Lumbago, herniated disc, or sciatica?
Dr. Stefan Nolte explains the difference between back pain
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Wer schon einmal mit starken Rückenschmerzen zu kämpfen hatte, kennt die Begriffe Bandscheibenvorfall, Ischialgie und Hexenschuss nur zu gut. Doch was genau verbirgt sich hinter diesen schmerzhaften Zuständen? In einem Gespräch mit Hellersen Insight erklärt Dr. Stefan Nolte, Chefarzt der Konservativen Orthopädie im Deutschen Wirbelsäulen- und Skoliosezentrum, den Unterschied zwischen diesen häufigen Rückenbeschwerden.
Anyone who has ever suffered from severe back pain is all too familiar with terms such as slipped disc, sciatica, and lumbago. But what exactly do these painful conditions involve? In an interview with Hellersen Insight, Dr. Stefan Nolte, Chief of Conservative Orthopedics at the Deutsches Wirbelsäulen- und Skoliosezentrum, explains the difference between these common back problems.
Photo: Anna Bizon | freepik.com
Video: Lumbago, herniated disc, or sciatica?
Herniated disc
Lumbago
Sciatica
Sudden pain? Find out what really helps with lumbago and more!
Herniated discs – Pain originating in the spine
The intervertebral discs are the flexible cushions of the spine that lie between the individual vertebrae. They ensure mobility and act as shock absorbers during everyday movements. A disc consists of two parts: the stable outer fiber ring and the soft, elastic core. The fiber ring protects the disc and maintains its shape, while the cartilaginous core ensures that the spine retains its flexibility.
A herniated disc occurs when the soft core of a disc protrudes through a tear in the outer fiber ring. “This herniated disc is usually painful because the protruding nucleus comes into contact with the surrounding nerve roots and causes inflammation,” explains Dr. Stefan Nolte. The tissue of the nucleus of the intervertebral disc is very aggressive and promotes inflammation.
In a herniated disc, the soft core of the disc protrudes through a tear in the fibrous ring.
Ischialgia – When the sciatic nerve is inflamed
Sciatica literally means “pain along the sciatic nerve.” This nerve runs from the lower back to the leg and can cause severe pain when inflamed. The sciatic nerve itself is formed by six nerve roots—five originate from the lumbar spine, and the sixth is the first sacral nerve. These roots bundle together to form a nerve strand, the sciatic nerve. A common trigger for inflammation of this nerve is a herniated disc, in which the disc nucleus presses on one of the nerve roots and causes inflammation there.
Dr. Stefan Nolte explains: “When the nucleus pulposus protrudes and comes into contact with one of the nerve roots, this causes severe inflammation, which triggers the pain. Depending on which nerve root is affected, the pain can radiate to different parts of the leg, such as the thigh, buttocks, or even down to the foot.”
“At the beginning, we usually use conservative measures to treat the inflammation directly at the site of the herniated disc.”
Dr. Stefan Nolte
Chief of Conservative Orthopedics
The treatment of sciatica aims to combat the inflammation of the affected nerve and thus relieve the pain. “At the beginning, we usually use conservative measures to treat the inflammation directly at the site of the herniated disc,” explains Dr. Stefan Nolte. This can be done with targeted injections containing anti-inflammatory drugs such as cortisone with an anesthetic. The aim of this therapy is to reduce the inflammation so that the nerve can recover and the pain subsides.
Protective reflex-induced poor posture (lumbago)
“Some patients confuse lumbago with a herniated disc, but it's not the same thing. Lumbago can be caused by a micro-injury to the disc and does not necessarily lead to a herniation.”
Dr. Stefan Nolte
Chief of Conservative Orthopedics
Lumbago – a protective reflex of the body
A lumbago is characterized by acute, sudden pain in the back. Unlike a herniated disc, this is usually a protective reflex of the body. “The body reacts to a micro-injury of the intervertebral disc with a severe muscle spasm to stabilize the affected segment of the spine and protect it from further damage,” explains Dr. Stefan Nolte. This spasm is painful and can make movement almost impossible.
“Some patients confuse lumbago with a herniated disc, but it's not the same thing. Lumbago can be caused by a micro-injury to the intervertebral disc and does not necessarily lead to a herniation,” explains the chief physician. In many cases, lumbago heals on its own, but targeted treatment can help relieve the pain more quickly.
