A herniated disk can cause lower back pain, numbness, tingling, and other symptoms. Certain factors make a herniated disk in the lower back more likely. Treatment may depend on the severity.
Other names for a herniated disk include a slipped, protruding, bulging, and ruptured disk. It happens when the soft cushioning tissue between the bones in the spine slips or bulges.
While a herniated disk can occur anywhere along the spine, it most commonly affects the lower back.
Read on to learn more about the symptoms of a herniated disk in the lower back. This article also looks at causes and risk factors, how doctors diagnose the condition, treatment options, and more.
Low back pain is usually the first symptom of a herniated disk. A person may find that the pain lasts for a few days before it begins to improve.
Other symptoms of a herniated disk in the lower back can include:
- sciatica, which happens when pressure on the spinal nerve causes a sharp pain that begins from the buttocks and travels down the back of the leg
- weakness in the foot or leg
- tingling or numbness in the foot or leg
- neck pain
- difficulty straightening or bending the back
- loss of bowel or bladder control in rare cases, which may be a medical emergency if it happens due to cauda equina syndrome
In some cases, a herniated disk may not cause any symptoms.
The most common cause of a herniated disk in the lower back is the natural wear and tear that develops with age. This is because spinal disks lose water over time and become less flexible, shrinking and making them more prone to slipping.
People assigned male at birth and between ages 20 and 50 years are more likely to experience a herniated disk.
Other factors that increase the likelihood of a herniated disk include:
- using back muscles instead of leg muscles to lift heavy objects
- frequently moving in ways that add strain on the spine, such as pulling, twisting, or bending
- regularly driving, particularly for long periods of time, as the combination of sitting and the vibration from the vehicle can add pressure to the spine
- being overweight, as it adds stress to the lower back disks
- smoking, as it causes the tissue to weaken
To assist with reaching an accurate diagnosis, a doctor may begin by asking questions about symptoms and performing a physical examination.
The examination may involve:
- asking the individual to walk on their heels and toes to assess the muscle strength in their lower legs
- assessing sensation by seeing if the individual can detect a gentle touch on their foot and leg
- testing reflexes in the leg and ankle
- performing a straight leg raise test, which is where the individual lies on their back while the doctor lifts their leg with the knee straight to see if there is pain down the leg and below the knee
A doctor may order an X-ray to rule out other possible causes. If symptoms do not improve in a number of weeks, or if the individual experiences severe symptoms, they may order an imaging test. This will usually be an MRI, but a CT scan or CT myelogram may be an option if a person cannot have an MRI.
In most cases, symptoms of a herniated disk will begin to improve within a few weeks without the need for surgery. Symptoms should fully resolve within around 3 to 4 months.
In rare cases, doctors may recommend surgery.
Nonsurgical treatments
Nonsurgical treatments that may help include:
- getting enough rest throughout the day but avoiding sitting still for long periods of time
- avoiding movements that worsen pain
- bending and lifting slowly and steadily if the movement is necessary
- undergoing physical therapy, where a person can learn stretching exercises that may help
- taking nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen
- receiving an epidural steroid injection if other treatments do not improve symptoms after around 6 weeks
Learn more about pain medications for herniated disks.
Surgery
Surgery may be a treatment option if symptoms do not improve or if muscle weakness progresses.
Types of surgery can include:
- Microdiskectomy: Microdiskectomy is the most common surgery for a herniated disk. This involves making a small incision near the herniated disk and removing it to alleviate pressure on the spinal nerve.
- Endoscopic diskectomy: Endoscopic diskectomy is a minimally invasive procedure that involves using an endoscope, which features a small camera on the end of a thin tube, to look at the area and then remove the disk.
- Open surgery: A person may need open surgery, which uses a larger incision, if there are multiple herniated disks.
A person’s doctor can advise on whether they recommend surgery and answer any questions a person may have.
Learn more about herniated disk surgery.
If a herniated disk causes compression of the spinal root nerves, it may lead to cauda equina syndrome.
Cauda equina syndrome is a serious condition that can cause symptoms such as:
- urinary retention
- fecal or urinary incontinence
- weakness of the lower extremities
- sciatica
- sexual dysfunction
A person usually requires emergency surgery for cauda equina syndrome.
Surgery for herniated disks can also cause complications. These include:
- infection
- injury to a nerve
- dural tear, which is a tear in the sac that covers the nerves
- nerve compression due to a hematoma, which is when blood pools outside of the blood vessels
A person should contact a doctor as soon as they experience symptoms of a herniated disk. While medical treatments may not be necessary in some cases, it is important to receive an accurate diagnosis and rule out other possible causes.
A person should seek immediate medical help if they experience symptoms of cauda equina syndrome. It is a medical emergency.
A herniated disk in the lower back most commonly occurs over time due to wear and tear. It is more common in males between 20 and 50 years old.
Other factors that make a herniated disk more likely include smoking, using the back to lift heavy objects, being overweight, and sitting still for long periods of time in a vehicle.
A person may experience sciatica pain, tingling, numbness, and weakness. In rare cases, cauda equina syndrome may develop, which is a medical emergency.
It is important to contact a doctor for an accurate diagnosis and treatment plan. In most cases, a person can manage a herniated disk with rest, pain relief medication, and gentle exercises. If symptoms do not resolve, surgery may be necessary.
