Frequently asked questions about Lumbar disc Herniation

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If my back hurts, can it be a hernia?

Not all back pain is due to a hernia, nor all hernias hurt. Lumbago, a lower back pain, is not usually due to a hernia; however, sciatica is caused by a hernia. On the other hand, more than 80% of the population has suffered from lumbago sometime in their life, which in most cases is caused by a muscle contraction, a poor posture, or osteoarthritis, and not by a hernia. 

Does herniation occur in a certain vertebra?

No. The vertebral column is formed by 24 superimposed vertebrae. There is a nucleus pulposus between each one of them that acts as a shock absorber and that allows some movement. When this disc degenerates, the nucleus pulposus leaks out: this is known as hernia. The pain appears when the hernia compresses the nerves that surround the disc. Depending on in which vertebra it occurs, it will affect different nerves and the pain will also affect a different area. The most common is the herniation of the lower vertebrae of the lumbar spine, which often produces pain that is radiated to the legs. The most common levels are L4-L5 and L5-S1. 

Is it a disorder associated with ageing?

Not at all. Sciatica and herniation are not generally caused by the ageing of the individual. In fact, it usually appears between 35 and 55 years of age. The reason for its appearance is highly associated with how you’ve moved your back. The main causes are: excess load and physical effort, pregnancy, overweight, and a sedentary lifestyle. 

What are the symptoms produced by a vertebral disc problem?

In cases of degeneration, it produces lower back or neck pain and, in cases in which the nucleus pulposus herniates, it produces sciatica. 

When does a patient have to be operated on?

When the lower back or neck pain has become chronic, and does not improve with any of the less invasive therapies. Also when the quality of life of the patient becomes restricted due to the pain. 

Is the post-operative period painful?

No. The patients can get up the following day and are discharged 24-48 hours after the surgery, with a prescription of oral analgesic treatment. 

Is the wound large?

No. The microdiscectomy is normally performed using a visual microscope, therefore minimally invasive techniques are used, with a wound of two-three centimetres in length. At the herniated disc level there is an incision of one centimetre from the midline of the back, to the left or to the right, depending on the side in which the hernia is. 

How soon can I return to work?

If it is a disc herniation which had to have surgery, and there were no complications during the procedure nor during your convalescence, around three weeks after the surgery you can resume a norm life and your job, provided that these do not require significant physical effort. 

Do I have to rest?

Microdiscectomy is a minimally invasive procedure, which does not make large muscle dissections, therefore the post-operative period is not very painful, and the patient does not need bed rest. They need reasonable rest for at least one week, without doing great physical effort, but walking is not contraindicated. 

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Substantiated information by:

José Poblete Carrizo
Salvador Fuster

Published: 29 October 2019
Updated: 29 October 2019

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