Lumbar Disc Herniation: Causes, Diagnosis, and Treatment

What is a lumbar disc herniation?

The spine is a complex structure that provides support to the trunk and enables movement. It is composed of a series of bones called vertebrae, stacked one on top of the other. The vertebrae are divided into different regions: cervical, thoracic, lumbar, and sacral. The lumbar region is composed of five vertebrae, known as lumbar vertebrae, and rests on the sacrum.

Between each vertebra is an intervertebral disc that acts as a shock absorber and provides flexibility to the spine. Each disc is composed of two parts: a central part, or nucleus pulposus, and a peripheral part, or annulus fibrosus. The annulus fibrosus surrounds the nucleus pulposus and helps hold it in place.

A herniated lumbar disc occurs when the annulus fibrosus cracks or ruptures, usually due to wear and tear or injury. When this happens, a portion of the nucleus pulposus escapes from the annulus and can compress the nerve inside the spinal canal. This nerve compression can cause pain, weakness, and numbness in the lower back and legs.

A lumbar disc herniation is a condition in which the nucleus pulposus material moves out of its normal position and can compress nearby nerve roots. This can cause pain and other symptoms in the lower back and lower extremities.

Symptoms of a herniated lumbar disc

By compressing the nerve, some symptoms of a lumbar disc herniation are:

  • Lower back pain
  • Leg pain
  • Pain in feet
  • Loss of sensitivity
  • Tingling
  • Feeling of stiffness

Severe symptoms of lumbar disc herniation

  • Paralysis at the foot (hanging foot)*
  • Paralysis at the knee (knee that gives out or fails)*
  • Urinary incontinence
  • Anal incontinence
  • Impotencia sexual

*The severity of the paralysis (partial or total) is what dictates the severity of the hernia.

How do I know if I have a lumbar disc herniation?

Physical examination

To diagnose a lumbar disc herniation, the first step is a physical examination that assesses sensation and checks for weakness, numbness, or decreased reflexes in the lower extremities. In addition, simple tests may be performed, such as asking the patient to walk, stand on their toes, or bend over to observe muscle mobility and strength. This examination helps the doctor determine if the symptoms are consistent with a lumbar disc herniation and whether further testing is necessary.

Magnetic Resonance Imaging (MRI) and Computed Tomography (CT)

A definitive diagnosis of a lumbar disc herniation is made through imaging tests, such as magnetic resonance imaging (MRI) or computed tomography (CT). These tests provide detailed images of the spine and intervertebral discs, helping to identify the location and size of the herniated disc.

In many cases, if there is no significant neurological involvement, such as paralysis or loss of bladder or bowel control, there is no urgent need to perform these imaging tests. However, if symptoms are severe or persist despite conservative treatment, your doctor will likely order an MRI or CT scan to confirm the diagnosis and plan treatment.

Interpretation of the results

Once the imaging tests are performed, the doctor will analyze them to identify the lumbar disc herniation and determine the cause of the patient's pain. The location and size of the hernia, as well as the presence of nerve compression, are key factors in deciding the most appropriate treatment. In some cases, additional testing, such as electromyography, may be necessary to evaluate the function of the affected nerves.

In summary, the diagnosis of a lumbar disc herniation is made through a physical examination, followed by imaging tests such as MRI or CT, which allow the patient's pain to be visualized and their location to be explained. Treatment is determined based on the location and size of the hernia, as well as the presence of nerve compression and other individual patient factors.

How to cure a lumbar disc herniation?

Treatments for lumbar disc herniation without surgery

In some cases, herniated discs heal on their own. It's important to know that a herniated disc can be cured without surgery. In fact, more than 80% of herniated discs can be cured in less than two months with medical treatment. This includes painkillers and sometimes morphine. Anti-inflammatory drugs and muscle relaxants can be combined. The combination of these three medications is the basis of conservative treatment and is the only one that has so far been formally proven to be effective. In cases of paralysis, we always begin with medical treatment.

Other treatments that are frequently associated:

  • Rest but without being constantly lying in bed.
  • Faja lumbar con refuerzo posterior o algún corsé.
  • Physiotherapy for spinal problems: When the acute phase of pain has resolved, exercises for herniated discs are often recommended.
  • Ozone Infiltrations (Ozone Therapy).
  • Other treatments such as mesotherapy, alternative medicine, discogel, etc., are NOT recommended because their effectiveness has not been formally proven.


It is during this 6-8 week wait (except in urgent cases) that hernias may produce painful symptoms that have not disappeared, prompting consideration of surgery. Some lumbar hernias are painful even after a few months of development and can damage the nerve by compressing it, leading to permanent lesions that are difficult to treat.

What is lumbar disc herniation surgery like?

In some cases, as mentioned above, spinal surgery for a herniated disc is necessary to provide a solution to the patient's spinal pain. Waiting too long without considering surgery is never a good solution. Many patients are often afraid of undergoing spinal surgery, which is understandable, considering the many myths surrounding it. Herniated disc surgery does not entail any greater risk than any surgical procedure.


Some spinal surgeries for lumbar disc herniation include:

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