Discography with disc injection aids in diagnosing disc herniation by reproducing the patient s pain pattern through injection at the level of the disc. The mechanism of action of the injection is unclear but they probably produce radicular pain by stimulating the already sensitized peridiscal tissues. Although recognized as highly sensitive, the technique is controversial because it is invasive and because a cause-effect relationship between the disc injections and the patient s pain has never been established. Over the course of lumbar disc degeneration and herniation, symptoms may progress to severe dysfunction and episodic patterns of remission and relapse over weeks to months. During periods of back pain, any movement may be nearly unbearable.
Remissions become fewer and shorter.
Neurogenic claudication commonly occurs as a result of nerve root compression by a herniated disc. Cauda equina syndrome, with compromised bowel and bladder function caused by the herniated disc, is a serious complication of lumbar disc herniation. It is uncommon, occurring in one to 16 percent of cases. Compression in the cauda equina area by the disc usually results in severe low back pain radiating into both legs, with saddle anesthesia and leg weakness. Back pain accompanied by significant weight loss may indicate the presence of a primary or metastatic tumor.