Guidance
2 Indications and current treatments
2 Indications and current treatments
2.1 Lumbar disc herniation occurs when the nucleus pulposus of an intervertebral disc protrudes through a tear in the surrounding annulus fibrosus. Symptoms include pain in the back or leg, and numbness or weakness in the leg. Serious neurological sequelae including painful foot drop, bladder dysfunction, and cauda equina syndrome, may sometimes occur.
2.2 Conservative treatments include analgesics, non-steroidal anti‑inflammatory medication, manual therapy and acupuncture. Epidural corticosteroid injections can also be used to reduce nerve pain in the short term. Lumbar discectomy is considered if there is severe nerve compression or persistent symptoms that are unresponsive to conservative treatment. Surgical techniques include open discectomy, microdiscectomy or minimally invasive alternatives using percutaneous endoscopic approaches. The choice of operative technique may be influenced by several factors, including the presenting symptoms and signs, and the location and size of the disc prolapse.