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Lumbar Disc Herniation


There are cartilage structures between our spinal bones, which we call intervertebral discs. With the rupture of the disc, the tissue herniates towards the spinal canal and compresses the nerves. In this case, the medical as lumbar disc herniation, public expression is given by the herniated disc name.


Conditions that cause lumbar disc herniation can be listed as follows:


  • Heavy lifting

  • Driving for a long time

  • Smoking

  • Professional sports

  • Pregnancy

  • Obesity

  • Still life


Symptoms of Lumbar Disc Herniation


  • Backache

  • Leg pain (sciatica)

  • Numbness and tingling in the legs and feet

  • Paralysis

  • Urinary incontinence

  • Impotence


Diagnosis of Lumbar Disc Herniation


The history taken by your doctor and the tests that can be done after the physical examination can be listed as follows.


Computed tomography (CT) : MRI is a preferred examination for the diagnosis of lumbar hernia before being discovered. Shows bone structures in detail. The fact that MRI shows soft tissues has caused it to replace CT to a large extent. In cases where MRI cannot be performed, such as cardiac batteries, ear devices, implants in the body, etc., CT is easily used.


Magnetic resonance imaging (MRI) : It is the most common noninvasive examination in the diagnosis of lumbar hernia. Neural structures and intervertebral disc can be seen in detail. Localization of herniated disc and nerve compression can be seen. In patients who have undergone lumbar surgery, it is an examination that is useful in the differentiation of recurrent herniated disc, epidural scar tissue and infection by injecting contrast material into the vein.


Stages of Lumbar Disc Herniation


Disc herniation are divided into 4 types according to their degrees or stages.

These stages are as follows:

  1. Bulging.

  2. Protrusion.

  3. Extrusion.

  4. Sequestration.

These stages are shown in the schematic picture at the bottom.


Lumbar Disc Herniation Treatment


In the treatment of lumbar disc herniation, first of all, conservative treatment methods are applied. These are bed rest (2 days is enough), pain relievers and muscle relaxants, physical therapy and rehabilitation, epidural steroid injections , chiropraxia, acupuncture etc. treatments.

In lumbar disc herniation, 90% pain reduction is achieved with such conservative treatments. Despite 6 weeks of conservative treatment, if the pain persists and / or paralysis is present, surgery may be recommended.


Today, many people desperately can resort to non-medical practices (cupping, leech, waist stretching, massage, fish tying on the waist, etc. these can be increased even more). Unfortunately, it is a bitter truth that there are many charlatans who exploit the innocent feelings of people in our country. Please do not rely on such practices.


In Which Cases Is Lumbar Disc Herniation Surgery Required?


A patient who meets the following criteria should have a herniated disc surgery.


  • Having pain for more than 6 weeks

  • Cauda equina syndrome: This condition requires EMERGENCY SURGERY. Bilateral or unilateral leg pain with severe back pain; saddle-like numbness in the anal area, numbness; It is accompanied by loss of strength, loss of sensation and urinary incontinence that can lead to progressive paralysis in the legs.

  • Rapid and progressive loss of strength (in less than 24 hours) i.e. paralysis

  • Persistent mild loss of strength (paralysis)

  • Chronic pain resistant to narcotic drugs

  • Continuation of complaints despite physical therapy and rehabilitation

  • Social Factors (Intense working life or a famous athlete, etc.)

Dr. Tamer Tekin

Bel Fıtığı Tedavisi
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