(Back|Spine)

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Low back strain vs herniated disc

The most common levels for a herniated disc are L4-5 and L5-S1. The onset of symptoms is characterized by a sharp, burning, stabbing pain radiating down the posterior or lateral aspect of the leg, to below the knee. Pain is generally superficial and localized, and is often associated with numbness or tingling.

Intradiscal Pressure

Symptoms of a herniated lumbar disc may often be difficult to distinguish from those of other spinal disorders or simple back strain.

The most difficult aspect of evaluating patients with symptoms of a central herniated disc is differentiation between low back strain and herniated disc. Pain caused by low back strain is exacerbated during standing and twisting motions, whereas pain caused by central disc herniation is worse in positions (such as sitting) that produce increased pressure on the anular fibers. Questions about whether the patient's pain became worse while driving to the appointment and sitting in the waiting room may be revealing. The pressure on the intervertebral disc is increased during sitting and bending postures, as opposed to standing or recumbent positions. This explains the exacerbation of herniated disc symptoms when the patient is in the sitting position.

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