A herniated disk refers to a problem with one of the rubbery cushions (disks) between the individual bones (vertebrae) that stack up to make your spine. A herniated disk can irritate nearby nerves and result in pain, numbness or weakness in an arm or leg. Patients who suffer from herniated lumbar disk are mostly between the ages of 30 and 50. Patients have generally complaints about lower back and leg pains. Patients usually indicate that their pre-existing mild lower back pain has increased with a strain and extended to their legs. Pain increase with coughing, sneezing, straining and lower back movements. Patients have difficulty standing upright. Some patients say that the pain increases while seated. With pain, patients may complain of numbness, tingling, weakness and thinning in the legs.
MRI is used for diagnosis. According to MR images, hernia is classified as bulging, protusion, extrusion and sequestrated disc. There is not always a complete match between lumbar hernia complaints and MRI findings. While a small hernia causes intolerable pain in one patient, a large hernia in another patient may cause very little pain.
Treatment of lumbar disc herniations can be divided into two groups as conservative (non-surgical) and surgical. Most of the cases respond positively to conservative treatment. It was reported that 75-90% of patients or even more had recovery. It is the most rational way not to hurry up for a surgery, instead to start conservative treatment first, to follow the patient closely and to decide based on the course of the disease and the outcome of the treatment. Bed rest should be kept very short (2-4 days). Medications may be added to the treatment. Back and abdominal muscles should be started to increase the muscle strength. After a while, the patient is allowed to stand up and walk with the corset. During this period, the patient is admitted to the physical therapy program.
Stunning results can be achieved with epidural ozone injection from the coccyx in both acute and chronic periods. In addition, dry needling, prolotherapy and ozonated PRP can be used in the treatment of lumbar hernia. If there is no response to conservative treatment, surgical treatment is applied.