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| Home > Spinal Disorders > Disc Herniations > Lumbar Disc Herniation - Overview |
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LUMBAR DISC HERNIATION
Overview
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Symptoms
Back or buttock pain, leg pain, weakness in the lower extremities, numbness or burning in the leg, bowel or bladder incontinence.
General Overview
A lumbar disc herniation (herniated disc) is a rupture and/or bulge of an interverterbral disc in the low back. The intervertebral disc is a complex spongy structure which consists of a central sticky gelatinous portion, the nucleus, and an outer fibrous ring of tissue, the annulus. These discs are found along the entire spine from the neck all the way down to the lowest part of the back. The function of this disc is to permit motion of the spine while also acting as a shock absorber and connecting link between each vertebral body. The outer layer, the annulus, may actually tear and result in extrusion or bulge of the inner part of the disc, the nucleus. This is called a disc herniation.
The nerve may become irritated either as a result of chemical reaction to an injured disc and/or to compression from the herniated disc itself. The space in which nerves normally sit is quite small and there is not much free space. The symptoms from this irritation can range from numbness, tingling and pain to bladder dysfunction, weakness and even partial paralysis. The particular area of the body which is affected depends upon which nerve is being irritated by the herniated disc.
The four stages to a herniated disc include:
- Disc Degeneration - chemical changes associated with aging causes discs to weaken, but without a herniation.
- Prolapse- the form or position of the disc changes with some slight impingement into the spinal canal. Also called a bulge or protrusion.
- Extrusion - the gel-like nucleus pulposus breaks through the tire-like wall (annulus fibrosus) but remains within the disc.
- Sequestration or Sequestered Disc - the nucleus pulposus breaks through the annulus fibrosus and lies outside the disc in the spinal canal (HNP).
Disc herniations usually occur in the young adult population, age 20-50. Approximately 90% of disc herniations will occur in low back at L4-L5 or L5-S1. L5 nerve impingement can cause weakness in extension of the big toe and potentially in the ankle (foot drop). Numbness and pain can be felt on top of the foot, and the pain may also radiate into the buttocks. S1 nerve impingement may cause loss of the ankle reflex and/or weakness in ankle push off (e.g. patients cannot do toe rises). Numbness and pain can radiate down to the sole or outside of the foot.
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Excerpts of this article (text/graphics) were provided by
"AllAboutBackandNeckPain.com" DePuy Spine ©2003.
All rights reserved.
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