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Musculoskeletal - Herniated Disc
n this episode, we review lumbar disc herniation, a common cause of radicular back pain in adults ages 30–50. We break down the pathophysiology of nucleus pulposus herniation leading to nerve root compression, along with classic symptoms such as radiating leg pain, numbness, and weakness. The discussion highlights key exam findings like a positive straight leg raise, appropriate use of MRI, and evidence-based management—emphasizing that most cases improve with conservative treatment. We also review red flags and when to escalate care to prevent complications such as cauda equina syndrome.
References
1) Bushardt RL, Colomb-Lippa DM, Klinger AM, Reed H. The JAAPA QRS Review for PAs: Study Plan and Guide for PANCE and PANRE. 1st ed. LWW; 2021. ISBN: 9781975143817.
2) Deyo RA, Mirza SK. CLINICAL PRACTICE. Herniated Lumbar Intervertebral Disk. N Engl J Med. 2016 May 5;374(18):1763-72. doi: 10.1056/NEJMcp1512658. PMID: 27144851.
3) Jin H, Lopez AM, Romero FG, Hoang R, Ramesh A, Bow HC. A Systematic Review of Treatment Guidelines for Lumbar Disc Herniation Neurospine. 2025; 22(2):389-402.
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By Kristopher Maday, PA-C, DFAAPAn this episode, we review lumbar disc herniation, a common cause of radicular back pain in adults ages 30–50. We break down the pathophysiology of nucleus pulposus herniation leading to nerve root compression, along with classic symptoms such as radiating leg pain, numbness, and weakness. The discussion highlights key exam findings like a positive straight leg raise, appropriate use of MRI, and evidence-based management—emphasizing that most cases improve with conservative treatment. We also review red flags and when to escalate care to prevent complications such as cauda equina syndrome.
References
1) Bushardt RL, Colomb-Lippa DM, Klinger AM, Reed H. The JAAPA QRS Review for PAs: Study Plan and Guide for PANCE and PANRE. 1st ed. LWW; 2021. ISBN: 9781975143817.
2) Deyo RA, Mirza SK. CLINICAL PRACTICE. Herniated Lumbar Intervertebral Disk. N Engl J Med. 2016 May 5;374(18):1763-72. doi: 10.1056/NEJMcp1512658. PMID: 27144851.
3) Jin H, Lopez AM, Romero FG, Hoang R, Ramesh A, Bow HC. A Systematic Review of Treatment Guidelines for Lumbar Disc Herniation Neurospine. 2025; 22(2):389-402.