Foot drop due to herniated disc

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With the XFT FES Foot Drop System. Buy Now for £975. Free & Secure P& Proven Program Shows You How To Instantly Relieve Sciatica Pain Naturally Herniated Disc Foot Drop Explanation Foot drop is a colloquial term used to describe a condition in which the patient has difficulty in elevating the front of the foot while leaving the heel on the ground. It is most often diagnosed as coming from L5 nerve root compression, but may also be diagnosed as being caused by L4 or S1 in other rare cases

Herniated disc foot drop is caused by a trapped sciatic nerve. There are many conditions that can cause weakness in the muscles of the lower extremity. All are serious as this is a potentially irreversible syndrome causing permanent disability, and the need for a special brace or shoe In a literature review of cases of drop foot caused by single-level thoracic HIVD, T10/11 disc herniation mostly causes lower extremity weakness and increased patella and Achilles tendon reflex. T11/12 disc herniation also had lower extremity weakness but not patella hyperreflexia Nerve compression that leads to foot drop is typically caused by a herniated disc in the lumbar spine, specifically at L4-L5; the fourth and fifth vertebrae in the low back. Most herniated discs get better with time and do not require surgery Foot drop due to lumbar degenerative conditions: mechanism and prognostic factors in herniated nucleus pulposus and lumbar spinal stenosis Double root compression was the most common condition associated with foot drop due to HNP

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Surgery may be an option to correct or alleviate the underlying problem causing drop foot. For example, if drop foot is caused by nerve compression from a lumbar herniated disc, then a spinal surgical procedure called discectomy (disc removal) may be required to relieve or 'decompress' the nerve. In some cases, drop foot is a complex problem with foot drop. A central lesion can be suspected in patients with upper motor neuron signs such as positive Babinski`s sign, hyperreflexia or clonus. These types have been called spastic foot drop4. Radiologically the herniated disc is big, central and rarely paramedian located. L4-L5 and L5-S1 localized herniated discs can commonly cause.

Herniated Disc Foot Drop - Herniated Dis

Foot drop is a classic symptom of amyotrophic lateral sclerosis. However, this alarming symptom has many other possible causes, including a compressed or irritated nerve in the low (lumbar) back. A herniated disc is a common cause of the so-called pinched nerve Foot drop due to fracture of the vertebrae and nerve damage may be treated with medication and a lumbar brace. Sometimes, minimally invasive procedures such as vertebroplasty or kyphoplasty may be performed, where bone cement is injected to stabilize and reform the fractured vertebra. Watch Spinal Compression Fracture Vide Not typically: Typically due to compressive pathology of the L4 nerve root or L5 -- most commonly at the l4-5 level. Not just a small herniated disc. There are other causes: neuromuscular, peripheral sciatic or peroneal nerve palsies or injuries. See your spine surgeon Herniated disc foot pain is an occasional symptom of lumbar or lumbosacral disc herniations, which might negatively influence the nerve roots that eventually form the sciatic nerve A disc herniation usually occurs in the neck region or in the lower (lumbar) back. When it occurs in the lower back, it has the potential to cause numbness in a foot - and only the foot in some cases. The foot may also be tingly and weak. If the symptoms are caused by a pinched nerve, the treatment might involve surgical decompression of.

Herniated disc foot drop is caused by a trapped sciatic nerve

How Do You Treat Drop Foot - SpineUnivers

Foot drop. Herniation of a lumbar disc can sometimes cause a condition called foot drop. This is when someone has difficulty lifting a foot when walking or standing on the ball of the foot. Neurological signs. Neurologic problems, which includes foot drop, can also come about due to back issues Pain that starts near the back or buttock and radiates down the leg to the calf or into the foot (this is from sciatica, meaning pressure on the large sciatic nerve in the lower back, buttocks, and legs Muscle weakness in the legs Numbness in the leg or foot Decreased reflexes at the knee or ankl Herniated discs are most common in people in their 30s and 40s, although middle aged and older people are slightly more at risk if they're involved in strenuous physical activity. Lumbar disc herniation is one of the most common causes of lower back pain associated with leg pain, and occurs 15 times more often than cervical (neck) disc herniation

Pre-op T1 axial image showing the L4-L5 central disc

Foot drop due to lumbar degenerative conditions: mechanism

I have a herniated disc L5 s1 which caused foot drop I can

Surgery might be needed to correct a slipped disc that impinges on the nerve running to the foot and causing foot drop. If foot drop is the result of injury to the nervous system, such as a slipped disc impinging on the nerve leading to the foot, correcting the injury through surgery will relieve the problem. If it results from injury to the dosiflexors, the muscles responsible for lifting the. Foot Drop. Foot drop, also known as drop foot is characterized by the inability to lift the front of the foot. Individuals tend to drag their foot and may have to raise their knee as though walking upstairs in order to walk without dragging their foot. It is a sign of an underlying neurological, muscular or anatomical issue rather than a disease Foot drop: This symptom is characterized by weakness or heaviness that makes it challenging to flex the ankle and bring up the front of the foot. In addition, foot drop resulting from an issue with an L5 nerve root will produce pain that radiates down the outside of the calf and over the top of the foot, ending at the big toe. Heel walk: Heel. If the lumbar spine is affected, muscle weakness may also result in a condition known as foot drop. This occurs when you have difficulty lifting the foot while standing or walking. Conversely, a herniated disc in the neck can cause muscle weakness in the arm or hand

The prognosis factors of foot drop due to lumbar degenerative disease had been reported in several studies, but there are still some controversies. A study of 55 patients showed no statistically significant relationship was found between the extent of recovery and age, diagnosis (herniated nucleus pulposus vs. lumbar spinal stenosis), duration. Antigravity weakness of the tibialis anterior muscle, commonly known as a foot drop, is a common debilitating condition secondary to lumbar nerve root deficiency, and one of the causes is compression or inflammation due to stenosis (either from bone spurs, ligamentum flavum, facet cysts, or a herniated disc).Controversy exists regarding the appropriate management of this condition with equal. When foot drop is due to MS, such as a herniated disc or compressed nerve, might be fixed by surgery as there is something pressing on the pathway — then the disc or other mass can be.

Foot drop from herniated disc - Back & Neck - MedHel

3. Tingling and Numbness. If your disc is pressing on a nerve, you may also experience tingling, numbness, or a pins-and-needles feeling from your L4-L5 disc region. The numbness may be felt in one leg that can begin in the buttock or behind the knee and extend to the thigh, ankle, or foot, as stated by WebMD Herniated Disc or Back Surgery. Sometimes a herniated disc can be so severe that it compresses the nerve root as it exits the spinal cord. The L4 nerve root is the nerve that communicated with the anterior tibialis. So, if this nerve root is compressed, someone may have a drop foot Symptoms. Symptoms of a herniated lumbar disc include: Pain, usually in the lower back and legs. Weakness or numbness. Difficulty lifting the feet when walking or standing called foot drop. Painful tingling or feelings like electric shocks, usually in the buttocks and legs. Usually, the first (and by far the most common) symptom of a herniated. Herniated discs can cause a certain amount of numbness in your legs and feet. If you feel thinking or pins and needles, you might have an issue with sciatica or herniated discs. This feeling can get in the way of your normal movement. If this happens, schedule an appointment to see what your issue could be. 5. Foot Drop. If you've never heard. Moreover, since thoracic discectomy cases with neurological manifestation (foot drop) are rare, we encountered 12 patients in last 10 years. 4.2. Conclusions. Significant neurological recovery can be expected in patients with foot drop due lower-thoracic disc herniation, irrespective of approach and symptom duration

• In the spinal cord, pressure from a herniated disc can cause foot drop and often can be accompanied by numbness on the front or side of the leg. The foot drop can be subtle, often noticed by the patient hearing their foot slap on the ground during walking So, when a herniated disc occurs at this point on the spine, it may lead to sciatica. Lumbar Herniated Disc & Sciatica Symptoms. It is not uncommon for a herniated lumbar disc to put stress upon or inflame nearby nerves, leading to pain radiating along the length of the nerve. In fact, the most common cause of sciatica is a lumbar herniated disc Foot drop is a somewhat common and scary lower back pain symptom most often associated with herniated discs in the lower lumbar spine. A dropped foot is not always a tell-tale sign of nerve compression, unless it is studied to make sure that the diagnosis actually fits the symptomatic profile Foot drop is a condition where the patient's foot loses its ability to flex properly and therefore droops down in comparison to the normal foot. Due to weakness in the muscles which cause the ankle to flex, the patient cannot lift the front of the foot upwards. This may be due to a number of causes such as a herniated disc or a tumour but.

Disc Herniation Case Studies| Spine Institute of San DiegoLumbar Microdiscectomy | Microdecompression Spine SurgeryJoint Pain Center Point AL - Gremmels Chiropractic Center

A herniated disk occurs when a portion of the nucleus pushes through a crack in the annulus. Symptoms may occur if the herniation compresses a nerve. A herniated disk refers to a problem with one of the rubbery cushions (disks) that sit between the individual bones (vertebrae) that stack to make your spine. A spinal disk has a soft, jellylike. A herniated disc alone may not cause you that much pain. The pain you experience is caused by the disc putting pressure on the spinal cord and on nerve roots. The location and intensity of the pain you experience depends on which nerves are affected by the disc and where it's putting pressure. Let's say the disc is putting pressure on nerves.

Herniated discs are usually caused due to the degenerative condition from normal or traumatic wear and tear on the disc. The herniation can be bulging, or sometimes called a slipped disc, puts pressure on spinal nerves, which leads to potentially debilitating pain Introduction Unilateral foot drop due to lumbar disc herniation (LDH) is a well-known entity, and surgery may provide satisfactory results.1 Bilateral foot drop (BFD) is a severe condition as it. Herniated Disk L5/S1 with Consitant Calf Cramps. I have been fighting with a herniated disk since 2009 and still have to live a limited life style. I am still unable to do anything remotely physical or active. I had an MRI done which showed I herniated my L5/S1 disk. When this first happened I was hardly able to walk

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Common Causes of Foot Drop - Spine-healt

A herniated disc may be caused by injury or degeneration from age. Symptoms depend on the location of the herniation and whether nerve tissue is being irritated. An MRI or CT scan is performed to diagnose a herniated disc. Treatment may involve physical therapy, cortisone injection, pain medications, anti-inflammatory medications, muscle. About one in four back pain patients has a herniated disc. Spinal stenosis, a narrowing of the spinal column, is another common cause of back pain. Dr. Foroohar offers a number of non-surgical and surgical treatments to relieve the pain of herniated discs and spinal stenosis. Only 10 to 15% of patients I evaluate for spine problems need. The terms ruptured disc and slipped disc seem to be used more commonly in the last few decades. People often assume that everyone who has back pain has a ruptured disc. However, a true herniated nucleus pulposus (the official medical name for this problem) is not very common. Most problems that cause pain in the back are not due to a herniated.

Evaluation of Foot Drop - School of Medicin

  1. Nerve compression can occur due to a disc herniation or bone spur formation in the lower back and can cause motor weakness. Weakness will first be noted as an abnormal gait. Tibialis anterior weakness leads to foot drop. As noted previously, the swing leg needs to shorten while propelling through to the next heel strike. Herniated Disc.
  2. About Lumbar Herniated Disc. Herniated disc, commonly known as slipped or ruptured disc, is a condition in which the central part of the intervertebral disc protrudes into the spinal canal. This typically occurs due to a tear in the tough fibrous annular ring that surrounds the soft inner core of the disc
  3. Foot drop 1. Name: Rahila Najihah AliMatrix Number : DPH/0102/11Batch : July/11Date: 19th June 20131Foot Drop 2. Definition2 Inability to raise the front part of foot due toweakness or paralysis of tibialis anterior musclethat lift the foot Foot drop occur due to peroneal nerve injury Can happen to one foot or both fee
  4. Herniated disc and nerve impingement causing RADIATING PAIN: Ironically, while pain might seem to be a more intolerable symptom than numbness or weakness in a foot or hand, radiating pain (radicular pain or radiculopathy) can often be treated successfully without surgery, and you can try watchful waiting, for a couple months to see if non.

Drop Foot (Foot Drop) and Steppage Gait (Footdrop Gait

  1. This is a bulging disc. With continued degeneration due to mechanical stress, wear and tear, or trauma, the annulus may tear and allow the nucleus pulposus to extrude or rupture through the tear into the spinal canal. This is a ruptured or herniated disc. pictures. Lumbar IVDS. Pai
  2. Herniated Discs may occur due to a myriad of reasons. Natural age-related wear and tear remains the most common culprit of disc injuries, with a higher rate of occurence in Men between the ages of 20 and 50
  3. Signs and Symptoms. The leaking material from within a herniated disc can touch or compress a nerve. When this occurs in the lower back, the resulting symptoms can include: Low back pain, radiating down one or both legs, and sometimes into the feet ( Sciatica) Numbness and/or tingling in the region of the body supplied by the affected nerve (s.

Lumbar spinal stenosis is a narrowing of the spinal canal in the lower part of your back. Stenosis, which means narrowing, can cause pressure on your spinal cord or the nerves that go from your spinal cord to your muscles. Spinal stenosis can happen in any part of your spine but is most common in the lower back A herniated disc is a common source of back and neck pain. Often referred to as a slipped or ruptured disc, this condition typically happens in the lower back, but can also occur in the smaller disc in the neck. A disc herniates or ruptures when part of the center nucleus pushes through the outer edge of the disc and back toward the spinal canal In February 2021 I developed acute severe sciatic pain after a PT session meant to address existing low back pain. I had never had an MRI before that point and no doctor had ever suggested it was disc issues, so the PT did a twisting stretch on my back that I found out later would be 100% ill-advised for a person with bad/bulging discs The most common musculoskeletal symptoms along with a back spasm include hip pain, spinal curvature, backache, muscle weakness, foot drop, etc. Patients may also experience some neurological symptoms due to the back spasms such as sciatica, headache, nerve problems in the arm, buttock, shoulder, or leg that produce pain, numbness, or tingling, etc

Foot drop due to lower motor neuron injury is well documented. However, foot drop due to a central cause of cervical disc prolapse is very rare. Case presentation A 55-year-old male presenting with neck pain, right and left arms radicular pain and numbness, and unilateral right foot drop following cervical disc prolapse In a report of 46 cases of foot drop related to lumbar disease, 52% was due to disc herniation, and 35% due to spinal stenosis . In two case series, 57% of patients with foot drop had lumbar disc herniation, and the remaining had lumbar spinal stenosis [14] , [15]

Foot drop is defined as a weak anterior tibialis muscle (on foot extension) and is usually caused by lower motor neuron (LMN) disease. Common causes are L4-L5 radiculopathy, caused by either a herniated nucleus pulposus or foraminal stenosis, and peroneal peripheral neuropathy Foot drop is a health issue in which the raising of the front part of the foot is difficult. Foot drop is not a condition or disease but rather, a symptoms of an underlying health issue. Muscle and/or nerve damage caused by injury and/or an aggravated health issue, such as a lumbar herniated disc, spinal stenosis, spondylolisthesis, and/or. Dexamethasonein the management ofsymptomsdue to herniated lumbardisc' L. N. GREEN because of persistent profound foot drop, even thoughhe wascompletelyfree ofpain. Thefoot drop did not improve after the operation. mechanical signs of herniated lumbar disc-namely, a positive Lasegue sign and restriction oflumbarspinalmotion. • In the spinal cord, pressure from a herniated disc can cause foot drop and often can be accompanied by numbness on the front or side of the leg. The foot drop can be subtle, often noticed by the patient hearing their foot slap on the ground during walking Pain in your back, legs, and alternating between locations may be a sign of a herniated disc. Numbness in legs; A herniated disc can cause a person to experience leg pain and the legs or feet to go numb. Sharp pain; A herniated disc can cause chronic pain along with sharp pains in the back or legs. Foot drop; Foot drop is a common in patients.

Iizuka Y, Iizuka H, Tsutsumi S, Nakagawa Y, Nakajima T, Sorimachi Y, Ara T, Nishinome M, Seki T, Shida K, Takagishi K (2009) Foot drop due to lumbar degenerative conditions: mechanism and prognostic factors in herniated nucleus pulposus and lumbar spinal stenosis. J Neurosurg Spine 10(3):260-26 Summary. Foot drop is a walking condition that can occur due to stroke, multiple sclerosis (MS), and other neurological disorders. Foot drop causes weakness or paralysis of the muscles that pull.

Introduction. Peroneal nerve palsy is the most common entrapment neuropathy in the lower extremity, most often occurring at the fibular neck, where the nerve is more superficial, and susceptible to injuries (Masakado et al., 2008).The presentation of foot drop is the most frequent initial manifestation of this disorder, which has numerous causes Foot drop (also referred to as drop foot) is a blanket term used to describe the condition where a patient has trouble lifting their foot completely when walking. With foot drop, the patient does not have full control over the front part of the foot. This causes it to drag, and can possibly result in the patient tripping and falling 1. Sit-Ups. While core strength is crucial for rehabilitating a herniated disc, the goal is to reduce spinal movement. If you remember our jelly donut analogy, flexing the spine squashes the front portion of the disc and bulges it backwards. Sit-ups will only aggravate the symptoms and slow down the healing process Vitamin K levels drop when a spinal disc is injured because it binds to the injured site to assist in aiding the healing process. If you are in need of herniated disc medication try increasing your vitamin D intake with leafy greens, cheeses, soy products, and liver

A herniated disc can make contact with the nerves along your spine and cause symptoms down the legs. This nerve supplies the sensation to the outside of your lower leg and to the top of your foot and may cause pain in these areas. In addition, the muscles that move your foot and big toe in an upward direction may be affected since the L5. RESULTS. Fifty-two patients (22.9%) suffered from foot drop. Multivariate logistic regression analysis revealed that diabetes mellitus, disc calcification, patients who had an acute episode or acute-on-chronic episode, and patients who presented with lateral recess or extraforaminal type of disc herniation were at greater risk of foot drop If foot drop is due to ongoing compression of a nerve, such as by a herniated disk, then relieving the compression sooner enhances the chances of complete recovery. I am glad you saw the surgeon.

In addition, some patients with a herniated disc may experience no symptoms. A rare symptom associated with a herniated disc is foot drop, a condition in which it becomes difficult to lift the front of the foot due to weakness, irritation, or inflammation to the nerve responsible for foot movement of the lower leg. Treatment of a. A herniated disk is a condition that can occur anywhere along the spine, but most often occurs in the lower back. It is sometimes called a bulging, protruding, or ruptured disk. It is one of the most common causes of lower back pain, as well as leg pain or sciatica.. Between 60% and 80% of people will experience low back pain at some.

Foot Drop from Pinched Nerve vs

  1. Unilateral foot drop due to lumbar disc prolapse is seen occasionally. Cauda equine features with associated bilateral foot drop due to lumbar degenerative and disc pathology is also seen occasionally. But bilateral foot drop due to a L4-L5 disc prolapse is very uncommon and almost impossible theoretically. This case had only bilateral foot.
  2. A herniated disk is where a disk in the spine becomes damaged and puts pressure on the spinal cord and nearby nerves. This can cause nerve irritation that leads to: weakness in one or both legs.
  3. Herniated disk at the L4-5 level is a common cause of foot drop. Foot drop is weakness bending your foot upwards towards your nose. This may range from mild to severe. As the weakness increases the foot tends to slap down when walking or must be lifted up high to prevent it from snagging on the floor
  4. Foot drop with weakness of the anterior tibial, posterior tibial, and peroneal muscles with Sensory loss demonstrated over the anterior shin and dorsal foot suggest a radiculopathy at L5 Foot drop occurs due to the involvement of Sciatic nerve, Direct injury to the dorsiflexors, Common peroneal nerve pals
  5. How it helps - Spinal decompression should be the very first thing you do to treat a herniated or bulging disc because it essentially creates space between your vertebrae, and thus takes pressure off the discs.. How to do it - Use a bar or the top of a door (or anything you can hang from) and allow your body to just hang. - Hang for 30 seconds and do 3 sets
  6. A herniated disc in the spine is a condition during which a nucleus pulposus is displaced from intervertebral space. It is a common cause of back pain. The patient's who experience pain related to a herniated disc often remember an inciting event that caused their pain. Unlike mechanical back pain, herniated disc pain is often burning or stinging, and may radiate into the lower extremity
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I've spent the last three weeks in hospital with herniated l3 and l4 discs and a severely prolapsed l5s1 disc. I'm due to go on holidays in 3 weeks with hubby and children. For the last month I have been able to walk, slowly as also have foot drop from nerve damage and severe sciatica. Did you have the nerve block If the L5 nerve root is involved, the most common cause is a herniated disc. Other causes of foot drop are diabetes (due to generalized peripheral neuropathy), trauma, motor neuron disease (MND.

Foot Drop Treatments - Spine-healt

  1. Triangle Disc Care - Raleigh - http://www.triangledisc.com - Michael had foot drop and was losing the function of his leg due to a pinched nerve (sciatica)
  2. The hamstrings are depicted above in red. If someone sustains a hamstring injury, often it is the correct thing to do to stretch the hamstrings. However, if you are suffering with sciatica due to a herniated disc, this exercise is definitely one to be avoided.. This is the most crucial of the herniated disc exercises to avoid because it's the one that I see patients doing all the time before.
  3. Basically all the signs and symptoms of L4-L5 disc Bulge vary according to the condition and the problem. Basically pain of different types, numbness, drop foot, complete loss in movement can happen in such cases. Pain due to L4-L5 herniated disc. Pain is the basic symptom of the L4-L5 disc protrusion
  4. Herniated lumbar disc is a common entity with an estimated incidence of 1-2% per annum. MRI studies showed that nerve root compressions are often asymptomatic. Boden et al 1 reported that 20% of those aged less than 60 years and 36% of those above 60 years old with no history of radicular pain, have HLD on MRI
  5. A herniated disc is sometimes also known as a slipped disc or prolapsed disc. It can occur anywhere in the spine although is most common in the lower back. Weakness in the foot is especially common, with difficulty lifting the foot (known as foot drop) often reported in those with L4/L5 herniation. Pain patterns

can l1-l2 herniated disk cause foot drop? Answers from

  1. Intervertebral disc disease, also known as IVDD, is a painful condition affecting a dog's back. According to petMD, the discs that cushion between the spinal column vertebrae bulge or burst into the spinal cord. This can result in nerve damage, significant pain, and even full or partial paralysis
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  3. A large ruptured disc can cause cauda equina syndrome. During a herniation, the gel-like center of a spinal disc can bulge or rupture through a weak area in the disc wall and compress the nerves. In the majority of cases, the disc herniation occurs at the L4-5 or L5-S1 discs in the lumbar spine
  4. Foot-drop & Spinal-stenosis Symptom Checker: Possible causes include Lumbar Disk Herniation. including a herniated disc, spinal stenosis, arthritic changes of the lumbar facet joints, and previous Stiffness & Discomfort in the calf region and foot joints Foot Drop due to nerve compression in the leg Repetitive Ankle Sprains at the.

Drop Foot is caused by an underlying medical condition and can be either temporary or permanent. Usually this is caused by a nerve injury below the knee. The main symptom of Drop Foot, and often the only symptom, is the limited ability to lift the front portion of the foot. This will cause the foot to drag or slap the ground with each step Bilateral foot drop can also result from parafalcine lesion and is characterized by spastic foot drop with hyperactive ankle jerks and positive Babinski sign. Our patient had an acute bilateral foot drop, due to a L3-L4 disc prolapse

A herniated disc occurs when the nucleus breaks through the annulus fibrosus. It is called a non-contained disc disorder. Whether a disc bulges or herniates, disc material can press against an adjacent nerve root and compress delicate nerve tissue and cause sciatica. The consequences of a herniated disc are worse Herniated lumbar disc symptoms generally affect the lower back and legs: Sciatica, leg pain that travels down the sciatic nerve. Pins and needle sensation or numbness. Weakness in the leg or foot. Drop foot—or dragging of the foot due to muscle weakness. Loss of bladder or bowel control. Any of the symptoms above can be from a number of other. There is plenty of evidence to suggest that neutral spine core stability exercises and treadmill walking can be effective for those recovering from a herniated disc, regardless of location of the herniation [ 14 ]. Those stability training exercises are key. Increased stability can reduce muscle tightness as well as muscle spasms

Due to the repeated injuries this nucleus pulposus herniated from the intervertebral space and presses the sciatic nerve results insciatica pain. As the age progresses the elasticity of nucleus pulposus gets reduced and this limits the ability of the disc to absorb shock, ultimately irritation of the nerve and pain Lumbar herniated disc: A herniated disc in the lower back is one of the most common causes of sciatica. In fact, an estimated 90 percent of sciatica cases involve a damaged intervertebral disc. As a disc loses its shape, it can apply pressure to the sciatic nerve Herniated disc exercise 3: Lower back muscle training. The third exercise you should perform is designed to increase the strength of your big back muscles. Because of the pain in your back, muscles tend to get weaker. Also, stronger back muscles will reduce the pressure on the disc