Lumbar disc herniation A torn, slipped or herniated disc means the same thing. Disc herniation is most often seen in patients between the ages of 20 and 50, but can develop at any age, and in older patients is again associated with arthritis and nerve root compression. Symptoms and diagnosis Most patients usually experience one or two episodes of lower back pain that is not related to trauma, followed by lower extremity pain, which is commonly referred to as sciatica. A ruptured or herniated disc is caused by degeneration and tearing of any part of the disc. If the patient’s symptoms persist for more than a few weeks or if there is significant and/or lower extremity weakness, or loss of bowel function, an MRI or CT scan is required to confirm the diagnosis. Treatment Symptoms are usually self-limiting, with limited activity. Non-steroidal anti-inflammatory medications and short periods of bed rest can help to relieve the condition, and most patients recover without surgery. If the pain is particularly severe, functional exercise and physical therapy may be considered. If symptoms are reduced, it takes about 4 weeks to gradually return to full normal activity. Although steroids were and still are used to treat sciatica, they should only be used for a short period of time because of the serious complications that can occur. If there is no significant improvement within one to three months after non-surgical treatment, or if the painful weakness in the lower extremities persists or even worsens, surgical treatment needs to be considered. The most common treatment for this condition is disc removal, in which a small incision is made in the back to remove that part of the disc that is protruding, and the procedure is usually effective in eliminating symptoms. The procedure can be performed on an outpatient basis for healthy patients, but sometimes patients may need to be hospitalized for one or two days for observation due to side effects from anesthesia and pain medications used after surgery. After surgery, rehabilitation exercises are required and the patient will gradually return to daily activities. The time to return to work and sports will vary from person to person and will need to be discussed with the surgeon.