Lumbar disc herniation occurs when the nucleus pulposus of an intervertebral disc protrudes through a tear in the surrounding annulus fibrosus. Symptoms include pain in the back, pain in the leg (sciatica), and numbness or weakness in the leg. Serious neurological sequelae may sometimes occur.
Conservative treatments include analgesics, non‑steroidal anti‑inflammatory medication, manual therapy and acupuncture. Epidural corticosteroid injections may be used to reduce nerve pain in the short term. Lumbar discectomy is considered if there is evidence of severe nerve compression or persistent symptoms that have not responded to conservative treatment. This can be done by open discectomy or less invasive percutaneous approaches.
Percutaneous intradiscal radiofrequency treatment of the intervertebral disc nucleus may be used for low back pain caused by contained herniated discs that has not responded to conservative treatment, when open surgery is not suitable.