Herniated Disc (cont.)

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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, referred to as sciatica. 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 one or 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?

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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.

Medically Reviewed by a Doctor on 8/1/2012

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