Herniated nucleus pulposus (HNP) in the lumbar spine is a type of spine degeneration that can cause lower back pain and sciatica. The intervertebral discs that normally cushion the spine are thick, spongy pads. The outer layer of these discs is a tough fibrous material, known as the annulus fibrosus, and the inner layer is a gel-like fluid called the nucleus pulposus. When a disc weakens and a tear develops in the outer wall, the nucleus pulposus can rupture into the spinal column, potentially causing pain if the material comes into contact with the spinal cord or a nerve root.
The cause of lower back pain
HNP in the lumbar spine is a relatively common form of spine degeneration. It is commonly found in the L4/L5, L5, and L5/S1 areas of the spine. The lumbar spine is tasked with supporting much of the body’s weight while providing the flexibility we require from our lower back. This combination of mobility and strain puts significant pressure on the lumbar spine, which is why lower back pain is so common. However, the presence of HNP in the lumbar spine isn’t enough to cause back pain on its own. A herniated disc causes symptoms when the disc material comes into contact with the spinal cord or a nerve root in the spinal column. If a person is experiencing pain from the HNP in the lumbar spine, they are really experiencing pain from nerve compression in the lumbar spine.
Treatment of HNP is usually a combination of managing the symptoms and helping the disc heal – because a torn disc isn’t necessarily a permanent condition. Most physicians will first treat patients with conservative treatments, gradually increasing intensity and invasiveness over several weeks until pain relief is achieved. Some of the most common treatments include:
- Low-impact exercises or stretching classes
- Deep tissue massage or chiropractics
- Heat or cold therapy
- Pain medications or muscle relaxants
- Limited rest or spine stabilization
Occasionally, non-surgical treatments aren’t enough to alleviate pain from HNP in the lumbar spine. If you are considering surgery as your next option, contact Laser Spine Institute to learn about the numerous benefits of our minimally invasive spine procedures.