[Medical Q&A] Will lumbar disc herniation definitely cause back pain?

Planner: Chinese Medical Association

Reviewer: Shao Zengwu, Chief Physician and Professor of Union Hospital affiliated to Tongji Medical College, Huazhong University of Science and Technology

uncertain.

The clinical manifestations of lumbar disc herniation vary greatly due to different segments, locations, types, and compression of different numbers of nerve roots and cauda equina. Most patients with lumbar disc herniation first have recurrent low back pain, followed by lower limb pain. Some patients experience low back pain and lower limb pain at the same time, and some patients only have lower limb pain without low back pain. Low back pain sometimes manifests as diffuse pain in the lumbar sacral region, and pain in the buttocks and posterior thigh may occur. This type of pain is referred pain. When the nerve root damage is severe, there may be a decrease in sensation of the dermatomes in the affected area of ​​the nerves, numbness of the lower limbs, and in severe cases, weakened muscle strength in the innervated area, or even muscle paralysis. When the lumbar disc protrudes posteriorly or the nucleus pulposus prolapses, it can compress the cauda equina in the dura mater sac. Patients may experience numbness in the saddle area, sexual dysfunction, and urinary and bowel dysfunction. In severe cases, urinary retention or incontinence may occur.