Symptoms of Herniated Disc

The bones that make up the spine (vertebrae) are cushioned by round discs of cartilage filled with a soft, jelly-like center or nucleus. A herniated disc (also called "bulging" or "slipped disc") occurs when the outer shell ruptures and the nucleus leaks out. While minor cases may be asymptomatic or cause mild pain, a herniated disc can lead to pain, tingling, numbness, and weakness in the back, neck, limbs, or buttocks.

This article discusses the frequent and rare herniated disc symptoms, the complications that can arise, and the signs it's time to get help.  

Frequent Symptoms

Symptoms vary based on the location and severity of the herniated disc. Much depends on whether the condition affects the cervical spine (the vertebrae of the neck) or the lumbar spine (lower back). This issue rarely impacts the middle of the back or thoracic spine. Furthermore, if the leaking nucleus of the vertebrae isn’t affecting surrounding nerves, you may experience mild symptoms or none at all.

Lumbar Herniated Disc Symptoms

A lumbar herniated disc is the most common type. Typical signs of a herniated disk in the lower spine vertebrae include:

• Low-back pain: Periods of low-back pain are usually the first symptoms of a herniated disc and may precede full onset. This pain grows and recedes in intensity and is often described as sharp and similar to an electric shock. The discomfort may worsen when sitting, standing, or walking.
• Sciatica: When a herniated disc impacts the sciatic nerve of the low back and limbs, you may experience sciatica symptoms, causing sharp or burning pain radiating from the lower back and buttocks through the leg, sometimes reaching the feet. Typically, this occurs only on one side of the body.
• Numbness and weakness: A herniated disc may cause numbness, weakness, and tingling that occurs with sciatica pain, which can spread to the legs and affect the feet. It often affects only one side.   

Cervical Herniated Disc Symptoms

Cervical herniated disc symptoms affect the neck vertebrae and can feel like:

• Dull or sharp pain in the neck or between the shoulder blades
• Pain radiating through the arms, hands, and fingers
• Numbness and tingling in the shoulder or arm
• Worsening pain when the neck or shoulders are in certain positions

Rare Symptoms

A herniated disc can lead to cauda equina syndrome (CES) in rare and more severe cases. The cauda equina is a bundle of nerves originating at the bottom of the spinal cord and ending in the upper portion of the lumbar spine. These nerves are associated with sensation and motor ability in the legs and bladder.

Severe disc herniation can compress the nerves of the cauda equina, leading to CES. Typical signs of this condition include:

• Loss of bladder and bowel control
• Low back pain
• Weakness or loss of mobility of the legs
• Saddle anesthesia, or reduced sensation in the perineum (the area between the anus and the scrotum or vulva), buttocks, anus, groin, and thighs

Complications and Subgroup Indications

While herniated discs can be very debilitating, many cases are asymptomatic, and about 90% of people with symptoms recover within six to 12 weeks without needing surgery or treatment. However, severe and persistent cases can cause significant, lasting damage to the structure of your spine.

Complications

Over time, a herniated disc can cause spinal stenosis or the narrowing of the space surrounding the spine or the spaces formed by the vertebrae (foramina). This puts pressure on the nerves and spine, causing lasting damage, potentially leading to:

• Chronic back or neck pain
• Loss of limb mobility and weakness
• Cramping
• Numbness
• Loss of bladder or bowel control
• Tingling and pins-and-needles sensation

Chronic pain from a herniated disc can impact mental health. In one study, nearly half of the patients with chronic back or neck pain due to herniated discs experienced mood disorders, including major depressive disorder and generalized anxiety disorder.

Herniated Disc and Pregnancy

Low-back pain affects about half of pregnant people, and, in some cases, a lumbar herniated disc is at fault. The risk of developing the condition rises as pregnancy-associated weight gain increases strain on the spine. Some research suggests hormonal shifts during pregnancy increase the risk of discs sliding out of position and rupturing.

Most pregnant people do not require surgery for a herniated disc, but it can impact their quality of life. Severe cases or those that develop into CES can influence decisions about delivery. Vaginal births can worsen herniated discs, so a healthcare provider may recommend delivering the baby via cesarean section (C-section).

Herniated Disc and Obesity

Excess weight and obesity—a body mass index (BMI) of 30 or more—can increase the chances of developing a herniated disc. With extra body weight, the spine is under more pressure, which can damage the structure and cause discs to move out of position and become damaged.

Herniated discs can worsen the quality of life of those who are overweight or living with obesity. Evidence suggests that excess weight may also worsen outcomes after surgery for a herniated disc.

When to See a Healthcare Provider

Most herniated discs resolve independently, without the need for treatment. If your symptoms persist longer than four to six weeks, and the pain or numbness worsens, you should call your healthcare provider.

Additionally, the following may be signs of a more severe case and prompt immediate attention:

• Debilitating weakness in the limbs
• Loss of sensation around the genitals or rectum
• Loss of bladder and/or bowel control
• Symptoms along with a history of cancer, recent infection, or fever
• Symptoms resulting from or worsening with a fall or accident
• Progressive weakness and numbness

Summary

A herniated disc arises when the cartilage discs that cushion the spine's vertebrae move out of position and leak. Though the condition is sometimes asymptomatic, it can cause severe back pain, numbness, limb weakness, and sciatica symptoms. Most people recover from herniated discs within four weeks without treatment, though persistent symptoms and complications, such as loss of bladder or bowel control, prompt medical treatment.