Can a Hernia Cause Back Pain?

Key takeaways:

• Herniated discs can cause varying symptoms of pain, numbness, and weakness.
• The underlying cause of the disc herniation may suggest more serious complications if it’s causing other symptoms.
• Your symptoms will vary based on the spinal level of the disc herniation.

Back pain is an extremely common medical problem in the United States – and a leading cause of disability. Acute back pain may result from a variety of causes. The most common cause is herniation of the bones (vertebrae) that make up your spine.

How are hernias and back pain related?

The spine is made up of 33 vertebrae. These bones are divided into levels (or sections) that correlate with their individual functions. In between the vertebrae are soft, spongy pads known as discs. The discs help support the spine and keep it in place. They also add a layer of lubrication between the bones that allows your back to be flexible and stretch.

As people age, discs gradually wear out. That makes them more vulnerable to damage, such as herniation, which means a rupture. When doctors refer to a herniated disc, it means that part of the disc is protruding through a weakened part of the spine. This causes various symptoms, including pain that can be severe.

Disc herniation is typically seen in the lumbar vertebrae. This is the lower part of your spine between the bottom of your ribs and your hips. Disc herniation can affect any level of the spine, although it rarely affects discs in the thoracic area, which refers to the upper to middle back.

Types of hernias that can cause back pain

Disc herniation can result from a number of causes. The most common are age-related changes in which the supporting structures of the discs and vertebrae are affected. The spongy discs become stiffer and less mobile. This makes the disc more fragile as it shrinks, which causes the space in between the vertebrae to also shrink. This makes the disc more susceptible to herniation, with symptoms that are typically due to nerve root compression.

These changes can be further classified as a disc bulge, in which one structure in the spinal cord (the nucleus pulposus) becomes displaced through a single layer or multiple layers of a supporting structure (the annulus), although it does not tear the entire ring.

In addition to disc herniation, you may experience changes in the spinal joint. These joint changes can lead to the development of bony overgrowths, which can lead to symptoms. As mentioned, the parts of your body where you’re experiencing symptoms will vary based on the level of the spine that’s affected.

Symptoms associated with back pain from a hernia

Disc herniation can cause significant pain, often described as shooting pain. To understand the relationship between herniation and back pain, it helps to know how the spinal cord works.

A long, tubular structure made of nervous tissue, the spinal cord runs down the spine from the brain to the lower back. Its function is to help the brain communicate with the rest of the body. So when you feel pain, it’s because the spinal cord is doing its job. Following are some of the symptoms you may experience when having back pain from a hernia.

Pain or sensory changes

Your spinal cord plays multiple roles. These include communicating sensations and signals to the brain about your body and its environment.

Other parts of the nerve roots at each vertebral level also communicate sensory information, such as vibration and temperature. Nerve roots also communicate about proprioception, which is your body’s ability to sense its own movements, action, and position. So, how you perceive these other sensations may also be affected for specific parts of your body if you have a herniated disc.

Numbness or tingling

In addition to pain and sensory changes, many patients with herniated discs experience numbness or tingling. This is also related to the nerve root compression at a specific vertebral level.

It is a common symptom; one study found that it occurred in 27 percent of patients with lumbosacral radiculopathy. That’s a term for a disease that impairs the normal function of the nerve roots in the lumbar or sacral spine.

Weakness

As mentioned, each vertebral level and nerve root has its own nerve connections to the body’s muscles. So, you can predict which muscles are likely to be affected based on disc herniation of a specific level of your spine. Some muscles have connections with multiple nerve roots, so you may not notice a sudden decrease in muscle strength. One type of disc herniation could affect your ability to get up from a chair due to weakness in the quadriceps muscles.

Other symptoms

Although you may not think of your organs as muscles in the traditional sense, your organs (like muscles) are controlled by nerve roots.

This includes your lungs, gastrointestinal tract, and bladder, as well as all the rest of your organs. As a result, disc herniation can affect the function of your organs. If you have a herniated disc, you may experience loss of control of your bladder or bowels, changes in your breathing, or difficulty swallowing, among other symptoms.

How to tell if your back pain is caused by a hernia

If you experience a sudden development of symptoms after trauma, increased exercise, or stress to the back, your symptoms are likely due to a herniated disc.

Considerations based on the location of back pain caused by a hernia

The location of back pain may suggest the level of disc herniation. Thus, you would likely experience symptoms correlating to that nerve root.

These symptoms may include numbness, weakness, tingling, an increase or decrease in pain, and muscle weakness. You may also experience changes in sensation of temperature, vibration, or proprioception.

How to get relief from hernia-related back pain at home

Fortunately, there are treatment options you can try on your own to help manage the symptoms of a herniated disc. Following are some of the most widely used options.

Tylenol and other pain medications

Over-the-counter pain medications, such as acetaminophen (Tylenol) and ibuprofen (Advil), may help take the edge off your symptoms. Another idea to relieve your pain is to use topical medications like Icy Hot, Bengay, or lidocaine patches.

Remember, though, that pain medications are not a permanent fix. If you notice your symptoms getting worse despite the consistent use of pain medications, consult with your doctor.

Stretching, strength training, and mobility exercises

Although you may not immediately relieve the herniated disc, careful stretching and mobility exercises can help relieve the pressure and level of nerve root compression. Working on strength training of your back muscles and core can also help support the muscles surrounding the spinal cord. That can not only rehabilitate a herniated disc but also help prevent future injury.

Cooling and heating

Using cooling and heating can help minimize the pain and help the surrounding muscles relax which can help with symptoms. Ice packs and heating pads are great to have on hand for this purpose.,

When to see a doctor about back pain from a hernia

Dealing with back pain from a herniated disc can be upsetting. It is important to know when you should seek further evaluation from a healthcare professional.

You should see a doctor if:

• Your pain does not improve despite the use of the treatment options outlined above;
• You notice changes in your ability to walk or move normally;
• You experience unintentional weight loss;
• You have a history of family members with vascular disorders.

You should go to the emergency room if:

• You’ve experienced loss of consciousness;
• You experience loss of control of your bowel or bladder;
• You have a concurrent fever (temperature greater than 100.4℉;
• You start vomiting;
• You have an uncontrollable headache;
• You have sudden vision changes;
• You’ve had head trauma.

Questions to ask your doctor about back pain from a hernia

• Should I get imaging studies done, like x-rays or an MRI?
• Should I get any neurodiagnostic tests, like nerve conduction tests?
• Should I have blood work done?
• Should I have cerebrospinal fluid studies?

How a doctor can help treat back pain from a hernia

Although your doctor may not have an immediate fix to your herniated disc, your healthcare team can offer additional treatment options.

Additional pain medications

Your doctor may give you a prescription for stronger pain medications or muscle-relaxing drugs that help relieve symptoms.

Physical therapy and exercise modification

Your primary care provider may provide a referral for physical therapy. By working with a physical therapist, you can learn additional exercises that help mobilize your back and rehabilitate it as you recover from your herniated disc.

Systemic steroids

Your doctor may offer the option of using steroids to reduce inflammation, which could help with your symptoms.

Frequently asked questions: hernias and back pain

You’ll probably have many questions about having a herniated disc and how it will affect your life and activities. Here are some of the most commonly asked questions.

How long can back pain from a hernia last?

Unfortunately, herniated discs can take a while to fully recover. This recovery process may only be a few days if the extent of herniation is not serious. However, symptoms can last for a few weeks to several months (and possibly longer), depending on the severity.

What if you have back pain from a hernia while pregnant?

If you have back pain while pregnant, it is important to consult with your obstetrician to ensure there are no complications with your pregnancy.

Managing back pain

While herniated discs may not be life-threatening, they can be extremely frustrating to deal with and cause multiple symptoms – including severe pain. Speak with your healthcare provider if you are experiencing persistent or worsening symptoms.

General Medicine follows a strict editorial process, including using real experts to write our articles, vetted primary sources, fact-checking, a secondary medical review, and updates as necessary. This article was medically reviewed and fact checked by Dr. Pallabi Sanyal-Dey, MD.

Sources

Christopher E. Alexander, et al., “Lumbosacral Radiculopathy,” StatPearls, February 27, 2024. www.ncbi.nlm.nih.gov/books/NBK430837.

Brown, H.A., and M.E. Pont, “Disease of Lumbar Discs: Ten Years of Surgical Treatment,” Journal of Neurosurgery, May 1963. https://pubmed.ncbi.nlm.nih.gov/14186059.

Beth Oller, M.D. (Reviewer), “Herniated Disc,” Familydoctor.org, October 10, 2023. familydoctor.org/condition/herniated-disc.

Oluwaseun O. Adigun, et al., “Anatomy, Back, Spinal Cord,” StatPearls, June 26, 2023. www.ncbi.nlm.nih.gov/books/NBK537004.