Herniated Disc Symptoms and Neurological Effects

A herniated disc compresses nerve roots or the spinal cord, causing symptoms based on location:

1. Pain: Local or radiating (radiculopathy) along nerve path (sciatica if lumbar).
2. Muscle Weakness: In myotome of affected nerve (e.g., foot drop with L5).
3. Numbness/Tingling: In dermatome of compressed nerve.
4. Reflex Changes: Diminished/absent reflexes (e.g., knee jerk with L4).
5. Gait Disturbance: Balance/coordination issues from motor/sensory loss.
6. Bowel/Bladder Dysfunction: Saddle anesthesia, retention, incontinence = cauda equina syndrome (surgical emergency).
7. Spinal Cord Compression (myelopathy): Upper motor neuron signs (spasticity, hyperreflexia, Babinski) — urgent neurosurgical evaluation.

Symptom severity ≠ herniation size. Many herniations are asymptomatic. MRI + clinical correlation guides management.