A herniated disc is a common condition, but that doesn’t mean everyone experiences it the same way. Depending on the severity of the herniation and its location, you might have different symptoms than another person—or you might not have any symptoms at all.
This article explains the factors that play into herniated disc symptoms, and lists the symptoms for the areas of the spine most susceptible to herniations in both the lower back and the neck.
Herniated Disc Symptoms: Why Location & Severity Matter
If you’ve been doing your research, you probably already know what a herniated disc is: the displacement of the middle part (the nucleus) of an intervertebral disc. Sometimes this displacement occurs as part of the natural degeneration caused by aging, where the outer layer of the disc becomes weak and allows the inner layer to push out. Other times it happens as the result of mechanical pressures, like bending or lifting improperly. However it happens, there’s always a chance that the displaced disc could start pushing against a nearby nerve, creating the potential for pain.
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Severity Of A Herniated Disc
Although any type of disc displacement is usually referred to as a “herniated disc,” there are actually varying degrees of displacement.
- The term bulging disc is used to describe a stage of displacement where the nucleus is still contained within the outer layer, but is pushing out or bulging against the outer rim of the disc.
- When the pushing force creates abnormal pressure and the bulge increases significantly, the condition may be considered a protrusion.
- If the outer layer weakens enough, the nucleus of the disc may come out, or herniate, into the bulge—this is a true herniated disc.
Bulging discs are common but they don’t always cause pain; in fact, many people have them without realizing it. A study from the 1990s showed that more than 50 percent of people randomly chosen for MRI scans had one or more bulging discs and no back pain. A bulging disc—or a disc in any stage of displacement—only becomes a problem when it pushes against a nerve or the spinal cord. In general, the more a disc protrudes, the greater the likelihood you’ll experience herniated disc symptoms. But even a herniated disc could be fairly asymptomatic, depending on the next factor: location.
Location Of A Herniated Disc
To understand different herniated disc symptoms you need to have some knowledge about the regions of the spine and the spinal nerves.
Going down the spine, there are four major regions:
- Cervical—the neck area
- Thoracic—the upper back and rib cage area
- Lumbar—the low back
- Sacral—the bottom of the spine
Each of these regions includes a certain number of vertebra (the individual bones that interlock with one another) that together make up the 29 vertebrae of the human spine. Each is labeled with the first letter of the region where they are located and a number.
- Cervical—seven vertebrae, C1–C7
- Thoracic—12 vertebrae, T1–T12
- Lumbar—five vertebrae, L1–L5
- Sacral—five pseudo vertebrae, S1–S5
Between the vertebrae are discs. Specific discs are referred to by the vertebrae they are located between, for example the L4–L5 disc, or the C5–C6 disc.
Between the vertebrae there are spinal nerve roots that come from the spinal cord and run to various parts of the body. Nerves distribute sensation and pain in certain patterns into your extremities. The areas of skin served by the various sensory nerve roots are called dermatomes; visualizations such as the one below can help you begin to understand how symptoms arise, and how they can be traced back to a specific area of the spine.
When a specific nerve root is irritated or compressed by a displaced disc, it produces herniated disc symptoms in the form of pain, tingling, or numbness in the area controlled by the affected nerve root.
For instance, the L3 nerve root activates the muscles called hip flexors, where you pull your knee toward your stomach. If this nerve root was impacted in some way, you may notice flexor weakness or hip pain. If you’re having pain in the front of the leg or foot, the cause is likely the L4 root. The bottom of the foot is likely S1. The symptoms will follow the nerve that is being compressed, giving doctors a way to track the pain back to its source.
Similarly, cervical herniated disc symptoms—those in the C5 to C7 range—will likely be some type of tingling, numbness or pain in your arms, whereas a lumbar disc herniation will cause similar symptoms in your leg.
Herniated Disc Symptoms
Symptoms of a herniated disc include pain, tingling, or numbness (any or all of these) in the area of the body served by the affected nerve root. Weakness is also a symptom, and could be indicative of a more serious herniation. In rare cases, a large central herniation could produce cauda equina syndrome, when the nerve roots of the cauda equina (the collection of nerves at the end of the spinal cord) are compressed. These nerves serve the lower limbs and pelvic organs and could cause problems with bowel, bladder, and sexual functioning.
Below are the areas where herniated discs occur most commonly, and the areas of the body that are likely to exhibit symptoms. Keep in mind that these are general classifications; symptoms may vary from patient to patient.
For a herniated disc in the neck:
It is more common for herniated disc symptoms to arise as the result of a lower back herniation than a cervical one. Lumbar herniated disc symptoms are:
Of those areas listed above, the most common are C5–C6 in the neck and L4–L5 in the lower back. Why? Because those levels are where the major forces of our mechanical movements tend to intersect, making them more susceptible to displacement.
Your herniated disc symptoms will provide information to your doctor that will be helpful during an examination, but the only way to know for sure if you have a herniated disc is with an MRI.
Keep in mind that most patients gradually recover from a herniated disc on their own, without surgery, over the course of several weeks to a couple of months. If the condition appears to be improving slightly at two to three weeks, there’s a high probability it will resolve on its own. Throughout the time of gradual improvement, there are things you can do to alleviate the pain.
If the pain hasn’t subsided after six to eight weeks, you and your doctor should discuss your options. If surgery is recommended (or if you’re facing a second or third surgery for a recurrent herniated disc), we encourage you to do your research first to ensure you’re taking the right course of action to restore a healthy spine.