Introduction
A slipped disc is a degenerative spinal disease. Each intervertebral disc consists of an outer fibrous ring and an inner gelatinous core. If the gelatinous core bulges outwards slowly or suddenly due to degenerative changes and breaks through the fibrous ring, this is called a herniated disc (prolapse).
A herniated disc occurs by far most frequently in the lower lumbar spine, as this is where compressive forces and wear are greatest. Depending on the direction in which the core of the intervertebral disc protrudes and which structures are compressed, typical symptoms occur. A herniated disc in the lumbar spine can cause severe back pain as well as symptoms in the legs due to the compression of associated nerve tracts. The reason for this is that the nerve fibres that supply the muscles of the legs with motor energy and the skin sensitively emerge from the spinal cord at the level of the lumbar spine. Typical symptoms can include pain in the legs, numbness or tingling or even paralysis.
Numbness and tingling in the leg
Significant for a herniated disc are sensitivity disorders (sensory disturbances such as numbness or tingling) within a skin area that is supplied by nerve fibers of a certain spinal segment (dermatomes). Similar to paralysis, sensory disturbances (tingling) in the legs indicate a pronounced herniated disc, which should definitely be treated medically to prevent permanent nerve damage.
Paralysis of the leg
In paralysis, a distinction is made between paresis (an incomplete reduction of strength) and plegia (complete paralysis). If a herniated disc causes compression of motor nerve fibres that enable muscle tension, this can lead to a reduction in strength or even paralysis of the legs. This is always a sign of a severe herniated disc and requires immediate medical treatment.
Often in such cases surgery is necessary to prevent permanent damage. Only if paralysis in the legs is really present is it an absolute indication for surgery. Severe pain or numbness, however, is only a relative indication for surgery.
Leg pain
Back pain is a widespread disease and often ordinary “back pain” (lumbago) is behind the complaints. If the pain appears sudden and shooting, this indicates a herniated disc. If there is pain in the legs at the same time, the suspicion becomes stronger.
Pain in the legs does not mean a pulling in the thigh (as in ischialgia), but pain in the area supplied by a certain nerve root. The pain in the leg is often stronger than the pain in the back and radiates into the tip of the toes. Often the pain is aggravated by movement, sneezing or coughing, as the pressure in the spinal canal is thus minimally changed.
Radicular pain (from radix = root) originates from one or more nerve roots in the area of the spinal column. They follow the course of the affected nerve and are felt in its individual supply area. The pain is thus often felt in the leg up to the tip of the foot.
In the case of a herniated disc, the nerve root can be irritated, so that the pain in the area supplied by the nerve (often the legs in the case of a herniated disc in the lumbar spine) is often felt more strongly than at the actual source of the pain. In some cases, the radicular pain is accompanied by other symptoms such as tingling (paresthesia) or paralysis (paresis). Radicular pain, in contrast to the rather unspecific pseudo-radicular pain, strongly indicates a herniated disc in the lumbar spine.
The next article might also be helpful for you: Slipped disc of L3/L4Pseudoradicular pain is significantly more frequent than radicular pain and can often be confused with it. On closer examination, however, it is noticeable that pseudoradicular pain does not occur in the supply area of a specific nerve. Also, the accompanying paresthesia does not refer to a specific nerve area and paralysis does not occur in connection with pseudoradicular pain.
The cause of pseudoradicular pain may, for example, be in the small spinal joints (facet joints) or the sacroiliac joint. Different structures are irritated depending on the direction in which the nucleus of the jelly protrudes. If the gelatinous core protrudes backwards, it compresses the spinal cord and leads to the symptoms described.
Often, however, it does not emerge directly straight backwards, but rather slightly to the left or right. Depending on whether the irritated structures (nerve roots, spinal nerves) are located on the left or right side, there are failures on the respective side. These can manifest themselves in the form of pain, sensory disturbances (tingling, numbness) or motor limitations.
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