If you have lower back pain that is located only on the left side or right side of your lower back, there is a high chance that it is due to a herniated disc. In fact, pain from a herniated disc is usually located on one side of the lower back. This is due to the fact that many herniated discs are caused by uneven pressure on the intervertebral discs in the lower back. The most common location for a disc to bulge and herniate is toward the posterior of the disc on the left or right side – this is due to the fact that this is where the discs annulus fibrosus is weakest and most vulnerable. This is why sciatica caused by a herniated disc is usually located in one leg; the disc is pressing on one side of the sciatic nerve.
Is it a lumbar strain or a herniated disc?
Pain from a herniated disc does not always produce sciatica. Herniated disc pain can remain in the lower back and does not necessarily radiate down towards the legs. This is a common problem in diagnosing herniated discs – many doctors will perform the straight-leg test (having the user sit in a chair and raise one leg at a time) to try and detect any pain in the legs, which is useless if the pain is restricted to the lumbar region. If you have lower back pain that is located on one side, it is best to have an MRI scan to get an image of the spine and determine if there is any damage to the lumbar discs. An MRI scan is the only way to diagnose such an injury as it captures images of the soft tissue – an X-RAY cannot do this. Disc injuries can be misdiagnosed as a lumbar strain. It is important to be aware of any damaged discs. If your left or right side lower back pain has not healed within six weeks, there is a large possibility that your pain is coming from a damaged disc as lumbar strains will heal within that time.
What can herniated disc pain feel like?
Pain from a bulging or herniated disc is unlike any other pain that people typically experience. The type of pain can vary greatly from person to person, too, due to the complex structure of the lower back muscles, connective tissue, spine and nerves.
Types of pain caused by a herniated disc:
• Pain that feels like a line going down the lower back (most people can actually show and draw a line exactly where the pain is)
• Pain that feels like a line going sideways across the lower back
• Pain may feel electrical. Bending forward or backward may actually produce an involuntary muscle spasm or shock.
• Bending forward may cause the user extreme pain, as it causes the disc to bulge out even further and press on nerves.
• Bending backwards may cause the user extreme pain, as the disc is pinched by the top and bottom vertebrae.
• Bending sideways may cause the user extreme pain, as the disc is being pushed out even further
• The user may not be able to physically bend forward or backward much as their range of motion has been compromised by their damaged disc.
• Pain that feels like burning or a very hot sensation within the lower back. This is typically due to inflammation.
• Pain that feels like cold, sharp pain. This type of pain also occurs in the feet (cold foot) with an L4-L5 or L5-S1 herniated disc that is pressing on the sciatic nerve, however this feeling may also be felt in the lower back.
• Pain from a herniated disc may feel so severe that the user is unable to walk. This is due to the large amount of inflammation around the injury which is putting a lot of pressure on the nerves in the lumbar region. This is typically felt with a new injury and the pain gradually fades away once the inflammation has settled down.
• Pain may be severe in the tailbone region (common with L5-S1 disc bulges).
• Pain may feel like a tingling sensation that may come and go.
• Pain may feel like a dull, throbbing pain that won’t go away.
• Pain may feel like a dull, numb pain.
When should I be worried?
Even though herniated discs aren’t as serious as doctors make them out to be, it’s best to have a diagnosis – even if it requires an expensive MRI scan.
Certain cases should be taken very seriously and may require a specialist’s attention. These cases include:
• Numbness of the groin or bowels. This may indicate that the herniated disc is pressing on the cauda aquina and is a sign of a large herniation that has erupted through the Posterior Longitudinal Ligament (PLL).
• Numbness and paralysis in one or both legs that is not getting better. This may indicate that the disc is pressing very hard on the sciatic nerve and the disc and is not healing well. Nerves can take many months and years to heal and it is best to reduce the pressure on them as soon as possible.
• Pain that is not getting better.
Do not underestimate the damage that stress can have on you. Even though stress is psychological, it can manifest itself into physiological processes. Stress is directly linked to the lower back and can cause lower back pain.
Can a lumbar herniated disc cause paralysis?
In a word, yes. However it is quite rare and not exactly “paralysis”. The spinal cord ends at the upper lumbar region, terminates at the conus medullaris and then branches off into the cauda equina and sciatic nerve. Therefore if a disc were to press on the cauda equina or sciatic nerve for a very long time, there is the possibility of permanent nerve damage. Thus while there is no damage to the spinal cord, there is a possibility of completely losing control of the bladder or bowels and one or both legs. However these cases are still rare, and losing full control of the legs is uncommon as the sciatic nerve will usually heal from any temporary compression, albeit slowly.
Paralysis due to a disc herniation are more common in the cervical and thoracic spine, although they are still rare and only caused by severe herniation’s. The spinal cord travels along these regions and can be compressed. There is also less space between discs and the spinal cord in the cervical and thoracic regions.
Other causes of left side or right side lower back pain
Other causes of lower back pain located only on the left or right side can include the following. This list is not exhaustive and there are many other problems that can contribute to back pain.
• Spinal stenosis. This condition occurs when the intervertebral column begins to encroach upon the spinal cord.
• Scoliosis. An abnormal curvature in the spine which can be easily detected by X-RAY.
• Spondylolysis. A defected vertebrae which can be detected with an X-RAY.
• Lumbar strain
• Facet joint pain
• Spinal fractures and fractured vertebrae
• Dislodged bone fragments
• Disease. Check for any abnormal lumps although in most cases it is a benign lymphoma.
• Bladder and kidney problems. These can be diagnosed with a cystoscopy and biopsies. This is usually accompanied with fever and nausea and urinary problems.
• Sacroiliac Joint Pain (SJP). The sacrum consists of 5 vertebrae fused together and are joined to the iliac bones. This joint can cause pain due to muscle imbalances, natural wear and tear of the joint and loss of bone strength.
• Muscle imbalances between each side of the spinal erectors. This can be caused by one side of the lower back being stronger than the other. Common causes of this are misalignment”s in the body causing the user to overcompensate for one side.
What causes herniated disc pain?
A disc herniation involves a disc that has been damaged and is now situated beyond its normal anatomical range. The disc may be bulging slightly or the bulge may be large and may be encroaching upon spinal nerves. It all depends on the size of the bulge and the amount of space in the spinal canal. People may have large disc herniation’s yet have no symptoms of sciatica due to having a large amount of space in their spinal canal. Inversely, a person may have a small disc bulge yet have excruciating pain in their legs as they have a narrow spinal canal and the disc is pressing on nerves.
Be aware that people can also have large disc herniation’s and be asymptomatic. The body can “adapt” to a herniated disc in such a way that the pain is lessened.
Lower back pain caused by a bulging or herniated disc is due to:
• Inflammation, especially if the injury is new or the disc has been reinjured
• Chemical irritation. This occurs as the nucleus pulposus (the substance within the disc) is treated as a foreign material when it comes into contact with the human body. Chemical irritation may also be produced from a disc that is pressing on nerves and the protective sac (thecal sac) containing the spinal nerves; this occurs because nerves and the sac do not come into contact with other hard structures such as discs and vertebrae – they are only surrounded by spinal fluids. The thecal sac contains spinal fluid that provides nutrition to the spinal cord and nerves.
• Mechanical irritation. This occurs when performing movements such as bending forward or backward; it is a pain signal warning the person to maintain a neutral spine and not execute a large range of motion while it heals the disc injury.
Click here to read the main guide about healing a herniated disc.