From the Guidelines
Lumbar disc protrusions typically do not have a specific millimeter measurement that correlates with symptom exhibition, as symptoms are more closely related to the location of the protrusion and individual factors such as spinal canal diameter and pain sensitivity. The relationship between lumbar disc protrusion size and symptoms is complex, and research suggests that the size of the protrusion is not the sole determining factor in whether symptoms occur 1. Some key points to consider include:
- Nonspecific lumbar disc abnormalities, including protrusions, are common in asymptomatic patients and can be demonstrated on various imaging modalities 1.
- The prevalence of degenerative spine findings, including disc protrusions, increases with age in asymptomatic populations 1.
- Even in cases of disc herniation, imaging may have a limited role in management, as many disc herniations show some degree of reabsorption or regression by 8 weeks after symptom onset 1.
- Individual factors, such as the location of the protrusion relative to nerve roots, spinal canal diameter, pain sensitivity, and inflammatory responses, play important roles in symptom development 1.
- The correlation between protrusion size and symptoms is not always straightforward, and some people with large protrusions may experience minimal symptoms, while others with smaller protrusions might have severe pain due to these anatomical and physiological differences.
From the Research
Lumbar Disc Protrusion Symptoms
- The exact millimeter measurement of lumbar disc protrusion at which people typically exhibit symptoms is not explicitly stated in the provided studies 2, 3, 4, 5, 6.
- However, a case report 6 mentions a patient with a large prolapsed lumbar disc herniation, where the sagittal protrusion length of the L5/S1 intervertebral disc was initially 12.35 mm and decreased to 3.49 mm after conservative treatment.
Factors Influencing Symptom Severity
- The severity of symptoms is influenced by various factors, including the patient's risk factors, the location, and the extent and type of disc herniation 2.
- The clinical sequelae of lumbar disc herniations can range from mild low back and buttock pain to severe, immobilizing cases of sciatica to cauda equina compression syndromes 4.
Treatment Options
- Treatment options for lumbar disc herniations include nonoperative measures such as medications, physical therapy, and potentially lumbar injection, as well as surgical intervention for patients who fail to respond to conservative measures 2, 3, 4, 5.
- A case report 6 demonstrates the effectiveness of conservative treatment in reducing the size of a large prolapsed lumbar disc herniation, highlighting the potential for conservative therapy to be effective in select cases.