Clinical features
The clinical features of prolapsed intervertebral disc are:
- back pain with very limited movement
- usually in a fit young adult
- sudden onset while lifting or stooping
- inability to straighten up: lumbar lordosis may be lost and there may be a protective sciatic scoliosis
- pain felt in leg and buttock - sciatica - may be a day or two later
- worsened by coughing and straining
- may be paraesthesia or numbness in the leg or foot
- urinary retention may result if cauda equina compression - this is a surgical emergency
- tenderness in the midline of the lower back
- pain may be worsened by foot dorsiflexion and bowstringing of the popliteal nerve
- sometime "crossed sciatic tension" - sciatic pain in the affected leg on raising the unaffected leg
Reference
- Low back pain and sciatica in over 16s: assessment and management. NICE Guidelines (November 2016 - last updated December 2020) NG59
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