Common Diagnosis
Lumbar Disc Herniation
A lumbar disc herniation occurs when a piece of disc material breaks off and compresses a nerve or the thecal sac. Most symptomatic disc herniations resolve on their own over time.
Overview
A lumbar disc herniation occurs when a small piece of lumbar disc material breaks off and herniates from its normal location, compressing the nerve or the thecal sac. The most common areas are the lower two disc spaces, L4-5 and L5-S1.
If the disc herniates laterally, it compresses a nerve, usually causing unilateral leg pain. If it herniates centrally, it causes back pain and sometimes bilateral leg pain. A disc herniation at L4-5 to one side can produce a foot drop from compression of the L5 nerve root.
An L4-5 disc herniation can cause severe leg pain starting in the buttock and radiating to the top of the foot with or without a foot drop. An L5-S1 herniation can cause severe leg pain starting in the buttock radiating to the bottom of the foot with or without weakness when stepping down. A herniated disc at L3-4 causes thigh pain, and L2-3 causes groin pain.
Most symptomatic disc herniations resolve on their own over time. It is estimated that only ten to fifteen percent of patients who present with a symptomatic disc herniation will need surgery.
Symptoms
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Causes
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When to see a specialist
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Non surgical treatment options
We offer comprehensive non surgical treatment plans tailored to each patient's condition, focused on pain relief, mobility improvement, and overall spinal health. While we do not perform these treatments in house, we collaborate with trusted local specialists to ensure you receive the highest level of care.
Physical therapy
We develop personalized physical therapy prescriptions based on your specific needs and refer you to experienced local providers. These programs are designed to improve strength, flexibility, and posture, helping to reduce pain and enhance mobility while promoting long term spinal health.
Epidural injections
For patients who may benefit from epidural steroid injections, we provide expert evaluations and referrals to trusted local physicians who specialize in pain management. These injections can reduce inflammation and nerve related pain caused by conditions such as herniated discs and spinal stenosis, offering significant relief with minimal downtime.
Chiropractic care and acupuncture
Chiropractic care can help patients with leg pain as a component of their condition. Acupuncture works best in the presence of severe muscle spasms. Both are considered alongside physical therapy and medication as part of a comprehensive conservative plan.
View all non surgical options →
The initial course of treatment after diagnosis is oral steroids for seven days, rest, and non steroidal anti inflammatory agents for pain. Once the pain has lessened, you may be referred for a course of physical therapy. Other options include an epidural injection to help with the pain.
Surgical options
Patients are initially evaluated by a physiatrist to ensure all non surgical options, including physical therapy and non narcotic pain management, are exhausted before considering a surgical solution.
Lumbar microdiscectomy
This surgery is performed for patients with lumbar radiculopathy from a disc herniation or foraminal stenosis. Patients are put to sleep with general anesthesia and turned prone. The level is localized through x ray and accessed through a small incision in the lower back measuring 1.5 inches in length. Using a microscope, a small amount of the lamina is removed and the disc space identified. The disc fragment is then removed, leaving the majority of the non herniated disc intact. The surgery takes approximately 45 minutes. Patients usually go home the same day.
Recovery
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Sources and further reading
Patient questions
Frequently asked questions
Our clinical team explains Lumbar Disc Herniation using your history, examination, and imaging. Symptoms vary by nerve or spinal cord involvement. An accurate diagnosis guides whether conservative care or surgery is the safest next step.
Symptoms may include neck or back pain, arm or leg pain, numbness, weakness, or balance changes when the spinal cord is involved. Severity and duration help determine urgency and treatment options.
Evaluation usually includes a neurological examination and MRI. X ray or CT may assess bone alignment. We correlate imaging with your symptoms before recommending injections, therapy, or surgery.
Physical therapy, medication, activity modification, and selective injections are common first steps. We monitor progress over four to eight weeks and escalate only when symptoms persist or neurologic deficits progress.
Seek urgent care for rapidly worsening weakness, loss of bowel or bladder control, saddle anesthesia, or severe pain after trauma. Call (914) 948 3008 for guidance if you are unsure how quickly to be seen.
Get in touch
Contact us today.
Office
Institute For Spine Surgery244 Westchester Avenue, Suite 209
West Harrison, NY 10604
Phone
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