Herniated Disc Symptoms

Herniated Disc Symptoms

Disc herniations range from causing no symptoms to causing severe and incapacitating symptoms. Symptoms are based on the spinal region, nerve proximity, and size of the herniation. They occur most commonly in the lumbar, cervical, thoracic spinal regions, in that order.

Cervical Herniation (Neck)

Spinal nerves that branch out of the cervical spine control function in the upper extremities (shoulders, arms, and hands). Therefore, a herniated disc in this region that compresses a nerve will produce symptoms in the upper extremity including a sharp shooting or throbbing pain, numbness or tingling, and decreased sensation. These typically occur unilaterally, only on one side of the body, and the specific location of the symptom will vary based on the nerve being compressed. For example, weakness in the deltoid muscle while raising your arms from your sides could indicate a disc herniation at the C4-5 level. Other potentially affected muscles include the bicep, triceps, wrist, and hand muscles.

C4-C5 Herniation: The C5 nerve root is responsible for the deltoid muscle which sits on top of the shoulder, outside of the upper arm. A herniation at the C4-5 level would cause shoulder pain and possibly weakness of the deltoid muscle.

C5-C6 Herniation: The C6 nerve root is responsible for the bicep and wrist extensor muscles. The bicep bends the elbow and the wrist extensors allow for pulling the wrist back to put the palm up. A disc herniation may cause weakness at one or both muscles groups with pain that may radiate down the thumb side of the arm.

C6-7 Herniation: The C7 nerve root is responsible for the triceps and flexors of the wrist. The triceps straighten the elbow and the wrist flexors bend the wrist to bring the hand closer to the forearm. A disc herniation may cause weakness at one or both muscle groups. Pain may radiate down the back of the arm and into the middle finger.

C7-T1 Herniation: The C8 nerve root is responsible for flexion of the fingers, such as with making a fist. A disc herniation may cause a weakened grip with pain that radiates into the pinky side of the arm.

Spinal Cord compression: If a disc herniation compresses the spinal cord, symptoms, called cervical myelopathy may exist, which consist of difficulty with fine motor movements, unsteadiness when walking, and/or changes with bladder habits, such as incontinence.

Other symptoms that may be related to a disc herniation in the neck are local symptoms of pain in the neck, stiffness in the neck, headaches, and decreased range of motion in the neck.

Thoracic Herniation (Mid Back)

Spinal nerves exiting from the thoracic spine are related to chest and abdominal functions (such as skin sensation, intercostal and abdominal muscles), except for the first thoracic nerve which also is responsible for some of the fingers. Therefore, a herniation at the thoracic level will produce symptoms of pain that radiate around the torso near a specific rib. These typically occur unilaterally, only affecting one side of the body. Common symptoms include sharp, shooting, stabbing, or electrical pain. The specific location of the symptom will vary based on the nerve being compressed.

T1-T2 Herniation: The T1 spinal nerve is responsible for the ring and pinky fingers and the area around the first rib. A herniation here may cause pain at the back or chest around the first rib, or pain in the ring and/or pinky fingers.

T2-T6 Herniation: The T2 through T6 spinal nerves are responsible for the muscles between each rib, intercostal muscles, and skin over the ribs. A disc herniation may cause pain in the back or chest at the corresponding rib.

T7-T12 Herniation: The T7 through T11 spinal nerves are responsible for the intercostal muscles of the corresponding rib, skin on the thorax, and the abdominal muscles. A disc herniation may cause pain in the back, chest, or abdomen.

T12-L1 Herniation: The T12 spinal nerves are responsible for the abdominal muscles and the skin over the buttocks. A disc herniation at this level may cause pain into the buttocks or over the abdomen.

Spinal Cord Compression: Compression at any level may cause symptoms of unsteady gait, weakness in the legs, or bladder changes, such as incontinence. In severe cases of compression on the spinal cord in the thoracic region of the spine may cause complete paralysis from the waist down.

Lumbar Herniation (Lower Back)

Spinal nerves that branch out of the lumbar spine control function in the lower extremities (buttocks, hips, legs, and feet). Therefore, a herniated disc causing nerve compression in this region will produce symptoms in the lower extremities including a sharp, shooting, burning, or electrical pain and potentially numbness or changes in sensation. For example, weakness at the knee while straightening the leg could indicate a disc herniation at the L3-4 level. Other potentially affected muscles include the quadriceps, tibialis anterior, and flexors of the foot. Symptoms may also include neurogenic claudication, a nerve-related pain that increases with walking and improves with rest. These typically occur unilaterally, only on one side of the body, and the specific location of the symptom will vary based on the nerve being compressed.

L1-L2 Herniation: The L1 spinal nerve root is responsible for the psoas muscle, which is found within the body cavity along the lumbar spine. Weakness in the psoas muscle and pain in the groin and front of the thigh may occur; the former can cause difficulty with lifting the leg, for example, while walking up stairs.

L2-L3 Herniation: The L2 nerve root is responsible for the iliopsoas muscles. A disc herniation at this level may cause weakness in an iliopsoas muscle, which may cause difficulty while walking up the stairs and/or pain that radiates into the front of the thigh.

L3-L4 Herniation: The L3 nerve root is responsible for the quadriceps femoris muscles, located on the front of the thigh and helps extend, or straighten, the knee. A disc herniation may cause weakness of quadriceps femoris, which may cause weakness while straightening the leg and/or pain in buttocks that radiates to the lower portion of the front of the thigh.

L4-L5 Herniation: The L4 nerve root is also responsible for the quadriceps femoris muscles and in some people is also responsible for the tibialis anterior muscle. The quadriceps femoris straightens the knee and the tibialis anterior brings the toes up while walking. A herniation may cause weakness while straightening the knee or lifting the toes when walking, which may lead to a foot drop. Pain may radiate from the buttock to the top of the back of the thigh and then to the front of the shin.

L5-S1 Herniation: The L5 nerve root is responsible for the tibialis anterior muscle in most people and foot and toe dorsiflexion. The tibilais anterior brings the toes up toward the face and foot and toe dorsiflexion brings the foot toward the face. Pain may radiate from the buttock, down the back of the thigh and calf, and into the foot, mainly on the inside of the foot.

S1 Herniation: The S1 nerve root exits below the S1 vertebral body, which is responsible for calf muscles, which allow for plantar flexion, or pressing down like on the gas pedal in the car. A disc herniation may cause weakness with plantar flexion which could cause difficulty or inability to stand on toes and pain that may radiate from the buttock down the back of the leg and into the bottom of the foot’s outside edge.

The main symptoms of lumbar disc herniation would radiate based on the location of the disc herniation. There are other symptoms such as localized lower back pain, decreased range of motion in the lumbar spine, and limping or difficulty walking. An emergent spinal condition found only in the lumbar spine is cauda equina syndrome. The spinal cord ends around the T12-L2 vertebral bodies in a collection of nerves called the cauda equina, which is like a horsetail. If a large disc herniation places pressure on the cauda equina, this produces a large amount of inflammation around these nerves and distinct symptoms which include saddle anesthesia (numbness in the perineal regions, the region that would make contact when sitting in a saddle), bowel and/or bladder incontinence, weakness in the legs, and unsteadiness with walking. This is a rare condition, but is serious and needs emergent attention to prevent irreversible damage to the nerves.

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