Symptoms: What does Lumbar Disc Herniation feel like?
Disk herniation can cause a variety of symptoms but the most common symptom people report is pain. The process of a disk herniating causes pain fibers in the disk itself to become activated, and the body feels this as back pain. When the disk comes in contact with one of the spinal nerves, this causes pain that goes down the leg. Often times people will describe it as “sciatica”. This is a sharp, shooting pain that can radiate down the leg. Depending on the location of the herniation, some people can have pain that radiates down the front, back or side of the leg. Pain can be so severe that it radiates down to parts of the foot.
While pain that radiates down the leg is the most common symptom, there are many other types of nerve symptoms that people with disc herniations report. Some people report having a tingling sensation or “pins and needle” type feeling that radiates down the leg. Some people report a warm or burning sensation that radiates down the leg. It is also very common for people to complain of a vague numb type feeling in the leg.
Pain associated with disk herniations can be very severe and disabling but disk herniations can also cause symptoms that require urgent medical attention. Some disk herniations can push so forcefully on a nerve that it causes weakness in the leg or foot. Disk herniations can cause weakness with lifting the leg or foot. Some people will report being unable to go upstairs due to hip weakness or weakness in the leg and foot. It is also very concerning if a person has weakness or numbness in the leg that is getting progressively worse. Some disk herniations can be so large that the herniated disk can press on several nerves in the spinal canal and cause a loss of bladder or bowel function, resulting in incontinence. This is sometimes associated with numbness in the genital area and is another very concerning symptom. If a person develops any of these symptoms, they should immediately present to an emergency room.
Evaluation: How is Lumbar Disc Herniation diagnosed?
Diagnosing a disk herniation starts with a discussion about the symptoms the patient is having. A physical exam is performed that checks for muscle strength in all the major muscle groups of the legs. The health care provider will also assess for sensation and reflexes in the legs. Your health care provider may also perform special physical exam tests like a straight leg test (SLT) to assess for disk herniations. Information obtained from the history and physical exam will often indicate to the health care provider if there is a concern for a disk herniation and if additional testing is needed.
X-rays of the lumbar spine is the next step in testing. X-rays can help assess for disk space narrowing, fractures, and spinal alignment. An MRI of the lumbar spine may also be needed and that will allow your doctor to look directly at the lumbar disks. The MRI is able to show disk herniations and the nerve that is being pressed upon. If you are unable to have an MRI, a CT Myelogram maybe ordered instead.
Recovery: What Can Be Expected?
Overall, the results of microdiscectomy are generally very good. Pain is usually one of the first symptoms to improve after surgery. Patients tend to have more improvement in leg pain than back pain. Your surgeon will likely limit your lifting, twisting, and bending for a few weeks after surgery. This is to prevent a recurrent disk herniation which can happen with or without surgery. Rehab typically involves a walking program but it can also be helpful to work with a therapist to help restore strength and flexibility.
Physicians
The following physicians specialize in the treatment of Lumbar Disc Herniation: