Struggling with pain that radiates down your leg and into your foot and ankle? If so, you may be experiencing nerve irritation or sciatica resulting from a lumbar disc herniation (LDH). Whether it’s the result of a degenerative change or a sudden injury, nerve compression caused by a lumbar herniated disc can truly be debilitating, and the long-term effects can be life-altering.
This blog post covers the symptoms of a herniated disc in the lower back, as well as the process a physician uses to diagnose and treat the root cause of your symptoms.
Common Signs of a Lumbar Herniated Disc
The most common signs of a herniated disc in the lower back include pain shooting down the leg and into the foot (sciatica), numbness and tingling in the legs, weakness or loss of muscle control, decreased mobility, including difficulty lifting the foot (foot drop).
A large lumbar disc herniation can compress multiple nerve roots causing cauda equina syndrome, a surgical emergency. Symptoms include:
- Loss of bladder/bowel function (incontinence)
- Numbness in the “saddle” area (groin and buttocks)
- Severe motor and sensory loss in lower extremities
- Difficulty performing normal everyday activities
On the other hand, it’s less likely to be a lumbar herniated disc if you’re experiencing mostly back pain (as opposed to mostly leg pain). A comprehensive exam, testing, and diagnosis are essential in order to treat both the symptoms and underlying cause of your sciatica.
How a Lumbar Herniated Disc Is Diagnosed
Lumbar disc herniation is often first diagnosed by a physician’s assistant (PA), nurse practitioner (NP), primary care physician, or physiatrist. Diagnosing a lumbar herniated disc typically involves a combination of physical exam and symptom analysis, a review of your medical history, and radiographic imaging.
Advancements in radiographic imaging now allow physicians to hone in on the root cause of pain and discomfort using x-rays, computed tomography (CT) scans, and/or magnetic resonance imaging (MRI) scans. MRI is not indicated for the initial diagnosis and work up, but may be used later to complete a more accurate assessment of where a herniation has occurred and which nerves are impacted as a result. In addition, during your consultation, your doctor will likely do the following:
Ask About Your Pain Type and Location
You may be asked to describe the type of pain you’re experiencing, as well as which activities (or lack thereof) seem to improve or worsen symptoms. Your physician will also assess the location of your pain and where it originates, which can help determine which disc is the likely culprit.
Perform a Physical Examination
While performing a physical exam and relevant testing, your physician will not only evaluate you to look for common signs of a herniated disc in your lower back, but also rule out other conditions that can cause sciatica symptoms, such as piriformis syndrome, lumbar spinal stenosis, sacroiliac joint dysfunction, and spondylolisthesis.
During the physical exam, you’ll also perform a series of tests to assess your movements. This will likely include a neurological check to evaluate reflexes and loss of sensation, range of motion tests such as leaning forward and bending from side to side, gait monitoring to observe if you’re walking abnormally due to pain, and a leg raise test to see whether pain is felt when the leg is raised at a 30- to 70-degree angle.
Inquire About Your Home and Work Habits
Your doctor will inquire about your home and work habits to learn more about the pressure on your discs. For example, a completely sedentary lifestyle puts increased pressure on your lumbar discs and can cause stiff, tense muscles. Alternately, having a physically demanding job that involves a lot of heavy lifting will also put increased pressure on your lumbar discs.
Learn About Your Family Medical History
Thanks to genetics, you may be predisposed to experiencing various lumbar spinal conditions. Your doctor will likely ask questions to learn whether you or your family members have a history of spinal problems. It’s important to note whether you’ve already had and treated a lumbar herniated disc and are now experiencing reherniation.
After reaching a proper diagnosis, your doctor will make a recommendation on the best approach to treatment for a lumbar herniated disc. This typically begins with conservative treatments such as stretching programs, over-the-counter (OTC) and prescription pain medications, hot and cold therapy, relaxation techniques, and physical therapy, and may progress to epidural steroid injections.
With that said, your physician may explore surgery for your herniated disc, such as a lumbar discectomy, depending on the extent of your herniation, severity of symptoms, and if conservative treatments have failed after a period of six weeks or longer.
Choosing the Right Doctor for Diagnosis and Treatment
If you’re struggling with symptoms that may be warning signs indicative of a lumbar herniated disc, the best next step is to consult with a doctor for diagnosis and treatment. When researching spine specialists in your area, look for one with the right qualifications to ensure you’re in good hands during treatment.
For example, we recommend patients look into the following before selecting a medical professional for their consultation—especially if pain is incredibly severe and disabling, because this may signify a need for surgery.
Level of Training
Is the physician you’re considering experienced in diagnosing and treating patients who are experiencing sciatica symptoms due to a lumbar herniated disc? Research his or her educational background and credentials to make sure you’re in the right hands.
How successful has the physician been at diagnosing and treating spinal conditions? Do they track patient outcomes with the goal of further improving? Consider whether the physician you’re considering tracks patient outcomes to improve and refine their approach over time.
You wouldn’t see a dermatologist to treat a heart condition, right? Look for a medical professional who is certified by a specialty board such as the American Board of Orthopaedic Surgery, the American Board of Neurological Surgery or the American Board of Physical Medicine and Rehabilitation , to ensure adequate training criteria are met.
What do other patients have to say about their experiences with the doctor in question? Would they recommend said physician to other patients like you? Utilize unbiased medical review websites like Healthgrades for a balanced assessment of what to expect from a certain medical professional.
Is the doctor you’re evaluating open to treating you without surgery, or with new innovations and techniques that may achieve better outcomes? Make sure your physician considers innovation that has been proven effective to ensure you’re receiving the least invasive and most effective treatment option available to you.
With all this in mind, you should also trust your instincts during your consultation appointment. Even the most qualified physicians may not be the right fit for you, and your comfort plays a significant role in how well you adhere to treatment regimens and ultimately how successful your results are afterwards. With the right physician and the right treatment approach, you can successfully relieve signs of a herniated disc in your lower back and move forward, free of pain, discomfort, and limitations.
While this blog is meant to provide you with information you need to make an informed decision about your treatment options, it is not intended to replace professional medical care or provide medical advice. If you have any questions about the Barricaid, please call or see your doctor, who is the only one qualified to diagnose and treat your spinal condition. As with any surgical procedure, you should select a doctor who is experienced in performing the specific surgery that you are considering.
If you have any questions about the Barricaid, you may ask your doctor. For additional information, please visit www.barricaid.com. For complete risk-benefit information: www.barricaid.com/instructions-for-use.