The lumbar region, or the lower back, is the point in the back most prone to injuries and pain. Many of the pain conditions associated with the lower back begin with the spinal discs between your vertebrae. These spinal discs are tough on the outside, and soft on the inside, acting as cushions between each bone in your spinal column.
However, over the years, they become prone to injury as they endure more wear-and-tear and lose more and more moisture. One of the more common injuries related to the spinal discs in the lower back is a disc herniation. Also known as a ruptured disc or pinched nerve, a lumbar herniated disc occurs when the harder shell (annulus) of one of your spinal discs ruptures, causing the soft interior (nucleus pulposus) to expand and put pressure on the surrounding nerves (causing the aforementioned pinching).
What Does Herniated Lumbar Disc Feel Like?
The actual rupture doesn’t trigger any pain – the pain occurs when the nucleus begins compressing the nerves around the vertebrae the disc is attached to. Because of its size and relatively central location around the lumbar spine, one of the most common nerves affected by a herniated disc is the sciatic nerve, which has multiple nerve roots in the lower back.
The sciatic nerve itself runs down through the hip and into the leg, all the way into the foot. This is why a common symptom for a lumbar herniated disc is unilateral (one-sided) leg pain, numbness, or weakness. Sometimes, this condition is also called a “slipped” disc, but it is important to note that the disc itself does not slip – it is only its contents which “slip out” by expanding due to herniation. Conditions caused by compressed nerves are also called radiculopathy.
Aside from pain or numbness down one leg, other common signs of a herniated disc include general lower back pain, and weakness (struggling to hold your weight on one side). It is important to note that severe tingling and any significant weakness are major reasons to seek a doctor’s help. While most cases of disc herniation resolve themselves, there can be severe complications in some cases.
It is interesting to note that disc herniation can occur entirely without pain. You may have a slipped or ruptured disc, and not even know it. In these cases, you would only be able to confirm that your disc is damaged via an imaging test. In most cases, a doctor will utilize an imaging test anyway to confirm that your pain is a result of disc herniation, and not another nerve issue (such as compression further down the nerve, spasms or cramps, and other causes).
Common Causes for Lumbar Herniated Disc
Time is the most significant factor in slipped discs – they become much more common with advanced age, occurring even after a minor strain. But certain factors compound that risk, including manual labor, a completely sedentary lifestyle, excessive bodyweight, smoking, and family history (those with spine problems running in the family may be more prone to slipped discs). Acute causes include heavy lifting, lifting with poor form, a rapid twist of the back, or in rare cases, physical trauma to the back (a blow to the lower back, or a fall). Thankfully, herniated disc pain tends to go away. But what if the pain stays?
Pain Relief Tips for Lumbar Herniated Disc
Pain relief when dealing with a herniated disc comes in the form of:
- Maximizing your use of hot and cold therapy.
- Improving your sleep posture (and workplace ergonomics).
- Eating a healthier, balanced diet (and cutting out cigarettes).
- Practicing myofascial release (or getting a professional massage).
- Staying moderately active (to promote healing and produce painkilling endorphins).
- Reducing stress on the disc (to avoid further pressing the nucleus out onto the nerves).
Know When to Use Heat, When to Use Cold
Both hot and cold therapy helps with pain. In general, icing a wound helps reduce the swelling immediately after an acute injury, reducing pain. Applying heat to a healing wound can help speed up the healing process and reduce pain. When dealing with a ruptured disc, it’s best to use heat in the mornings, and to decrease muscle tension. Use a cold pack after movement or exercise, or if you’re in need for more immediate pain relief after a long day (do NOT hold a plain ice pack to your skin. Use a cloth or other physical barrier to avoid an ice burn).
Utilize the Painkilling Benefits of Moderate Exercise
We still are not 100 percent sure why exercise helps with pain – but at least part of the reason why is that it releases natural painkilling endorphins, and can help the body build musculature in places where excessive stress may be killing your joints and back. But the key here is moderate exercise. A light walk in the mornings can be enough for some, especially if you’re generally leading a sedentary life. Other alternatives that may help reduce pain include:
- Laps in a pool
- Paced walking
- Elliptical trainer
- A recumbent bike ride
- Moderate strength training
However, you should probably avoid:
- Heavy lifting
- Hiking with a pack
- Rigorous bike rides
Consider Different Sleep Positions
Waking up feeling thrashed? Your sleeping habits might be exacerbating your pain. We tend to toss and turn a bit in our sleep – and lying certain ways can put more pressure on the nerves around our spinal discs. Consider sleeping with a pillow:
- Under your knees.
- Between your knees.
You can also try a different pillow or seek out a back-friendly mattress. Consult an orthopedic specialist for recommendations.
When the pain just isn’t going away, it’s time to seek professional help. Spine problems can be very serious, given that your spinal column encloses around a substantial portion of the central nervous system. Dangerous complications after a back injury or herniated disc can include damage to the surrounding nerves, and resulting chronic pain, long-term numbness or weakness, or cauda equina syndrome (in cases involving spinal stenosis).
In many cases, a conservative approach may be enough to greatly reduce pain – often via targeted pain relief (such as a nerve block). In cases where the cause of your pain is more severe than a herniated disc, or in cases where a complication may have occurred, your spine may require surgery. Most forms of spinal surgery aim to secure and stabilize the spine and remove unstable elements or bone growths. If you’re worried about your back injury, always consult a medical professional. Your doctor will also be able to help you create a pain management to suit your needs, or refer you to an experienced pain specialist.