Lumbar disc herniation
A lumbar disc herniation corresponds to the expulsion of a piece of disc on its posterior and/or lateral surface.
1) A bit of anatomy:
The lumbar region of the spine is made up of 5 vertebrae. Between these vertebrae, there are intervertebral discs in front, acting as a shock absorber, and joints behind, allowing movement between each level in flexion, extension and rotation.
In the center of these, the spinal cord passes and distributes nerve roots on each side, on each floor, which come out between each vertebra.
These roots travel from the neck to various parts of the upper limb and innervate the muscles, skin and joints along their route.
2) WHAT IS A LUMBAR DISC HERNIATION? WHAT ARE THE LESION MECHANISMS?
A lumbar disc herniation corresponds to the expulsion of a piece of disc on its posterior and/or lateral surface. In some cases, this fragment can compress a nerve root.
This compression then creates a “disco-radicular impingement”, which causes the root to pinch and create a painful signal on part or all of its path. The name given to the type of pain is associated with the affected nerve.
For instance :
Sciatic nerve: sciatica
Crural nerve: cruralgia
Cervical disc herniation can occur at any age. However, some factors seem predisposing:
The genetic (hereditary) factor
Smoking, which can accelerate disc degeneration
3) WHAT ARE THE SYMPTOMS?
In the event of a herniated disc with disco-radicular impingement, the symptoms may vary depending on the area affected and the extent of the compression:
Pain (“electric shock”, “burning”), it describes a specific path corresponding to the affected nerve
Sensitivity disorders (numbness, tingling)
Motor disorders, loss of strength or precision in movement, corresponding to severe damage to the root.
4) IS IT SERIOUS?
It is essential to understand that herniated disc can exist without creating pain. Indeed, this will only become problematic and symptomatic when a disco-radicular impingement is created. In this case, the pathology can meet various levels of severity.
If you experience symptoms similar to those mentioned above, it will be important to consult a doctor to determine the extent of the lesion and the resulting therapeutic choice.
These decisions will be made based on the questioning, the clinical examination as well as the analysis of the medical imaging performed (MRI, X-ray, EMG, scanner, etc.)
5) IS SURGERY MANDATORY?
A lumbar disc herniation generally progresses positively to medical and physiotherapy treatments. In the majority of cases, it can heal spontaneously in a few weeks, the disc fragment responsible for the compression being resorbed by the body.
Surgery will therefore not be considered first-line, and offered as an option if your symptoms do not improve significantly with conservative treatments or if the pain becomes intolerable and is not relieved with analgesics. It may also be recommended if you have signs of nerve damage, such as weakness or loss of feeling in your legs, and will be considered urgent if you have significant motor problems in the lower limb.
6) HOW DOES REHABILITATION TAKE PLACE?
The initial treatment will combine medical aid (analgesics, anti-inflammatories) with rest and physiotherapy. The latter will focus on different points:
Progressive global and specific muscle building
Educating the patient about their pathology and potential risks
In the event of surgery, physiotherapy rehabilitation will begin after a few weeks, and the return to sports activity will be considered 3-4 months after surgery.
7) CAN I CONTINUE TRAINING?
The lumbar disc herniation does not represent a compelling reason for interruption of the sport.
However, the choice to discontinue the activity will depend on the severity of the injury and the resulting symptoms. Consulting a health professional will then determine the causes of the pain as well as the procedure to follow in order to return to your sports practice as soon as possible in complete safety.
8) WHAT CAN I DO TO SPEED UP THE PROCESS?
In order to speed up the healing process, be sure to follow the recommendations of the health professionals with whom you work.
Laziness or, on the contrary, overzealousness, will be your enemies.
Conversely, discipline, rigor, perseverance as well as a positive and voluntary state of mind will help you get back in top shape as soon as possible!