Lumbar Hernia

A hernia is when an organ or tissue pushes through a weak spot in a muscle. A lumbar hernia (or flank hernia) is when tissue pushes through a weak area in the muscles of your lower back. This type of hernia is rare.

Lumbar hernias often happen on their own when back muscles become weak. They can also happen after an injury or surgery. Symptoms may include a visible bulge and pain or pressure. Treatment is usually needed because the hernia can grow larger and cause problems.

Symptoms of lumbar hernia

You may not notice symptoms when the hernia is small.

If you have symptoms, they typically happen once the hernia grows. They could include:

• A noticeable bulge in your low back
• Pain, discomfort and aching, especially when you cough or lift something
• Pressure or heaviness in your back
• Not being able to turn your back to look behind you
• Digestive issues or urinary issues (depending on the size and location of the hernia)

Lumbar hernia causes

Lumbar hernias usually happen in a naturally weaker area of muscle in your lower back. They occur beneath the 12th rib and above your hip bone.

You can be born with one (congenital) or develop it after birth (acquired). Congenital lumbar hernias usually happen along with other congenital conditions.

Most lumbar hernias are acquired. Acquired lumbar hernias can be either primary or secondary:

• Primary lumbar hernias: Some specific causes of primary lumbar hernias are obesity or weak back muscles. Anything that puts extra pressure on your abdomen — like strenuous physical activity or straining to cough, lift or poop — can also cause it. Most lumbar hernias are this type.
• Secondary lumbar hernias: This type happens due to trauma like injuries, broken bones, surgery or infection. It’s less common.

Risk factors

It’s most common in males between the ages of 50 and 70. Most lumbar hernias occur on the left side. Having any of these factors puts you at a higher risk:

• Chronic bronchitis or conditions that make you cough a lot
• Muscle atrophy (weak or thinning muscles)
• Surgery to your abdominal or pelvic region (like kidney or spinal surgery)
• Trauma, like a fall or broken bone
• Heavy weightlifting or anything that strains your abdomen

Your risk is higher if you have a job that requires heavy lifting (especially lifting while twisting) or standing most of the day. People who participate in contact sports (like football) or sports that use a twisting motion (like golf) are also at a higher risk.

Complications of lumbar hernia

The main complications come from the hernia getting larger. This can cause more pain and make it harder to treat.

Other complications include:

• Bowel blockage (part of your intestine gets stuck in the hernia)
• Trapped tissue (the bulging tissue can’t be pushed back in place)
• Loss of blood flow (the tissue inside the hernia stops getting blood, which is an emergency)

How doctors diagnose lumbar hernias

A healthcare provider can usually see or feel a lumbar hernia. They’ll order imaging tests like a CT scan to confirm it. Since lumbar hernias are uncommon, they can be mistaken for back strain, fatty lump or a herniated disc.

How are lumbar hernias treated?

Surgery is the main treatment for lumbar hernias. Hernia repair surgery involves closing the opening in the muscle. Your provider may try to use surgical mesh to help make the area stronger. This also reduces the chance that the hernia will come back. Full recovery from lumbar hernia repair can take a few weeks.

If the hernia is small, your provider may watch it over time. They may not need to repair it until it causes symptoms or becomes a problem. But most hernias get larger and eventually need repair.

When should I see my healthcare provider?

Contact your provider if you have signs of a lumbar hernia, like a bulge in your back and pain in the area. They can examine you to take a closer look at what’s going on.

What can I expect if I have a lumbar hernia?

Most lumbar hernias aren’t serious. But they do need treatment before they become large and cause complications. Prompt treatment also reduces the risk of hernias causing problems in the future.

Lumbar hernias can come back. But following your provider’s recovery instructions can lower the chance of this happening. Ways to decrease your risk of future hernias include:

• Strengthening your core and back muscles
• Avoiding heavy lifting or strenuous exercise
• Using proper techniques when you lift
• Maintaining a healthy weight for you
• Managing chronic coughing to reduce straining