Lumbar spine · Long Beach, CA

Lumbar herniated disc in Long Beach, CA

A herniated disc in the lower back is the most common cause of sciatica. Most heal on their own within a few months, and when they do not, a small outpatient procedure brings relief.

Lumbar herniated disc care in Long Beach, with patients welcome from across South Bay, Orange County and the greater Los Angeles area.

Book a consultation (562) 427-8119

Overview

What is a lumbar herniated disc?

The discs of the lower back carry more load than any others in the spine. When the soft center of a disc pushes through a tear in its outer ring, it can press on the nerve root passing behind it. The result is sciatica: pain that travels from the buttock down the leg, often with tingling, numbness or weakness in the foot. The two lowest discs, L4-5 and L5-S1, are involved in the great majority of cases.

Herniations often follow a lift, a twist or simply bending to pick something up, though the disc was usually weakening for some time beforehand. The outlook is good. Most herniations shrink as the body reabsorbs the disc material, and about 90 percent of people improve within six to twelve weeks. For those who do not, microdiscectomy is a short, highly effective procedure.

Book a consultation (562) 427-8119

Causes

Common causes

A disc herniates when the outer ring is weakened by wear and then overloaded.

Lifting and twisting

Bending and rotating under load is the classic trigger, especially with a rounded back.

Age related wear

Discs between 30 and 50 have lost some water but still have a soft center that can herniate.

Prolonged sitting

Sitting loads the lumbar discs more than standing and weakens the outer ring over time.

Sudden injury

Falls and accidents can rupture a disc in an instant.

Genetics

A family history of disc problems raises the risk.

Smoking and excess weight

Both reduce disc nutrition and increase the load on the lower back.

Symptoms

What it feels like

Leg symptoms are the signature of a herniated disc. Back pain may be present but is often the lesser complaint.

Common symptoms

Sharp, shooting or burning pain from the buttock down the back or side of the leg
Tingling or numbness in the leg, foot or toes
Weakness lifting the foot or pushing off the toes
Pain that is worse with sitting, bending forward, coughing or sneezing
Relief when standing or lying down
Low back pain and muscle spasm

See a doctor right away if

Numbness around the groin or inner thighs
Difficulty passing urine or loss of bowel control
Weakness in both legs or rapidly worsening weakness
Severe pain that does not ease in any position

These can be signs of a problem that needs urgent care. Call (562) 427-8119 or go to the nearest emergency room.

Diagnosis

How we find it

The history and examination usually identify the level. An MRI confirms the herniation and how it relates to the nerve.

01/Listen
Where the pain goes
The path of leg pain and the area of numbness point to the nerve root involved.
02/Examine
Nerve tension and strength
Straight leg raise, reflexes, sensation and strength of specific muscles confirm which root is affected.
03/Image
MRI when it will change the plan
Ordered for persistent symptoms, weakness or when a procedure is being considered.
04/Plan
Treat the person, not the scan
Many people have herniations on MRI without symptoms. Dr. Bhalla treats the one that matches your pain.

Treatment

How it is treated

Conservative care works for most people. Surgery is for severe or persistent leg pain, progressive weakness, or the rare emergency of cauda equina syndrome.

First: without surgery

Where almost everyone starts

Staying active with walking rather than bed rest
Physical therapy with extension exercises and nerve gliding
Anti inflammatory medication or a short oral steroid course
Medication for nerve pain
Image guided epidural steroid injection for stubborn leg pain

When needed: surgery

The least invasive option that will work

Microdiscectomy through a small incision, usually outpatient
Endoscopic discectomy for suitable herniations
Lumbar disc replacement or fusion only for recurrent herniations with disc collapse
Urgent decompression for cauda equina syndrome

Everyday care

Helping the disc settle

The disc heals on its own time, but these habits reduce pressure on the nerve and prevent the next one.

01Walk daily. It is the best treatment while the disc shrinks.
02Limit sitting to 20 to 30 minutes at a time during a flare.
03Lift with your legs, keep the load close and never twist under load.
04Build core and hip strength once the leg pain eases.
05Sleep on your side with a pillow between your knees or on your back with knees supported.
06Keep a healthy weight and stop smoking to protect the discs.

Questions

Things patients ask about lumbar herniated disc.

If your question is not here, call the office. We are happy to talk it through.

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Will my herniated disc heal on its own?

Usually, yes. The body breaks down and absorbs the herniated material over weeks to months, and the nerve recovers. About nine in ten people improve without surgery.

When should I consider surgery?

When leg pain remains severe after six to twelve weeks of good conservative care, when weakness is progressing, or immediately for any bladder or bowel symptoms. Earlier surgery is also reasonable for people who cannot work or function because of the pain.

What is microdiscectomy like?

A one inch incision, a microscope and removal of just the piece of disc pressing on the nerve. It takes under an hour, most patients go home the same day, and leg pain is often gone when they wake up.

Can the disc herniate again?

Recurrence happens in roughly five to ten percent of cases, most often in the first few months. Avoiding heavy lifting and bending early on, and building core strength, reduces the risk.

Near you

Lumbar herniated disc treatment in Long Beach, CA

If you are living with lumbar herniated disc in Long Beach or a nearby city, Dr. Bhalla can examine you, explain your options and plan the least invasive treatment that will work. Dr. Bhalla leads the Spine Center at MemorialCare Long Beach Medical Center.

Most people start with a consultation and imaging. Patients come from Signal Hill, Lakewood, Seal Beach, Orange County and across Southern California.

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