Lumbar disc herniation is a common low back disorder that produces low back pain and/or leg pain in adults. A herniated disc is a displacement of disc material beyond the intervertebral disc space, these usually remain asymptomatic however can cause discomfort if the disc compresses an adjacent nerve or the spinal cord. Disc herniation often occurs as a result of age-related degeneration of the outer fibrous portion of the disc (annulus fibrosis), however trauma, straining, torsion and lifting injury are also involved.

Often we get asked – I have a herniated disc, do I need surgery to fix it?

Not Necessarily! Physiotherapy often plays a major role in disc recovery. Infact, research shows no statistically significant differences between conservative management and surgical management of disc herniation after 1 and 2 years. Physiotherapy does not only offer pain relief and decrease disability, but it also contributes to protecting the body to prevent further injury.

Research shows that large disc herniations decrease in size proportionally more than smaller protrusions and therefore that the greater the herniation the greater the resorption.

In some instances however, surgical intervention may be required. Your Physiotherapist will determine your prognosis on examination, and take appropriate action.

Written by: Nicole Pereira

References:

Chui, CC, Chuang, T., Chang, K.H., Wu, C.H., Lin, P.W, & Hsu, W.Y. (2015). The probability of spontaneous regression of lumbar herniated disc: a systematic review. Clinical Rehabilitation 29 (2): 184-195.

Gugliotta, M., Da Costa, B. R., Dabis, E., Theiler, R., Jüni, P., Reichenbach, S., … Hasler, P. (2016). Surgical versus conservative treatment for lumbar disc herniation: a prospective cohort study. BMJ Open, 6(12), e012938. doi:10.1136/bmjopen-2016-012938

Jacobs, W. C., Van Tulder, M., Arts, M., Rubinstein, S. M., Van Middelkoop, M., Ostelo, R., … Peul, W. C. (2010). Surgery versus conservative management of sciatica due to a lumbar herniated disc: a systematic review. European Spine Journal, 20(4), 513-522. doi:10.1007/s00586-010-1603-7

Weinstein JN, Tosteson TD, Lurie JD, et al. Surgical vs Nonoperative Treatment for Lumbar Disk HerniationThe Spine Patient Outcomes Research Trial (SPORT): A Randomized Trial. JAMA. 2006;296(20):2441–2450. doi:10.1001/jama.296.20.2441