What Are the Early Signs of a Herniated Disc in the Lower Back?

Key points in 30 seconds

1. Numbness running down into the leg is a more important sign than back pain.
2. If it's worse when sitting, we suspect a disc problem.
3. A zing down the leg when you cough is also a common early sign.
4. If strength and sensation have also dropped, it's no longer early.
5. If your legs lose strength or you have trouble with your bladder or bowels, go to a hospital right away.

What we often hear

• "My leg is more numb than my back."
• "I thought I'd just tweaked it for a few days, but it isn't getting better."
• "Getting up after sitting is the hardest part."

What are the early signs of a herniated disc in the lower back?

Numbness running down into the leg is a more important sign than back pain. If the numbness runs from the buttock down the back of the thigh to the calf, we suspect a pinched nerve.

This is where simple lower back muscle pain and a herniated disc part ways. When it's muscular, the pain stays in the lower back; when a nerve is pinched, it travels down along the path of that nerve.

What's easy to miss early on?

Feeling worse while sitting. Sitting puts more pressure on the lower back than standing, so getting up after sitting for a long time is the hardest.

A zing from the lower back down the leg when you cough or sneeze is also a common early sign. Tightening the abdomen raises the pressure for a moment.

The same goes for a particularly hard time bending over to wash your face in the morning. The disc soaks up water during sleep, so it's most swollen in the morning.

How do you tell early cases from later ones?

We have you lie down and lift your leg. Seeing at what angle the numbness down the back of the leg comes back gives us an idea of how much the nerve is pinched.

We also have you stand on your toes and heels to check for weakness anywhere, and look for any areas where sensation has dulled. If strength and sensation have also dropped, it's no longer early.

If it's early, what do you do?

We work on calming the swelling and inflammation around the pinched nerve while also reducing the pressure on the lower back. How long and how you sit are especially important.

The bulging disc itself can't be pushed back in by hand. What we change is the condition around it and the amount of force on the lower back.

What are the limits of this judgment?

An external exam alone can't confirm whether it's a herniated disc. If confirmation is needed, we recommend imaging.

We must tell you this. If your legs lose strength, you have trouble controlling your bladder or bowels, or both legs go numb together, it's close to an emergency. In these cases, don't delay; go to a hospital right away. Waiting works against you.

We look separately at where the back ends and where the leg begins. Even with the same back pain, where to look differs depending on whether it travels down into the leg.

If you've started to feel something that begins in your lower back and runs down your leg, don't put it off. Checking early leaves you more options to choose from.

Recovery differs from person to person, depending on how much the nerve is pinched and how long it has been going on.