Specialized Care for Herniated Discs and Lower Back Pain
A lumbar disc herniation occurs when material from one of the spinal discs in the lower back extends beyond its normal boundary. Depending on its location and size, a herniated disc may irritate or compress a nearby spinal nerve, potentially causing lower back pain, sciatica, numbness, tingling, or weakness in the leg.
Some lumbar disc herniations cause no symptoms at all. For patients who do experience pain, determining whether the herniated disc corresponds to their symptoms is an important part of developing an effective treatment plan.
At TOPS Institute, we provide comprehensive evaluation and personalized treatment for lumbar disc herniation in Los Angeles and Beverly Hills. Our approach focuses on identifying the source of pain and providing targeted, nonsurgical and minimally invasive treatment options when appropriate.
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What Is a Lumbar Disc Herniation?
The lumbar spine consists of five vertebrae in the lower back. Between these vertebrae are intervertebral discs, which help absorb forces and allow the spine to move.
Each spinal disc has a softer, gel-like center called the nucleus pulposus surrounded by a stronger outer layer called the annulus fibrosus.
A lumbar disc herniation occurs when disc material extends through or beyond a weakened or damaged portion of the outer disc.
A herniated disc may occur at any level of the lumbar spine, although the lower lumbar levels are commonly affected. If the displaced disc material irritates a nearby nerve root, symptoms may travel from the lower back into the buttock and leg.
Herniated Disc vs. Bulging Disc: What’s the Difference?
Although the terms are sometimes used interchangeably, a bulging disc and herniated disc are not exactly the same.
A bulging disc generally involves a broader extension of the disc beyond its usual boundary. A herniated disc involves a more focal displacement of disc material through a weakened or disrupted portion of the outer disc.
Either finding may be visible on an MRI without causing symptoms.
The presence of a disc abnormality on imaging therefore does not automatically mean it is responsible for a patient’s pain. Clinical symptoms, examination findings, and imaging should be evaluated together.
What Causes a Lumbar Herniated Disc?
Disc herniation can occur gradually as spinal discs change over time or more suddenly following excessive strain or injury.
Potential contributing factors include:
- Age-related disc degeneration
- Repetitive bending, lifting, or twisting
- Heavy lifting
- Sudden spinal strain
- Previous lower back injuries
- Physically demanding activities
- Genetics
- Repetitive stress on the lumbar spine
As spinal discs lose hydration and flexibility over time, the outer portion of the disc may become more vulnerable to tears or weakening.
In some patients, a relatively routine movement may be enough to trigger symptoms when the disc has already undergone degenerative changes.
Symptoms of a Lumbar Disc Herniation
Symptoms depend largely on the location of the herniation and whether nearby spinal nerves are affected.
A lumbar herniated disc may cause:
- Lower back pain
- Pain extending into the buttock
- Shooting or burning leg pain
- Sciatica
- Numbness or tingling in the leg or foot
- Muscle weakness
- Changes in sensation
- Pain associated with certain movements or positions
- Difficulty sitting, standing, walking, or exercising comfortably
Some patients experience predominantly lower back pain, while others experience significant leg symptoms with relatively little back pain.
When a lumbar disc herniation irritates or compresses a spinal nerve root, it may cause lumbar radiculopathy, commonly associated with sciatica.
Learn More About Lumbar Radiculopathy (Sciatica)
Can a Herniated Disc Cause Sciatica?
Yes. A lumbar disc herniation is one of the common causes of sciatica.
When herniated disc material irritates or compresses a nerve root that contributes to the sciatic nerve, pain may radiate from the lower back or buttock into the thigh, calf, or foot. Numbness, tingling, or weakness may occur as well.
However, not every herniated disc causes sciatica, and not every case of sciatica is caused by a herniated disc.
Other conditions, including lumbar spinal stenosis and degenerative changes of the spine, can also irritate lumbar nerve roots.
How Is a Lumbar Disc Herniation Diagnosed?
Diagnosis begins with understanding the patient’s symptoms and determining whether they correspond to a particular spinal structure or nerve.
At TOPS Institute, evaluation may include a review of:
- The location and pattern of pain
- Whether pain travels into the leg
- Numbness or tingling
- Muscle weakness
- Reflexes and sensation
- Range of motion
- Movements or positions that reproduce symptoms
- Previous injuries
- Previous treatments or procedures
When clinically appropriate, an MRI can provide detailed images of the spinal discs, nerve roots, spinal canal, and surrounding soft tissues. X-rays or other imaging may also be used depending on the patient’s symptoms and clinical circumstances.
Because disc abnormalities are common even among people without pain, imaging findings should be interpreted alongside the patient’s symptoms and physical examination.
How Is a Lumbar Herniated Disc Treated?
A herniated disc does not automatically require surgery.
Treatment depends on the severity and duration of symptoms, neurological findings, degree of functional limitation, previous treatments, and whether a spinal nerve is involved.
Initial nonsurgical treatment may include:
- Activity modification
- Physical therapy
- Home exercise
- Appropriate medications
- Posture and movement modifications
- Gradual return to activity
For many patients, symptoms associated with a lumbar disc herniation improve with conservative care.
When persistent nerve-related pain does not respond adequately to conservative treatment, an interventional procedure may be considered.
Epidural Steroid Injections for Herniated Disc Pain
When a lumbar disc herniation causes inflammation around a spinal nerve root and produces radicular leg pain, an epidural steroid injection may be considered.
An epidural steroid injection delivers medication into the epidural space surrounding the spinal nerves with the goal of reducing inflammation and relieving nerve-related symptoms.
Depending on the location and pattern of symptoms, treatment may include a:
Lumbar Epidural Steroid Injection
or
Lumbar Transforaminal Epidural Steroid Injection
A lumbar transforaminal epidural steroid injection uses a targeted approach near a specific spinal nerve root and may be appropriate when symptoms correspond to an identifiable affected nerve.
The appropriate procedure depends on the patient’s diagnosis, symptoms, imaging findings, and individual clinical circumstances.
Does a Lumbar Herniated Disc Require Surgery?
Many lumbar disc herniations can be treated without surgery.
Conservative treatment and interventional pain management may help manage symptoms while the body undergoes its natural healing process. In some cases, herniated disc material may decrease in size over time.
Surgical evaluation may be appropriate when symptoms remain severe despite nonsurgical treatment or when significant neurological impairment is present.
Prompt medical evaluation is particularly important if a patient develops:
- Severe or rapidly worsening leg weakness
- Loss of bowel or bladder control
- Numbness around the groin or saddle region
- Significant new neurological changes
These symptoms can indicate serious nerve compression requiring urgent evaluation.
Lumbar Disc Herniation Treatment at TOPS Institute
An MRI showing a herniated disc does not necessarily mean that the disc is responsible for a patient’s pain—or that surgery is the next step.
At TOPS Institute, we evaluate the relationship between the patient’s symptoms, neurological findings, and imaging before recommending treatment.
If a herniated disc is irritating a spinal nerve and causing lumbar radiculopathy or sciatica, targeted interventions such as a lumbar epidural steroid injection or lumbar transforaminal epidural steroid injection may be considered when appropriate.
Our goal is to provide personalized, diagnosis-driven treatment designed to reduce pain, restore function, and help patients return to work, exercise, and everyday activities.
For patients seeking treatment for a lumbar disc herniation, herniated disc, or sciatica in Los Angeles or Beverly Hills, TOPS Institute provides specialized interventional pain management with an emphasis on nonsurgical and minimally invasive options when appropriate.
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Frequently Asked Questions About Lumbar Disc Herniation
Is a herniated disc the same as a slipped disc?
“Slipped disc” is a commonly used term for a herniated disc, although a spinal disc does not literally slip out of place. A herniation occurs when disc material extends beyond its normal boundary through a weakened or damaged portion of the disc.
Is a bulging disc the same as a herniated disc?
No. A bulging disc generally involves a broader extension of the disc, while a herniated disc is typically a more focal displacement of disc material. Either condition can exist without symptoms, so imaging findings must be interpreted in the context of the patient’s clinical presentation.
Can a lumbar herniated disc cause sciatica?
Yes. If a herniated lumbar disc irritates or compresses a spinal nerve root, it can cause lumbar radiculopathy and symptoms commonly described as sciatica, including radiating leg pain, numbness, tingling, or weakness.
Learn More About Lumbar Radiculopathy (Sciatica)
Can a lumbar herniated disc heal without surgery?
Many patients improve without surgery. Symptoms may decrease with time, physical therapy, activity modification, appropriate medications, and other nonsurgical care. Some disc herniations can also decrease in size naturally over time.
What is the difference between a herniated disc and degenerative disc disease?
A herniated disc involves displacement of disc material beyond its normal boundary. Lumbar degenerative disc diseasedescribes degenerative changes affecting the structure and function of one or more spinal discs. Disc degeneration can increase susceptibility to herniation, and the two conditions can occur together.
Learn More About Lumbar Degenerative Disc Disease
What injection is used for a lumbar herniated disc?
When a lumbar disc herniation causes radicular nerve pain, an epidural steroid injection may be considered. Depending on the location of the affected nerve and other clinical factors, a lumbar epidural steroid injection or lumbar transforaminal epidural steroid injection may be recommended.
Learn About Lumbar Epidural Steroid Injections Learn About Lumbar Transforaminal Epidural Steroid Injections
How long does pain from a lumbar herniated disc last?
Recovery varies. Some patients improve over several weeks, while others experience symptoms for longer periods depending on the size and location of the herniation, degree of nerve irritation, overall health, and other spinal conditions. Persistent or worsening symptoms should be evaluated to determine the appropriate next step.
Get Help for a Lumbar Herniated Disc
If lower back pain is accompanied by pain, numbness, tingling, or weakness traveling into your buttock or leg, determining whether a herniated disc is affecting a spinal nerve can help guide treatment.
Schedule a consultation with TOPS Institute in Los Angeles or Beverly Hills for a personalized evaluation and treatment plan for lumbar disc herniation and related nerve pain.
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