Some people who have a herniated disc experience no obvious symptoms. This is usually because the part of the disc that bulges out is only small or may not be pressing on the nerves or spinal cord.
However, most people who have a slipped disc will experience pain. The pain often begins in the lower back before sometimes spreading to other parts of the body.
The pain of a prolapsed disc tends to be deep, dull and persistent and it may radiate into all sorts of unexpected places. For example, a prolapsed disc in the lower back may produce pain in several places such as the buttocks, hip or groin. Some people find that these pains are worse if they bend in one particular way. Others find that their pains become unbearable if they stand up straight. And it isn't uncommon for people to complain that their pain is worse when they sneeze, cough or laugh.
With most slipped discs, pain is caused when part of the disc begins to press on one of the nerves that run along the spine. The sciatic nerve is the most commonly affected nerve.
The sciatic nerve is the longest nerve in the body and is made up of several smaller nerves. It runs from the back of the pelvis, through the buttocks and all the way down both legs, ending at the feet.
If you have pressure on the sciatic nerve, it can cause:
- a lasting, aching pain
- shooting pain down your leg, normally one leg would be more affected than the other
- a tingling sensation in one or both of your legs
- pins and needles on the sole of your feet or big toe
- pain in your hip on standing or walking – you can sometimes create this pain or spasm by pushing with your finger into the side of your hip – at least I can smile.
Sciatica is a symptom of another medical problem, not a medical condition on its own.
The sciatic nerve controls the muscles of the back of the knee and lower leg and provides sensation to the back of the thigh, part of the lower leg, and the sole of the foot.
If the slipped disc presses on any of the other nerves that run down your spinal cord, your symptoms may include:
- muscle paralysis (weakness)
- muscle spasms, when your muscles contract tightly and painfully
- loss of bladder control
Muscle spasms and paralysis tend to occur in your arms, legs and buttocks. The pain that you experience when a disc presses on a nerve is often worse when you put pressure on the nerve. This can happen when you:
A small-sample study examining the cervical spine in symptom-free volunteers has found focal disc protrusions in 50% of participants, which shows that a considerable part of the population can have focal herniated discs in their cervical region that do not cause noticeable symptoms.
Typically, symptoms are experienced only on one side of the body. If the prolapse is very large and presses on the spinal cord or the cauda equina in the lumbar region, affection of both sides of the body may occur, often with serious consequences.
At the level of the thirteenth rib, the human spinal cord terminates in a bulge (the lumbosacral enlargement). All remaining spinal nerves emerge from the lumbosacral enlargement. These remaining spinal nerves have the appearance of a horse's tail hence the name ‘Cauda equina’- which is Latin for Horse's Tail.
Although infrequent, Cauda equina syndrome is a diagnosis that must be considered in patients who complain of low back pain coupled with neurologic complaints, especially urinary symptoms.
Compression of the cauda equina can cause permanent nerve damage or paralysis. The nerve damage can result in loss of bowel and bladder control as well as sexual dysfunction.
Symptoms of the syndrome can include:
- lower back pain
- numbness in your groin
- paralysis of one or both legs
- rectum pain (pain in the lower bowel and anus)
- bowel disturbance
- being unable to pass urine
- pain in the inside of your thighs
If you develop any of these symptoms, contact your GP immediately or visit the accident and emergency (A&E) department of your nearest hospital.
Further information can be found at:
Lower Back Pain