Bulging Discs, Pinched Nerves and Sciatic Nerve Pain

What are the symptoms of bulging discs and pinched sciatic nerve symptoms?

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Bulging Discs - In the lower back each lumbar vertebra is separated from the one above and below by a disc. These discs are tough structures but sometimes they bulge to one side or another and in extreme cases they can can prolapse which is called a lumbar herniated disc.

Lumbar disc bulges and herniations really only cause pain if they irritate a nerve root, usually the sciatic nerve. This is what people commonly call a pinched nerve in the lower back. The medical term is radiculopathy. It is worth noting that the nerve may not be trapped - just irritated.

However, disc bulges are common findings on Lumbar MRI scans and they often don't cause any symptoms at all. Not all bulging lumbar discs hurt.

Less than 5% of people with back pain will have a lumbar disc problem that causes sciatic nerve pain.

Sciatic nerve pain :

• Often radiates out to the top of the buttock and down into the leg
• Sometimes spreads right down into into the lower leg and foot
• It usually affects only one leg and both the right and left leg can be equally affected
• It is often described as an extreme, severe toothache or burning pain that interferes with sleep
• It can cause pins and needles, tingling ,numbness or weakness in the leg, feet and toes.
• The leg pain may be worse than the back pain

• It is often worse with rest, especially sitting down and eased by activity, usually walking.
  
  
• Frequently it feels worse in the mornings - many people say the symptoms feel better as the day goes on.
  
  
• Sleep is often very disturbed (see best mattress for back pain)
  
  
• Many of my patients with this condition say they have to get up in the night, walk about for a while until it feels easier and sleep is possible.
  
  
• One memorable patient confused the family dog for weeks by taking it out for a walk at 3am!

What causes a disc prolapse or bulge?

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Many of us have bulging discs and we don't know it, however, for some the disc will cause a nerve root irritation. Sometimes this irritation or sciatica can start gradually for no apparent reason, sometimes it can start suddenly after an incident such as lifting and twisting at the same time. I saw someone recently who had this problem after lifting golf clubs out of the boot of his car (bending and twisting).

Usually a nerve root irritation from a bulging disc starts with pain, often building in intensity over 24-48 hours. The pain can be very severe and distressing.

How common is sciatic nerve pain?

Disc problems causing sciatic nerve pain or sciatica are much less common than non specific or simple cause of lower back pain. In fact less than 5% of people with back pain have this as a problem. Nonetheless, it still affects a significant number of people and if you have got it you certainly know about it.

What can you do for treatment for sciatica ?

I have put together some useful tips and suggestions in this sciatica home treatment section that you may find helpful.

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Causes of lower Back Pain other than Bulging Discs

Anatomy of the human Spine

Sciatic nerve pain

Sciatica Hub - all about bulging discs and sciatic nerve pain

Lower Back Pain Toolkit Home Page

References

Sciatica (Lumbar Radiculopathy) Management Clinical Guidelines

23-May-2011