Disc Herniation Symptoms

The medical literature states that back problems are second only to the common cold as causes of time lost from work. This means that billions of dollars are lost every year from back problems. The main source of back problems is unhealthy discs.

The primary symptoms of disc problems are lower back, mid-back and neck pain. A symptom is what you the patient feels in contrast to a sign, which is what can be seen by the examining physician. In this article about the symptoms and signs of disc injury, I well use the lower back or lumbar spine only A symptom is what you as the patient feels and a sign is what can be seen by the examining physician. In this article about the symptoms and signs of disc injury, I will use the lower back or lumbar spine only.

Back Pain: Severe back pain that comes on suddenly with or without a significant injury usually denotes a tear in the annulus or outer portion of the disc. This pain can be incapacitating in its intensity and cause you to freeze-up and seek immediate support from the closest structure or person. As long as the pain is in the back only, and not causing pain into the legs, the condition is not serious and will usually subside in one to two weeks. If the pain in the back persists, I recommend that you seek medical care. On occasion I have admitted patients with annular tears to the hospital in order to control their pain.

Milder back problems can occur from a simple back strain or a sprain. When a muscle has been injured, it is called a strain. A sprain. On the other hand, means that a ligament rather than a muscle has been damaged. Back strains and sprains usually do not involve the legs and are not incapacitating. Both strain and sprain injuries are the result of bending or the lifting of heavy objects.

Leg Pain: If leg pain develops along with back pain, the disc injury has involved one of the spinal nerves. Pressure or swelling about a spinal nerve will cause pain to radiate down the course of that nerve into the buttock and leg. Numbness, tingling and weakness are other symptoms and signs of nerve involvement. If the spinal nerve is experiencing pressure from a bulging disc, the pain in the leg can be severe. If the disc bulge or herniation gets smaller over time and the pressure on the nerve subsides, the leg pain will slowly lessen. However, if the spinal nerve has been damaged by the protruding disc, the numbness, tingling and weakness will persist even though the pain in the leg has gone away. Leg numbness, tingling and weakness without leg pain is usually a good sign since it is the leg pain that denotes pressure on the spinal nerve. Once the pressure on the spinal nerve is reduced, the symptoms of nerve damage frequently disappear without surgery or aggressive treatment.

Spinal Nerves: The spinal nerves can be involved from a disc problem in two ways. First, the nerve can experience pressure from a protruding or bulging disc due to direct contact of the disc with the nerve. The second way that the disc can cause nerve symptom and signs is by inflammation from the damaged disc causing inflammation in the nearest spinal nerve. The signs and symptoms of spinal nerve compression are usually more intense than those caused by inflammation.

Buttock and Leg Pain Without Back Pain: Sometimes a disc problem can present as a sudden onset of severe buttock and leg pain without any lower back pain. This presentation usually denotes a more serious condition meaning that the disc herniation has extruded into the area of the spinal nerve behind the disc and is causing marked pressure on the spinal nerve. The symptoms and signs of this condition are numbness, tingling and sometimes weakness in the muscles supplied by that specific spinal nerve. If these symptoms persist or progress in intensity, immediate medical care is needed. Progressive increase in these symptoms and signs can cause permanent nerve damage leaving you with permanent weakness and numbness in the leg. If the pressure on the nerve is relieved, the nerve damage can resolve. We spinal doctors do not known how long it takes for a spinal nerve to suffer permanent damage from pressure from a disc heriation. For me, if severe leg pain with numbness and weakness persists for more than several days, immediate medical treatment is indicated. This condition will require diagnostic testing and possible surgical treatment.

If a disc massively herniates into the nerve sac or cauda equina [nerve sac] , a surgical emergency can result. This condition would cause severe back and leg pain with weakness, numbness and loss of bowel and bladder control. The nerves to the bowel and bladder are in the cauda equina with the spinal nerves to the legs and can become compressed by a very large disc protrusion. This condition is called a cauda equina syndrome and require immediate surgical attention to prevent permanent damage.

Diagnostic Tool: Along with the above signs and symptoms of disc herniation, we spinal doctors have diagnostic tools to help us make the proper diagnoses of these disc herniations. Plain x-rays of the spine will give us basic information about the structure of your spine. Fractures of the bones along with deformities of the spine can be evaluated by x-rays. The spaces where the discs are located between the spina bones [vertebrae] can also be evaluated on a plain x-ray.

For further information about the discs, a magnetic resonance imaging [MRI] scan will be required. This diagnostic procedure uses magnetic rays to give information concerning the discs and nerves. The general health along with the structure of the discs can be seen on a MRI scan. Patients with pacemakers or other electronic implants cannot have a MRI scan. A computerized axial tomography scan or CAT scan can be used for patients that cannot have a MRI. Another diagnostic test is called an electromyogram (EMG) and nerve conduction study (NCE). This test studies nerve function and the conduction of the nerve impulses in the nerve. These diagnostic studies are essential for the accurate diagnosis of disc herniations.