Clinical evaluation and treatment options for herniated lumbar disc

Degeneration of the intervertebral disc from a combination of factors can r esult in herniation, particularly at the L4-5 and L5-S1 levels. The presenc e of pain, radiculopathy and other symptoms depends on the site and degree of herniation. A detailed history and careful physical examination, supplem ented if necessary by magnetic resonance imaging, can differentiate a herni ated lumbar disc from low back strain and other possible causes of similar symptoms. Most patients recover within four weeks of symptom onset. Many tr eatment modalities have been suggested for lumbar disc herniation, but stud ies often provide conflicting results. Initial screening for serious pathol ogy and monitoring for the development of significant complications (such a s neurologic defects, cauda equina syndrome or refractory pain)are essentia l in the management of lumbar disc herniation.