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 weakening or 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, or cauda equina syndrome, may sometimes occur.

2.2 Conservative treatments include analgesics, non-steroidal anti-inflammatory medication and manual therapy. 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 or minimally invasive alternatives using percutaneous endoscopic approaches. The choice of technique may be guided by several factors, including the presenting symptoms and signs and the location and size of the disc involved.

  • National Institute for Health and Care Excellence (NICE)