What are the systemic symptoms of lumbar disc herniation? In recent years, lumbar disc herniation has become increasingly common.Hospital surveys indicate that those experiencing these symptoms are predominantly concentrated in the middle-aged and young adult demographics. This inevitably draws our attention to the fact that as the pace of society accelerates, work pressures are intensifying, particularly among white-collar workers. Prolonged desk work combined with poor posture is leading to an increasing incidence of cervical and lumbar spine disorders. So, what are the symptoms of lumbar disc herniation? How can we recognize them early and seek timely diagnosis and treatment?
1.Lower back pain: This pain often precedes leg pain or may occur simultaneously. It primarily manifests in the lower lumbar or lumbosacral region. The pain arises mainly from the herniated disc stimulating the nerve fibers in the annulus fibrosus and the posterior longitudinal ligament. The pain is deep-seated, difficult to pinpoint, and typically presents as dull, stabbing, or radiating pain.
2. Radiating pain in the lower limbs:Since lumbar disc herniation most commonly occurs at the L4-L5 and L5-S1 intervertebral spaces, and the sciatic nerve originates from the L4-L5 and S1-S3 nerve roots, patients often experience sciatica. This pain may start in the buttocks and gradually radiate to the posterior-lateral thigh, lateral calf, dorsum and lateral sole of the foot, and toes.Central herniations often cause bilateral sciatica. Radiating pain in the lower limbs intensifies like an electric shock during activities that increase intra-abdominal pressure, such as coughing, sneezing, or bowel/bladder movements.
3. Numbness and Paresthesia: Herniated discs can cause localized compression or traction-induced compression in the nerve root's contact area. This compresses the nerve root's fibers and blood vessels, leading to ischemia and hypoxia. Consequently, abnormal sensations such as pain and numbness occur in the area innervated by the affected nerve root.
4. Muscle paralysis: Prolonged compression of the nerve root by a herniated disc can cause ischemic and hypoxic degeneration, resulting in nerve paralysis and muscle weakness.L4-L5 disc herniation may cause paralysis of the tibialis anterior, peroneus longus and brevis, extensor pollicis longus, and extensor digitorum longus muscles due to L5 nerve root paralysis. L5-S1 disc herniation may lead to paralysis of the triceps surae muscle due to S1 nerve root involvement.Intermittent claudication: Disc protrusion compresses nerve roots, causing inflammatory reactions like congestion and edema, along with ischemia. During walking, congestion in the obstructed vertebral venous plexus within the spinal canal exacerbates nerve root congestion and spinal vascular dilation. This simultaneously intensifies nerve root compression, leading to intermittent claudication and pain.
6. Spinal Postural Changes: Over 90% of patients with lumbar disc herniation develop functional scoliosis to varying degrees. Most curves tilt toward the affected side, while a minority curve toward the unaffected side, primarily determined by the relationship between the herniated disc and the nerve root. Scoliosis allows the nerve root to relax, alleviating pain. If the herniated disc is located anterolaterally to the nerve root, the spine curves toward the affected side.When the protrusion lies medial to the nerve root, the spine curves toward the unaffected side. This lateral curvature serves as a protective mechanism to reduce pressure on the nerve root from the protrusion.