As a disc degenerates and deteriorates, the internal nucleus may seep into the outside of the disc, and this condition is known as a herniated disc. The weak point in the outer nucleus of the intervertebral disc is directly below the spinal nerve root, so a hernia in this zone, exerts direct pressure on the nerve.
The nerve runs through the leg, and any type of pinched nerve in the lumbar spine can cause the pain to radiate along the path of the nerve to the buttocks and leg. This type of pain is also called sciatica or radiculopathy.
Disc herniation causes when all or part of a column disc is forced to pass through a weakened part of the disc. This can put pressure on the nearby nerves or spinal cord. In this article, we’ll show you the herniated disc symptoms and its treatment. Just follow below:
With the Cervical disc herniation
The disc might come out of place (herniated) or break due to injury or distention. If it occurs, there may be a pressure on the spinal nerves. And you will feel pain, numbness, or weakness.
The lower part (lumbar region) of the spine can most commonly be affected by a herniated disc. Besides, the neck (cervical) discs are another affected area. Middle and Upper (thoracic) discs are rarely compromised.
A herniated disc is a cause of radiculopathy. Any disease that affects the nerve roots of the spine.
Herniated discs occur more frequently in middle-aged and elderly men, usually after strenuous activity. Other risk factors may include:
- Lifting heavy objects
- Being overweight
- Repeatedly twisting or twisting the lower back
- Sit or stand in the same position for many hours
- Having a sedentary vine style
Herniated disc symptoms
Symptoms generally include one or a combination of the following:
- Leg pain (sciatica): It can occur with or without low back pain. Usually, leg pain is worse than low back pain.
- Numbness, weakness or tingling in the leg
- Lumbar pain or back pain in the buttocks.
- Loss of sphincter control (infrequent), which may be an indication of a serious medical condition called ponytail syndrome.
Symptoms of disc herniation at levels L4-L5 and L5-S1
The vast majority of herniated discs will be produced in the lower part of the spine at the L4-L5 or L5-S1 levels. In addition to the characteristic symptoms of sciatica, nerves pinched at these levels can cause:
Pinching the L5 nerve (at the L4 – L5 level) due to a herniated disc, it can cause weakness in the extension of the big toe and possibly the ankle (fall of the foot). You may feel numbness and pain in your upper foot, and the pain may also radiate into the gluteus.
Clipping of the S1 nerve (at the L5 – S1 level) due to a herniated disc, it can cause loss of ankle reflex or weakness when pushing the ankle (patients can not lift toes). Numbness and pain can radiate to the plant or the outside of the foot.
Tests and exams
A careful physical examination and medical history is almost always the first step. Depending on where you have the symptoms, the provider will examine your neck, shoulder, arms, and hands or lower back, hips, legs and feet.
Your provider will examine:
- Looking for numbness or loss of sensation
- Muscle reflexes, which may be slower or absent
- Muscular strength, which may be weaker
- Posture or shape of the curvature of the column
- Your provider may also ask you to:
- Sit, stand and walk. As you walk, your provider may ask you to do so on your toes and then on your heels.
- Bend forward, backward, and sideways.
- Move the neck forward, backward and sideways.
- Raise your shoulders, elbow, wrist and hand, and check your strength during these tasks.
- Leg pain that occurs when you sit at the examination table and lift the extended leg usually suggests the presence of a herniated disc in the lower back.
On another examination, you will bend your head forward and sideways, while the provider will apply slight pressure down on the top of the head. Generally, increased pain or numbness during this test is a sign of pressure on a nerve in the neck.
The exams that you can request are:
- Electromyography (EMG) to determine the exact nerve root that is compromised
- Myelography to determine the size and location of the herniated disc
- A nerve conduction velocity test can also be performed.
- MRI scan or CT scan of the spine will show if the herniated disc is exerting pressure on the spinal canal.
- X-ray of the spine to rule out other causes of cervical or back pain. However, it is not possible to diagnose a herniated disc only by means of an x-ray of the spine.
Treatments for Lumbar Disc Herniation
In most cases, if a patient’s pain is going to get better, they will begin to do so within about six weeks.
If the symptoms are reduced on their own, several non-surgical treatments can help relieve pain and facilitate long-term healing. Non-surgical treatments for herniated disc include:
- Osteopathic / chiropractic manipulation (manual manipulation)
- Therapy with heat or ice
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- Oral steroids (such as prednisone or methylprednisolone)
- An epidural injection (cortisone)
If pain and other herniated disc symptoms continue after six weeks, and if the pain is severe, it is reasonable to consider microdiscectomy surgery as an option.