Clinical manifestations of lumbar disc herniation

1. Low back pain with sciatica is the main symptom of lumbar disc herniation. Some patients also have single lumbar pain and lower limb pain. 2.Radiation pain in the lower limbs. This pain and numbness radiates along the travel and innervation area of the affected nerve root and is characteristic, so it is called root-type pain. The pain or numbness can be episodic or persistent. Sometimes there is a clear relationship between the appearance and relief of symptoms and the position and posture of the patient’s low back. Low back activity, coughing, sneezing, straining to defecate, and deep breathing can cause an increase in symptoms, which can be bilateral or unilateral. The pain can be bilateral or unilateral. The pain is relieved when resting in bed with the hip and knee flexed. Most of the pain is intermittent, but a few of them are persistent. 3. Numbness and weakness. When the affected nerve roots are heavily damaged, the strength of the innervated muscles is weakened and the sensation is reduced. In mild cases, there may be pain hypersensitivity, and in severe cases, muscle paralysis. 4. Clinical examination: lumbar stiffness and restricted movement. Patients may have functional scoliosis, and the physiological anterior convexity of the lumbar spine is reduced or disappears. Tension in the lumbar muscles, deep pressure pain at the spinous process and paraspinal process, and causing or aggravating radiating pain or numbness in the lower extremities, i.e. proving that the vertebral space is the site of lumbar disc herniation, and there can be pressure pain at the affected suprapatellar nerve, popliteal fossa or Chengshan point. If the pressure pain is not obvious in the prone position, the patient may take the standing position posteriorly and bend to the affected side, and there is radiating pain in the lower extremity next to the pressure spinous process. The lower extremity skin sensation is decreased or numbness is abnormal. The straight leg raise test is positive, the ankle dorsiflexion strengthening test is positive, and the femoral nerve pull test is positive. Tendon reflex is weakened or disappeared, and thumb strength is weakened. 5. Changes in urinary and fecal functions. When the herniated disc compresses the dural sac more heavily, damage to the cauda equina nerve may cause constipation, defecation difficulty, urinary frequency, urinary urgency, urinary retention or incontinence, decreased or absent perineal sensation, and sexual dysfunction.