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A lumbar hernia occurs when the degeneration of a disc in the lumbar spine causes the inner core of the disc to leak out of its shell. Disc degeneration occurs in everyone. Over time, normal use of the spine weakens the outer shell of the spinal discs. Injuries and strain can add to the degeneration. When the disc shell can no longer hold the inner contents of the disc, a hernia is the result.
A hernia can occur in any region of the spinal cord. The lumbar hernia specifically describes disc herniation of the lumbar spine. The lumbar region is in the lower curve of the back. This is the most common area of the spine for disc herniations to occur. In fact, the lumbar spine accounts for 90 percent of herniated discs.
The weakest point of the spinal discs is just under the spinal nerve root. Nerve tissue is very sensitive and easily agitated. The inner core and sometimes part of the spinal disc can put excess pressure on the nerve. The nerve that is most vulnerable in the lumbar spine is the sciatic nerve. Pressure on the sciatic nerve can lead to sciatica, which is incredibly painful.
Sometimes a lumbar hernia can cause weakness in the big toe and ankle. This may occur if the herniated disc causes impingement of the L5 nerve. Pain may travel from the nerve of the lumbar region to the buttocks. Another symptom is numbness and pain on the top of the foot.
If the lumbar hernia causes S1 nerve impingement, it can lead to loss of the ankle reflex or general ankle weakness. Some people lose the ability to lift off with their ankle, commonly called toe lifts. Pain from this type of nerve impingement can travel all the way down the leg to the sole or outside of the foot.
In some cases, a lumbar hernia will heal on its own. Unfortunately, this can be a slow and painful process. Herniated discs take about six weeks to heal if they heal at all. Physical therapy, anti-inflammatory drugs, and steroids can all be used to ease pain and hurry the recovery process.
Surgery may be required to relieve lumbar hernia pain. If the symptoms persist for more than six weeks, this indicates that the disc is not healing on its own and requires intervention. The surgery is called a microdiscectomy and is usually done in an outpatient setting. The surgeon will remove anything that is still putting pressure on the nerve root to create a better healing environment. Recovery from this surgery can take from one to three weeks.