Symptoms of a disc protrusion of the lumbar spine

First of all, it must be said that there are a considerable number of cases that cause no or only very moderate symptoms. Here the extent of the protrusion is too small or a slow progression preceded to which the nerves involved could adapt. However, there are a number of typical symptoms of various kinds that make one think of a disc protrusion in the lumbar spine area.

Which of these are noticeable in each individual case depends strongly on the exact extent and height of the disc protrusion. First, the patient often notices relatively strong pain in the area of the affected spinal segment. This pain is caused by the direct compression of nerve fibres.

Characteristic for disc protrusion at the level of the lumbar spine is that the pain radiates further into the areas supplied by the nerves. These include the buttocks, legs and even feet or toes. An occurrence mainly in the front and lateral thigh as well as lower leg and on the back of the foot speak for an involvement of the lumbar spine.

In addition to the pain, however, paraesthesia can also occur. In this case, the pain is not in the foreground, but an unpleasant tingling sensation or the feeling of a leg falling asleep. However, this can also go so far that one has no feeling in the affected segments due to the disc protrusion of the lumbar spine.

It is often described that these symptoms worsen with certain movements, especially when bending down or even coughing and sneezing. In addition to the sensitive complaints, motor disorders are usually added. As the nerve fibres that supply the muscles are also affected, feelings of weakness and rapid exhaustion can occur in the legs and buttocks.

This often becomes noticeable when climbing stairs. However, the extent of the symptoms cannot be directly equated with the extent of the disc protrusion. Finally, a typical symptom of a disc protrusion of the lumbar spine is the weakening of muscle reflexes, such as the well-known patellar tendon reflex, in which one briefly strikes the tendon below the patella in the bent leg.

The evaluation of reflexes is of great importance, especially in diagnostics. Basically, on the basis of the symptoms shown, it is not possible to distinguish reliably between a herniated disc and a prolapsed disc, since the degree of compression on the nerves is decisive for the loss of function. Therefore, a disc protrusion with high compression can cause significantly more symptoms than a herniated disc that does not touch any neurological structures.

The diagnosis of disc protrusion is based primarily on the medical history and clinical examination by the physician. Only when further clarification is required or there is uncertainty, imaging procedures such as MRI of the lumbar spine are added. At the beginning there is a specific questioning of the patient.

It is important to know when the pain first occurred and whether it was sudden, for example during a certain activity, or whether it became painful over time. It is also standard practice to ask whether the pain worsens or becomes weaker with certain movements. Furthermore, paresthesias or numbness can be checked and tested.

The extent of the symptoms plays a major role in order to assess the location of the disc protrusion more accurately. Pain or tingling in the foot, for example, indicate a disorder of the lower lumbar spine, the groin is affected in the upper lumbar spine. In the following some clinical-neurological tests follow.

Muscle strength and reflexes are tested. In addition, various gait and stance tests, if they are pathological, may indicate a disc protrusion of the lumbar spine. In addition, there is the possibility of tapping the spine.

With these simple measures, many interesting facts can be learned, which helps to make the right diagnosis. Imaging techniques are used for the definitive diagnosis of a lumbar disc protrusion. The gold standard in this field is magnetic resonance imaging (MRI of the lumbar spine).

With this method, it is also possible to distinguish reliably between a disc protrusion and a herniated disc with similar symptoms. The MRI of the lumbar spine has established itself in recent years as the most valuable imaging technique. Computer tomography (CT) and X-rays can also help to assess the bony parts of the spine and exclude other causes such as tumors and bone degeneration. It should be noted that a disc protrusion often does not cause any discomfort and therefore other causes for possible back pain can be considered, even if the MRI shows a disc protrusion. and