Lumbar disc herniation and sciatica in Tijuana

What this condition actually is

Between every two vertebrae sits a disc that cushions and allows movement. With wear, its outer ring weakens and the nucleus can push out and press on a nerve root. When that happens in the lumbar spine the pain does not stay in the low back: it runs down the buttock and leg along the path of the nerve. That is sciatica.

The good news, worth stating at the outset, is that most lumbar herniations improve without surgery. With adequate analgesia, targeted physiotherapy and controlled activity, a very high proportion of patients are substantially better within six to twelve weeks. The herniated fragment tends to dehydrate and shrink on its own.

Surgery is considered when that window passes without real improvement, when progressive muscle weakness appears, or in cauda equina syndrome, which is an immediate emergency. An MRI showing a herniation, in a patient whose pain is settling, is not a reason to operate: you operate on the person, not on the image.

Symptoms and warning signs of herniated disc and sciatica

• Pain running from the buttock down the leg, sometimes to the foot
• Tingling or numbness in a specific territory of the leg
• Pain that worsens on coughing, sneezing or straining
• Weakness lifting the foot or standing on tiptoe
• Pain that eases lying down and worsens after prolonged sitting
• EMERGENCY: loss of bladder or bowel control with numbness between the legs