Herniated Disc (cont.)
What are symptoms of a herniated disc?
The symptoms of a herniated disc depend
on the exact level of the spine where the disc herniation occurs and whether or
not nerve tissue is being irritated. A disc herniation may not cause any
symptoms. However, disc herniation can cause local pain at the level of the
spine affected.
If the disc herniation is large enough, the disc tissue can
press on the adjacent spinal nerves that exit the spine at the level of the disc
herniation. This can cause shooting pain in the distribution of that nerve and
usually occurs on one side of the body. For example, a disc herniation at the
level between the fourth and fifth lumbar vertebrae of the low back can cause a
shooting pain down the buttock into the back of the thigh and down the leg.
Sometimes this is associated with numbness and tingling in the leg. The pain
often is worsened upon standing and decreases with lying down.
If the disc
herniation is extremely large, it can press on spinal nerves on both sides of
the body. This can result in severe pain down both lower extremities. There can
be marked weakness of the lower extremities and even incontinence of bowel and
bladder. This is medically referred to as cauda equina syndrome.
How is a herniated disc diagnosed?
The doctor will suspect a herniated disc when symptoms described above are
present. The neurologic examination can reveal abnormal reflexes. Often pain can
be elicited when the straight leg is raised when lying or sitting. This is
referred to as a "positive straight leg raising test." There can be abnormal
sensation in the foot or leg.
A variety of blood tests are frequently done to determine if there are signs
of inflammation or infection.
Plain film X-rays can indicate "wear and tear" (degeneration) of the spine.
They do not, however, demonstrate the status of discs. In order to determine
whether or not a disc is herniated, an MRI scan or CT scan is performed for
diagnosis.
An electromyogram (EMG) can be used to document precisely which nerves are
being irritated by a disc herniation.
Next: How is a herniated disc treated? »
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