What are the symptoms of lumbar disc herniation?

Many people may feel back pain after working or studying for a long time. In this case, many people think that the pain can be relieved by applying external medicines. This method is certainly feasible for common back pain, but severe back pain is likely to be lumbar disc herniation. Its symptoms are often manifested in muscle paralysis and lower abdominal pain. In this case, you should go to the hospital for treatment in time. Here are some symptoms of lumbar disc herniation.

1. Low back pain

More than 95% of patients with lumbar disc herniation have this symptom, including those with vertebral disc type.

2. Radiating pain in the lower limbs

This symptom occurs in more than 80% of cases, and the latter type can reach more than 95%.

3. Limb numbness

It is often accompanied by the former, and only about 5% of patients present with numbness without pain. This is mainly due to the stimulation of the proprioceptive and tactile fibers in the spinal nerve roots. Its range and location depend on the number of nerve root sequences affected.

4. Coldness of limbs

In a small number of cases (about 5% to 10%), the patient feels chilly or cold limbs, which is mainly due to the stimulation of the sympathetic nerve fibers in the spinal canal. Clinically, it is common to find cases where patients complain of fever in their limbs on the day after surgery, which is the same mechanism.

5. Intermittent claudication

Its production mechanism and clinical manifestations are similar to those of lumbar spinal stenosis. The main reason is that in the case of nucleus pulposus protrusion, the pathological and physiological basis of secondary lumbar spinal stenosis may appear; for those with congenital developmental sagittal stenosis of the spinal canal, the protruding nucleus pulposus aggravates the stenosis of the spinal canal, which can easily induce this symptom.

6. Muscle paralysis

Paralysis caused by lumbar disc herniation is very rare, and most cases are caused by root damage, resulting in varying degrees of paralysis in the innervated muscles. In mild cases, the muscle strength is weakened, and in severe cases, the muscle loses function. Clinically, foot drop is most common due to involvement of the tibialis anterior muscle, peroneus long and brevis, extensor digitorum longus and extensor hallucis longus muscles innervated by the L5 spinal nerve, followed by the quadriceps femoris (innervated by L3-4 spinal nerves) and gastrocnemius (innervated by S1 spinal nerve).

7. Symptoms of cauda equina

It is mainly seen in patients with postcentral and paracentral types of nucleus pulposus herniation, and is therefore rare in clinical practice. The main symptoms are numbness and tingling in the perineum, defecation and urination disorders, impotence (in men), and symptoms of sciatic nerve involvement in both lower limbs. In severe cases, symptoms such as incontinence and incomplete paralysis of both lower limbs may occur.

8. Lower abdominal pain or pain in the front thigh: In high-level lumbar disc herniation, when the L2, 3, and 4 nerve roots are affected, pain will occur in the lower abdominal groin area or the anterior and medial thigh in the area innervated by the nerve roots. In addition, some patients with low lumbar disc herniation may also experience pain in the groin area or the anterior and inner thigh. One-third of people with lumbar disc herniation at 3rd or 4th vertebra experience pain in the groin area or anterior inner thigh. The incidence of intervertebral disc herniation in the L4-5 and L5-S1 intervals is basically the same. This type of pain is often referred pain.