Worldwide, lower back pain is the leading cause of disability, with nearly 30% people in the U.S. suffering from lower back pain at any given time. An estimated 80% of people will experience back pain in their lifetime, with serious physical, emotional, and economic consequences. Lower back pain costs the U.S. an estimated $100 billion dollars annually in both direct medical costs and indirect costs (e.g., lost wages and productivity). Of all lower back pain causes, the most common is herniated disc. Recognizing herniated disc symptoms can make a world of difference in treating this pain and getting back to your life.
What is a herniated disc?
The human spine consists of 33 vertebrae divided among five regions. These include:
- Cervical: The cervical spine is located in the neck and includes seven vertebrae
- Thoracic: The upper and mid-back is the thoracic spine, with twelve vertebrae
- Lumbar: Five vertebrae are located in this low-back region
- Sacral: The sacral area of the spine is largely immovable and consists of five vertebrae
- Coccygeal: There are four small bones in this region at the very end of the spine
In all regions of the spine, intervertebral discs are between each vertebrae. An intervertebral disc consists of two layers: an inner, jelly-like layer called the nucleus pulposus and an outer, fibrous layer called the annulus fibrosis.
These intervertebral discs cushion each vertebrae and help them move smoothly in your spine. A herniated disc occurs when some or all of the inner layer of the intervertebral disc ruptures through a weakened point in the outer layer. When the jelly-like inner layer leaks out through the outer layer, there is no cushion between the vertebrae. This can cause pain, inflammation, and even more serious complications.
A herniated disc occurs most frequently in the lumbar spine, specifically between the L4 and L5 vertebrae. This is the lowest region of your lumbar spine and may be less flexible than other vertebrae in this region. For this reason, it may be more susceptible to injury or the consequences of deterioration than other, more flexible parts of the spine.
What are some herniated disc causes?
Herniated disc causes include injuries that happen in an instant and degeneration over time.
- Injury: A sudden blow to the spine can cause an intervertebral disc to rupture. Injury can occur as a result of a fall, car accident, or other blow to the spine. Additionally, improper lifting or strain can cause a herniated disc.
- Degenerative disc disease: Degenerative disc disease occurs over time as the body ages. The intervertebral disc begins to lose some of its cushiony fluid. This can cause the walls of the intervertebral discs thin and rupture over time.
There are several risk factors for herniated discs. Poor posture and obesity put you at increased risk for herniated discs, as does a genetic disposition to herniated discs. Occupations that feature heavy, repetitive lifting are also risk factors for herniated discs.
What does a herniated disc feel like?
You will likely not feel the actual herniated disc in your spine. Most often, a herniated disc does not feel like anything at the site of the herniation. Occasionally, you may notice a flattening of the lower back if twinges of back pain have unconsciously altered your posture, but other than that, a herniated disc will not necessarily have signs or symptoms in the vertebrae.
So where and when will you notice your herniated disc?
You may notice that bending over to pick something up is challenging, either due to pain or muscle weakness. You might get a twinge of pain as you twist or when you are carrying something.
It is also possible that you will notice your herniated disc from unconscious behaviors. That is, you may begin to adapt your movements and postures in a way that offers pain relief and relief from muscle weakness. These can include things like resting an ankle on your knee when you are seated, or walking around more.
Sometimes these small changes are what leads to a herniated disc diagnosis. You may find yourself favoring one leg, placing additional stress on the opposite leg. This stress can lead to pain in other areas of the body, such as the hip. It may be this change that sends you to the doctor. A quick MRI to look at the soft tissues and ligaments of the hips might just reveal a herniated disc.
12 herniated disc symptoms
Believe it or not, it is possible to have a herniated disc without experiencing any symptoms. Patients will sometimes visit their doctor for another condition and see a herniated disc on their MRI.
In most cases, however, there are a few symptoms they experience. These can range from mild to severe. Here are the 12 most common herniated disc symptoms:
- Muscle weakness
- Sciatic pain
- Muscle spasms
- Overactive reflexes
- Pins and needles
- Hand numbness
- Neck stiffness
- Loss of bowel control
The hallmark of herniated disc pain and other symptoms is that they persist. We have all felt discomfort after a day of vigorous activity, but the symptoms of a herniated disc continue and possibly worsen over days, weeks, and months. It is important to visit your doctor for back pain that persists over several weeks, especially if you have one or more risk factors for herniated disc.
Pain can range from barely noticeable to excruciating. It may also come and go.
Depending on the location of your disc herniation, pain can occur in the arms, legs, all areas of the back, hands, or neck. Pain can be sharp and shooting or dull and aching. It may vary in intensity depending on the level of activity and time of day.
2. Muscle weakness
Herniated discs can place tremendous pressure on the nerves surrounding the spine.
Over time, this can create muscle weakness. Muscle weakness may also occur as a result of avoiding use of your leg or arm, even unconsciously.
3. Sciatic pain
The sciatic nerve is the longest nerve in the body, running from the lumbar spine, across the back of the buttocks and hips, and down the leg to the top of the foot. Sciatic pain can occur anywhere along the length of the sciatic nerve.
Many people refer to sciatica as a condition, but that is just the name of the type of pain. A herniated disc can cause sciatic pain that worsens over time as the condition worsens.
Tingling anywhere along the low back, leg, hip, or arm can occur with or without pain. This is also related to pressure on the nerves surrounding the vertebrae.
5. Muscle spasms
Muscle spasms can occur intermittently and may be more annoying than debilitating.
6. Overactive reflexes
This symptom of herniated disc may be accompanied by muscle spasms as well.
Many patients are troubled by numbness they experience as a result of herniated discs.
This numbness may persist even after the herniated disc is addressed. Numbness can occur down the legs and into the feet, or it may be present in the shoulders, arms, and hands.
8. Pins and needles
The feeling of pins and needles is similar to the prickly feeling you might experience when a limb falls “asleep” and begins to “wake up,” only this prickly feeling lasts longer.
This can also be a sign of nerve damage due to herniated discs.
Burning is a challenging symptom to describe, but you know it when you feel it.
Imagine you have moved too close to a fire, enough so you feel the excess warmth that is borderline painful. Some patients with herniated disc experience this as a major symptom.
10. Hand numbness
Hand numbness occurs typically for patients who suffer from cervical disc herniation.
The nerves that enervate the hands are compressed by the vertebrae in the cervical spine, resulting in numbness.
11. Neck stiffness
Likewise, damage in the cervical spine can lead to neck stiffness and pain.
12. Loss of bowel control
If you experience this symptom, head to the emergency room. This is not a symptom that will clear up on its own, and ignoring it can put your life at risk.
Do not hesitate or wait for it to clear up. Head straight to the emergency room.
Herniated disc vs. bulging disc symptoms
The major difference between a herniated disc vs. a bulging disc is that a herniated disc has actually split open and leaked intervertebral fluid. A bulging disc is common, especially as we age. The intervertebral disc bulges out between vertebrae but retains its integrity (and jelly-like fluid, too).
A bulging disc can be just as painful as a herniated disc, though.
The pressure a bulging disc places on nerves in the spinal column can produce the same symptoms as above (pain, tingling, pins and needles, etc.). If a bulging disc is caught early, it may be possible to treat it before the condition worsens. If not treated, these can turn into full disc herniation.
Preventing disc herniation
As with many conditions, the best herniated disc treatment is prevention.
To avoid developing herniated discs as you age, work to maintain a healthy weight with plenty of exercise and a healthy diet for strong bones. Specific strength training exercises that work the core of the body can help support a strong, healthy back.
Posture is important, too, especially if you spend much of your day working on a computer or driving. This can cause a forward slump in your shoulders, placing tremendous stress on your lumbar and cervical vertebrae.
Treatments for herniated disc
If you are diagnosed with a herniated disc, you can try the following five treatments, in order from the least to most invasive.
- Physical therapy: Physical therapists can help you improve your posture, strengthen the core of your body, and maintain a healthy weight. They will give you specific exercises to lengthen the spine to take pressure off the vertebrae.
- Chiropractic care: Chiropractic care can help to adjust and align an injured spine. Chiropractors often work with physical therapists to help strengthen the muscles along the spine.
- Non-steroidal anti-inflammatory drugs (NSAIDs): NSAIDs can help decrease inflammation and pain, especially as you begin physical therapy.
- Epidural steroid injections or nerve blocks: These types of injections can be used as a diagnostic tool as well as a way to ease pain. It does not fix the structural causes of the herniated disc but can be helpful in rehabilitation.
- Surgery: If patients continue to experience pain after treatment, or symptoms worsen, surgery may be the only remaining option. A discectomy may be performed to remove the herniated disc material that is irritating the spinal nerves. In very rare cases, the entire intervertebral disc needs to be removed. In these cases, fusion of the vertebrae with metal hardware can help provide stability to the spine.
If patients do require surgery, a period of physical therapy is also prescribed to prevent further damage to the spine. Somewhere between five and 10% of patients experience disc reherniation. Physical therapy can help improve your chances of a positive result and less ongoing pain.
If you are experiencing the herniated disc symptoms, it may be time to talk to a pain specialist. You can find a pain doctor in your area by clicking the button below or looking for one in your area by using the tips here: https://paindoctor.com/pain-management-doctors/.