Low back pain that lasts for a few days is considered the initial symptom of a herniated disc. The pain may seem to improve after a few days, only to be followed by a pained, numb, or weakened leg. The pain will often reach below the knee and into the ankle and foot. Some patients describe that the pain moves from the back or butt to the leg and into the foot. Symptoms of herniated disc may include one or all of the following:
- Back pain
- A numb or tingling sensation in the leg or foot
- Leg and/or foot weakness
- Bladder or bowel control loss, only for extremely rare cases and may also indicate cauda equine syndrome. This is a serious problem that requires immediate medical attention.
Disc degeneration does not always entail pain for all patients. Therefore, it is a challenge for doctors to determine if the patient’s pain is caused by a disc that is wearing out.
The doctor will ask for the patient’s complete medical history and conduct a physical examination in order to determine if he or she has a herniated lumbar disc. A magnetic resonance imaging (MRI) scan can confirm the diagnosis. During a physical examination, the doctor will examine the patient’s spine and may conduct several tests to pinpoint the exact cause of the patient’s low back pain:
- Neurological examination – This test checks for any weakness or sensory loss. The doctor will check how a patient walks on his or her heels and toes. The strength of the thigh, ankle, and toe will also be tested. The doctor can detect sensation loss by lightly touching the patient’s leg and foot. Knee and ankle reflex loss will also likely be tested.
- SLR (Straight leg raise) test – If a patient is under the age of 35, this type of test is considered the most accurate predictor of disc herniation. The patient will lie on his or her back. The doctor lifts the affected leg, while keeping the knee straight. When a patient feels any pain in the leg or below the knee, it indicates a herniated disc.
