According to the National Institute of Neurological Disorders and Stroke, back pain is the leading cause of job-related disability and loss of production in the United States. Each year, Americans spend $50 billion on back pain. Most back pain resolves in a few days with conservative management. Back pain related to a bulging disc in the lower back can cause debilitating symptoms.
Cauda Equina
Cauda equina syndrome is a medical emergency. This occurs when a low-back disc bulges and presses on the nerves in the lumbar and sacral areas of the back. These nerves control the bowel and bladder. Compression from a disc on these nerves can result in bowel and bladder incontinence and weakness or paralysis in the lower extremities, according to the American Academy of Orthopedic Surgeons. Patients with any of these symptoms should seek emergent care.
Sciatica
Sciatica occurs when a bulging disc in the lower back is pressing on the sciatic nerve. This nerve starts in the lower part of the spinal column and travels down the back of the leg. Compression from a bulging disc can cause electrical shock-like sensations to travel down the leg. Patients also complain of feeling chronic pain that is not relieved with over-the-counter medications. This condition can cause localized pain in the low back and buttocks, or pain can travel down the back of the leg into the foot, according to the National Institute of Neurological Disorders and Stroke. In extreme cases of sciatica, patients may feel weakness or have a loss of some motor function, due to compression on the nerve by the bulging disc.
Degenerative Disc Disease
With aging, the fibrous ring around the spinal discs deteriorates and allows the material in the center of the disc to bulge into the spinal canal. Aging also causes the discs to dehydrate and shrink in size, which decreases the cushioning of the spine. As the shrinking discs allow the spinal vertebrae to come closer together, any bulging discs are pushed further into the spinal canal and compression on the nerve roots result in shooting pain and possible motor weakness of the lower extremities. Over time, the compression on the nerves of the lower extremities can cause muscle wasting or atrophy. This happens because the muscle is not working or being used.
