The first symptom of a herniated disk is usually back pain in the area of the affected disk. Some researchers believe this pain is a signal that a disk's tough outer shell has been injured or weakened, not necessarily that the inner core has herniated. If the inner core does herniate and press on a nearby nerve, the resulting symptoms vary depending on the location of the herniated disk:
In the cervical region – There can be pain in the neck, shoulder, shoulder blade, arm or chest, together with numbness or weakness in the arm or fingers. If the pain is centered in the chest and arm, it can mimic the chest pain of heart disease. Occasionally, frequent urination and headaches can occur.
In the thoracic region – Symptoms tend to be vague, misleading and long lasting. There may be pain in the upper back, lower back, chest, abdomen or legs, together with weakness and numbness in one or both legs. Some affected people also complain of bowel or bladder incontinence.
In the lumbar region – Many people suffer from years of intermittent and mild lower back pain before a single triggering event (such as heavy lifting, sudden bending, abrupt twisting) aggravates their symptoms to the point that they seek medical attention. It also may develop without an identifiable triggering event. In most people with a lumbar disk herniation, severe leg pain is the chief complaint. This pain is called sciatica because it comes from pressure on the sciatic nerve. It usually begins in the lower back, then spreads into the buttocks and down the back of one thigh and leg. Sciatica typically becomes worse if the patient coughs, sneezes, bears down or moves the back abruptly. While often relieved by rest, sciatica may become worse with driving or lifting. In addition, there may be numbness, tingling or muscle weakness in the buttocks or leg on the side of the pain. In rarer and more severe forms of lumbar disk herniation, the nerve is compressed more extensively. If this happens, additional symptoms can develop, including rectal pain; loss of bowel and bladder control; and numbness around the genital area, buttocks or backs of the thighs.