Lumbar Disc Prolapse and Treatment Options Explained

Spine specialist consulting male patient

Our spines are made up of 33 vertebrae that protect the spinal cord and also allow for movement and flexibility.

Between each of these vertebrae is a small ‘disc’ made of fibrous cartilage around a more gelatinous core. These discs act as a cushion, absorbing shocks and enabling the spine to bend and twist during everyday activities.

If one of these discs gets damaged or begins to degenerate, it can result in a lumbar disc prolapse.

This condition is also known as a slipped disc or herniated disc.

What is a lumbar disc prolapse?

A lumbar disc prolapse occurs when the fibrous cartilage layer of a disc in the lower back ruptures and the inner gel-like material leaks out.

This puts pressure on the surrounding nerves and can cause pain, feelings of numbness and weakness in the legs and feet, as well as back pain.

What are the causes of a lumbar disc prolapse?

Causes of a lumbar disc prolapse are often the result of normal wear and tear on the discs, which can become brittle and prone to tearing as we age. This is called disc degeneration. It is seen to some degree in many normal spines as we age, and a prolapse can be minor and not symptomatic, even though it may be noted on an MRI or CT scan report.

Other causes that can contribute to a disc prolapse include obesity, smoking, and a sedentary lifestyle.

Traumatic events (such as falls, awkward bending, lifting or sudden forces applied to the spine) can sometimes be contributory to prolapses of the intervertebral discs, but these would be the minority of cases and most people affected do not have a history of injury to the spine.

Conventional and enhanced lumbar spine x-ray imaging is sometimes the first technique used to see the bones in your spine, but it does not provide the necessary information to diagnose a disc prolapse.

Your GP may suggest that a CT of the lumbar spine be performed to better assess the situation

Other investigations, especially an MRI scan, are very important in diagnosing a lumbar disc prolapse. Due to medicare funding rules, this may often be deferred until you have been referred to a specialist, who may then request the required investigations.

What are the symptoms of a lumbar disc prolapse?

The symptoms of a lumbar disc prolapse usually vary from person to person, but common symptoms include:

  • Lower back pain
  • Numbness or tingling feelings in legs (usually one side)
  • A searing or shooting pain down a leg
  • Weakness in legs

Often, the symptoms of a lumbar disc prolapse may go away on their own over the course of a few weeks. In severe or persisting cases though, surgical intervention may be required.

If you experience any of these symptoms, it is important to see a specialist to receive an accurate diagnosis and develop an effective treatment plan.

Treatment for a lumbar disc prolapse

Treatment of a lumbar disc prolapse typically depends on the severity of the condition, as well as your age, general health, and personal preferences.

If surgery is required, minimally invasive (keyhole) surgical techniques are often a preferred option as this technique offers greater precision and is a shorter procedure than traditional open surgery, resulting in faster recovery.

In fact, patients who undergo minimally invasive surgery for a lumbar disc prolapse at The Keyhole Spine Centre are usually managed as a day case, meaning no overnight stay.

Can I use herniated disc exercises to treat a lumbar disc prolapse?

Herniated disc exercises are a popular home remedy for back pain, but it’s important that you seek professional help as putting more pressure on a spine can cause more damage in some cases.

The help of a physiotherapist is crucial before embarking on any physical rehabilitation programme to manage your disc prolapse. Any exercises will be gradual and tailored to your own particular situation and progress.

Gentle herniated disc exercises that may help in the recovery phase after a lumbar disc prolapse (on consultation with your treating physiotherapist):

  • Yoga
  • Swimming
  • Walking
  • Cycling

Ensure that you perform all exercises in a slow and controlled manner, especially when bending or lifting.

Exercises should not hurt and if you feel pain, you should stop doing any herniated disc exercises and speak with a doctor.

Generally, people with back problems should avoid doing strenuous activities during recovery.

In summary

A lumbar disc prolapse can be a painful and debilitating condition, but with professional care and the right treatment, it can usually be easily managed.

If you are suffering from back pain and leg pain (sciatica) and suspect that you may have a lumbar disc prolapse, see a doctor as soon as possible for an accurate diagnosis.

If you develop problems with pain in both legs, difficulty passing urine or numbness around your genital area, it should be regarded as an emergency and you should seek care on an emergent basis, for example by presenting to the nearest hospital emergency department.

This is rare, but can be due to severe compression of the lower nerves in the spine from a large disc prolapse.