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Treatment strategy for lumbar disc herniation

The situation is contrary for patients with corresponding complaints. In the event of pain, an X-ray and MRI of the lumbar spine should be carried out early in order to obtain an exact diagnosis. It is important to pay particular attention to whether the spine is deformed (spondylolisthesis, scoliosis) and how the width of the spinal canal is represented. Often one finds a bulge in a spinal canal narrowing and / or deformity, but the clinically relevant change is of course not in the herniated disc but in the narrowing and / or deformity.


Pressure on the spinal nerve results in leg pain (pain corresponding to the affected root in the leg, sensory, motor disorder); pressure on the central cauda equina fibers can lead to cauda equina syndrome with paralysis and vegetative disorders (bladder and bowel paralysis, impotence).

With severe wear and tear of the vertebral joints, either alone or in combination with leg pain, severe back pain with blockages or pseudoradicular pain in the leg can occur.

It is always important to examine the patient carefully, on the one hand to determine the precise localization of the pain, and on the other hand to determine the neurological situation.

Dr. Helmut Hiertz