Symptoms
Usually a patient's main complaint is a sharp, cutting pain. In some cases there may be a previous history of episodes of localized low back pain, which is present in the back and continues down the leg that is served by the affected nerve. This pain is usually described as a deep and sharp pain, which gets worse as it moves down the affected leg. The onset of pain with a herniated disc may occur out of the blue or it may be announced by a tearing or snapping sensation in the spine that is thought to be the result of a sudden tear of part of the annulus fibrosis.

Diagnosis
A patient with a herniated disc will usually complain of low back pain that may or may not radiate into different parts of the body. They will often demonstrate a limitation in range of motion when asked to bend forward or lean backwards, and they may lean to one side as they try to bend forward. Patients will sometimes walk with an "antalgic" or painful gait, flexing the affected leg so as not to put too much weight on the side of the body that hurts. Straight leg raising may be positive indicating tension on the nerve root.

Abnormalities in the strength and sensation of particular parts of the body that are found with a neurological examination performed by a doctor provide the most objective evidence of nerve root compression. There are no laboratory tests that can detect the presence or absence of a herniated disc, but they may be helpful in the diagnosis of unusual causes of nerve root pain and irritation. An EMG or electromyographic test may help to determine which nerve root in particular is being pinched or is not working normally in the situation where several nerve roots may be involved. An MRI is the test of choice for diagnosis of a herniated disc, but a CT scan (CAT scan) may often be helpful because it provides better visualization of the bony anatomy of the spinal column, indicating where the source of pressure on the nerve root is located.

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The treatment for vast majority of patients with a herniated disc does not normally include surgery. Eighty percent of patients will respond to conservative therapy when followed for a period of five years. Treatment is most effective when a patient and a doctor have a good relationship and the patient understands the rationale behind the prescribed treatment. The primary element of conservative treatment is controlled physical activity. Usually treatment will begin with very short period of bed rest followed by a gradual return to normal activities. Sitting is bad for this condition because the sitting posture puts a large amount of stress and pressure on the lumbar spine, which may increase the pressure on the affected nerve root. The appropriate use of medications is an important part of conservative treatment. This can include anti-inflammatory drugs, analgesics and muscle relaxants or tranquilizers. Additionally, the right doses of aspirin have been proven to help. Surgical treatment is reserved for patients in whom conservative treatment options are not effective and a sufficient period of time has passed to indicate that the patient may need to have surgery in order to help them to get better.