Herniated Disc

Lumbar disc disease often starts a traumatic incident such as a car accident or with the dehydration of the disc material. The discs typically work as the shock absorbers of the spine. As a result of their dehydration there is an overall loss of disc height and function which places more stress on the already weakened disc material.


Eventually, this stress can cause an outward bulging of the disc into the spinal canal. Occasionally, the disc material can even rupture through the outer layer of the disc into the spinal canal. Lumbar disc herniation is characterized by a bulge or rupture of the disc material into the spinal canal, which can cause abnormal pressure on the nerve at that level, leading to symptoms in the back and one leg or foot.


Sciatica is actually a set of symptoms including pain that may be caused by general compression and/or irritation of one of five lumbar nerve roots that give rise to the sciatic nerve, or by compression or irritation of the sciatic nerve itself. The pain is felt in the lower back, buttock, and/or various parts of the leg and foot.


Microdiscectomy by Pablo Pazmiño, MD. Microdiscectomy is a minimally invasive approach towards removing disc herniations in the lumbar spine. If you or someone you know may benefit from a Microdiscectomy feel free to contact us.


  • Lower Back pain (Which may be worse with upright activity)
  • Buttock pain
  • Back stiffness (Which may be worse with certain work activities)
  • Numbness in the thighs, calves, feet and toes
  • Weakness in the legs, thighs, calves, feet and toes
  • Trouble walking because of weakness in the legs or loss of balance
  • Grinding or popping sounds or sensations in the lower back
  • Muscle spasms (Which may originate from the back or lumbar paraspinal muscles)
  • Headaches
  • The condition can cause irritability, fatigue, and sleep disturbances
  • This may impair the ability to work or your daily activities.


During your consultation, Dr. Pablo Pazmiño will take a complete medical history to rule out other conditions that can cause symptoms similar to lumbar radiculopathy. Dr. Pablo Pazmiño will also perform a complete and thorough physical examination. Radiography (X-rays) and other diagnostic imaging tests (MRIs, EMGs, CAT scans) will then be reviewed so that Dr. Pablo Pazmiño can evaluate your bony quality, any neural compression, bone spurs and other abnormalities to reveal the extent of damage to the lumbar spine.



At Santa Monica Spine we pride ourselves in our duty to educate our patients. Dr. Pablo Pazmino uses his background as a teacher to ensure that you understand your pathology, imaging and treatment options completely during each visit. Our patients often comment on their amazement at the amount of time and effort we take to review their studies, often in a manner which they have never seen before. We want our patients to be involved in every step of the process and we feel that education is the first step towards achieving that goal together.

Medical History

At Santa Monica Spine / Beverly Spine we are very thorough. Dr. Pablo Pazmiño will need a complete history of any medical illnesses, surgeries, or chronic conditions which you may have or for which you have seen other physicians in the past.

More specifically we will require a history of your back and leg pain itself. What is the exact location of the pain? When did the problem begin? What does the pain feel like? Has your back been injured before? Have you previously been treated for back or leg pain?

Nonsurgical Treatment

Nonsurgical treatment is effective in treating the symptoms of neck pain. Symptoms of neck pain may last for days, several months, or become chronic. If symptoms are mild, Dr. Pablo Pazmino may recommend a variety of nonsurgical treatments.

  • Rest. A soft cervical collar or neck brace may be used to limit neck motion and relieve irritation.
  • Medication. Dr. Pablo Pazmino may prescribe nonsteroidal anti-inflammatory medications (NSAIDs) or other non-narcotic pain relievers to relieve your pain and reduce swelling. Muscle relaxers, analgesics, and anti-inflammatory medications are also helpful.
  • Acupuncture. Dr. Pablo Pazmino works with a team of Acupuncture specialists and may recommend this if indicated for your symptoms.
  • Chiropractic Management. Dr. Pablo Pazmiño works with a reliable team of Chiropractors and may recommend this if indicated for your symptoms
  • Physical therapy. A course of therapy guided by Dr. Pablo Pazmiño may include hot and cold therapy, ultrasound or an active exercise program which may help relieve symptoms. Exercises may include core body strengthening, lumbar and lower extremity stretching, and aerobic exercises. Patients may also receive gentle massage and perform activities to improve posture.
  • Injections: A series of selective nerve root blocks or epidural injections of a cortisone-like drug may lessen nerve irritation and allow more effective participation in physical therapy. These injections are given on an outpatient basis over a period of weeks. Dr. Pablo Pazmiño only works with a small group of physicians who he trusts to perform these injections. Click here to see some of the recommendations Dr. Pablo Pazmiño makes in regards to injections and pain management physicians.



Nonsurgical treatment may take away most of the symptoms, but it does not treat the underlying structural cause. Follow-up visits are necessary so Dr. Pablo Pazmiño can check if symptoms have gotten better, worse, or have stayed the same.

Surgical Treatment

For some patients with significant pain and weakness, after failure of conservative management, Dr. Pablo Pazmiño may recommend a surgical treatment option. The surgical treatment options may vary and depend on the individual patient and their pathology. Surgery may be necessary for patients with progressive neurologic symptoms or severe pain that does not improve with other treatments. Surgery may remove bone spurs or disc material (Decompression) and provide lasting pain relief.

In our practice, surgery is always reserved as a last option, but when necessary can have excellent results and often can improve your overall quality of life. If surgical treatment is warranted Dr. Pablo Pazmiño can offer a variety of procedures for treating Lumbar disc herniations.

When Should You Seek Medical Care?

If severe pain occurs following an injury (motor vehicle accident, diving accident, or fall), a trained professional, such as a paramedic, should immobilize you to avoid the risk of further injury and possible paralysis. Emergent medical care should be sought immediately.

Immediate medical care should also be sought when an injury causes pain in the neck that radiates down the arms and legs.

Radiating pain, or numbness in your arms or legs which causes weakness in the arms or legs without significant neck pain should also be evaluated.

If there has not been an injury, you should seek a Spinal Evaluation with Dr. Pablo Pazmino when pain is:

  • Continuous and persistent
  • Severe
  • Accompanied by pain that radiates down the arms or legs
  • Accompanied by headaches
  • Accompanied by numbness, or tingling
  • Accompanied by weakness!

Many patients seek care for Herniated Disc pain by Dr. Pablo Pazmiño because as an Orthopaedic surgeon he is specifically trained to diagnose, treat, and help prevent problems involving the muscles, bones, joints, ligaments, and tendons. Although Dr. Pablo Pazmiño confines his practices to Spinal pathology he also treats a wide variety of diseases, injuries, and other conditions, including Degenerative Disc Disease.