Hernia Nucleus Pulposus In A 65-Year-Old Female Patient : a Case Report

Abstract

Lumbar herniated nucleus pulposus (HNP) is an intervertebral disc disorder that may cause radicular pain and motor dysfunction due to neural compression. This case report describes the clinical presentation, diagnosis, and response to conservative management in a 65-year-old woman with lumbar HNP. The patient presented with intermittent pain radiating from the right hip to the right foot for one year, worsening over the previous six months. The pain intensified when rising from a seated position and improved when lying down. She had difficulty walking independently and a history of falling onto her buttocks seven years earlier, without bowel or bladder dysfunction. Physical examination revealed pain-limited movement and right lower extremity muscle strength of 4/5, with positive right-sided Lasègue, Patrick, and contra-Patrick tests. Lumbosacral MRI showed posterior disc herniation at L5–S1 compressing the anterior thecal sac and bilateral spinal nerve roots, L4–L5 disc bulging, and L5–S1 degenerative disc changes. Treatment consisted of diclofenac, vitamin B12, a lumbar corset, and activity-modification education. After one month, the Numeric Rating Scale (NRS) pain score decreased from 8/10 to 5/10, while right lower extremity muscle strength remained unchanged. These findings indicate short-term pain improvement without documented motor recovery. Given the single-patient design and short follow-up, the effects of individual interventions and long-term outcomes cannot be established. This case emphasizes the importance of monitoring pain and neurological function during conservative management of lumbar HNP.