The phrase disc lesion describes a continuum of problems that range from a repetitive disc sprain to a herniation and ending in degeneration. Many different factors can contribute to disc lesions like repetitive mechanical loading, shear stress and vibration. The stressors summate with time and load leading to a weakening of the annular fibers and the eventual disc lesion. This weakening of annular fibers can lead to chemical irritation or physical compression of nearby nerve roots.

Risk factors for lumbar disc lesions include (1,2):

  • Sedentary lifestyle or occupation

  • Driving motorized vehicles

  • Vibration

  • Smoking

  • Previous full term pregnancy

  • Obesity 

  • Tall stature 


The presence of a disc herniation on imaging does not correlate with low back pain since 20-36% of the adult population have asymptomatic herniations. (3) Disc lesions present as back pain with or without radiating pain or symptoms down one or both legs. Patients may or may not have motor or reflex loss depending on the level of nerve root involvement. 

Treatment of a lumbar disc lesion often depends on the extent of the symptoms. The goals of treatment are to centralize symptoms, reduce pain and inflammation, decrease mechanical compression and improve functional core stability. Spinal manipulation is very effective in the treatment of disc lesions and is equally as effective as surgical decompression. (4) Soft tissue techniques can be performed to the muscles around the lumbar spine and hip. Rehabilitation should focus on core stabilization, aerobic capacity and any functional weakness. 

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Lumbar Disc Lesion

  1. Nachemson AL. Prevention of chronic back pain. The orthopedic challenge for the 80's. Bulletin of the Hospital for Joint Diseases Orthopedic Institute. 1984;44(1):1-5.

  2. Sapiee NH, Thambyah A, Robertson PA, Broom ND. Sagittal Alignment with Downward Slope of the Lower Lumbar Motion Segment Influences its Modes of Failure in Direct Compression: A Mechanical and Microstructural Investigation. Spine. 2019 Aug 15;44(16):1118-28.

  3. Baker AD. Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects. A prospective investigation. InClassic papers in orthopedics 2014 (pp. 245-247). Springer, London. 

  4. McMorland G, Suter E, Casha S, du Plessis SJ, Hurlbert RJ. Manipulation or microdiskectomy for sciatica? A prospective randomized clinical study. Journal of manipulative and physiological therapeutics. 2010 Oct 1;33(8):576-84.