Patients may experience a single occurrence or several episodes of back pain or neck pain before an intervertebral disc bulges or ruptures. Once a rupture occurs, it is likely to be followed by sharp or throbbing pain that can cause mild to severe discomfort in the back or neck and shooting pain down a limb. Discs that are damaged in the middle or lower part of the back may cause numbness, tingling or weakness (paresthesia) in the buttocks, legs or feet. Injured cervical (neck) discs may cause these sensations down the shoulder and arm, sometimes to the hand and fingers.

Activities that pressure a nerve can cause flare–ups of pain in people with herniated discs. For example, shooting pain may occur during coughing, sneezing or straining. Pain also is often worse following prolonged sitting or standing. In most cases, just one limb is affected. However, pain may affect both legs or both arms when herniation occurs in the midline of the spine and compresses nerves on both sides of the body.

Patients with herniated discs may find that the pain interferes with nearly all aspects of their lives. The pain can make it difficult to sit or bend. Many patients experience sharp sciatica pain that begins in the back and radiates down into the legs. Although herniated discs are extremely unlikely to result in paralysis, the back and limb pain is often intense enough to severely affect a patient’s quality of life.

Certain symptoms associated with herniated discs indicate very serious conditions warranting immediate medical care. Patients should see a physician promptly if they experience either of the following:

• Significant or progressive muscle weakness. Patients who suddenly find themselves unable to lift their foot, stand on their toes or use their arm may have a damaged nerve that is significantly worsening. This may require surgery.
  
  
• Loss of bowel or bladder control (incontinence). Either of these symptoms – which are sometimes accompanied by numbness in the saddle (perianal) area near the anus – may indicate that the nerves that control the bladder or bowel have been compressed. In such cases, the nerves may need to be surgically decompressed. In addition, incontinence may be a symptom of cauda equina syndrome, which requires immediate medical attention to prevent permanent neurological damage.