Your spine is composed of a series of vertebral bones spaced out by soft cartilaginous discs of tissue. These discs serve to absorb shocks associated with movement, they also help permit twisting of the spine. Over time these discs can dehydrate and begin to flatten or bulge. If a disc bulge extends far enough, it can qualify as a “herniation”, although the medical terms “protrusion” and “extrusion” are more commonly used now. The difference is simply how far back the bulge goes.
The discs of your low back, or lumbar spine, carry a heavy load and are more susceptible to degeneration and herniation than discs in other segments of the spine. The lowest levels, L4-5, and L5-S1 are the most common levels to cause pain that radiates from the back into the legs. This happens because disc herniations at these levels can potentially compress the L4, L5, and S1 nerve roots, which come together to form the “sciatic nerve” which runs down the back of each leg.
An episode of “radicular pain”, more commonly known as sciatica, typically lasts 6-8 weeks. During that time, conservative treatments are often helpful. These include:
• Physical Therapy
• Ant-inflammatory medications
• Oral Steroids
• Epidural Injections
• Limiting strenuous activity, but not remaining bed (or sofa) bound
If your pain has not been reduced in that time period, or you are having severe neurological problems with numbness and weakness, bowel or bladder changes, surgery may be indicated.