Case of Note: Herniated Disc

Case of Note: Herniated Disc

As we worked through spinal conditions and imaging this week, we found a useful and not entirely uncommon case study: A patient with low back pain.  


This patient presented with severe lower back pain and pain extending into both lower legs.  


This imaging was done using MRI technology. He was prescribed the procedure due to the severity of pain in his lower legs, a symptom called radiculopathy, which is a shooting pain distributed through the nerves in the legs. You can see a disc has protruded from the normal position between the lumbar vertebrae and presses on the spinal canal (between numbers 3 and 4 the black gap between vertebrae seems to “spill” out in the back). This MRI exam was extremely useful in identifying the level of patients abnormality and and the extent of abnormality.  


Initially, the patient elected a conservative route for treatment and had an epidural pain injection. Pain medicine is injected to the area around the herniated disc for relief of pain. This procedure resulted in temporary partial pain relief. After that treatment and a course of physical therapy he was referred for a surgical consultation as his pain continued. A microdiscectomy gave relief and has allowed him to return to normal activity.





Originally published 5/23/14 on