The condition we call a herniated disc or lumbar disc herniation begins with lower back pain and causes pain that spreads to the leg on that side due to compression of the nerve root on the side where the herniation occurs. In a herniated disc, at the beginning of the disease, there is first lower back pain, and then as the disease progresses, leg pain develops. The way leg pain occurs depends on which lumbar vertebra the herniated disc is located in. For example; If there is a herniated disc between the third and fourth lumbar vertebrae in the waist, the pain generally spreads from the hip to the front of the leg to the knee, whereas if there is a herniated disc in the L5-S1 range in the waist, the pain spreads below the knee and towards the outer part of the foot. Pain in a herniated disc is accompanied by numbness, loss of strength and loss of reflexes. These findings, like pain, vary depending on the intervertebral space (between which lumbar vertebrae) the hernia occurs.
Coming to our question, of course, not every leg pain is a herniated disc. Some diseases can cause pain in the leg and can be confused with a herniated disc. When we look at these, sacroiliitis (inflammatory diseases of the sacroiliac joint), arthrosis (calcification) of the hip and knee joints, piriformis syndrome (compression of the sciatic nerve in the hip by the piriformis muscle), facet syndrome (conditions due to disease of the facet joints between the vertebrae in the waist), sciatic nerve or lumbar spinal cord. Conditions such as neuropathies of the nerves that come out and move towards the leg, stenosis in the spinal canal in the waist (spinal stenosis), lateral recess syndrome (compression of the nerves coming out of the waist at the entrance to the canal (foramen) on the side of the canal, rather than in the spinal canal), and tumors of spinal cord origin, abscesses and inflammations are the most common causes of leg pain. These are important reasons.
Pain from the waist to the leg or leg pain called sciatica can be diagnosed by first taking a good patient history and then performing a careful physical and neurological examination. There are actually some specific tests that are applied to diagnose some of the diseases that cause leg pain mentioned above, and when these are performed during the examination, the correct diagnosis is reached. A definitive diagnosis is then made with the requested laboratory and radiological examinations (such as direct x-ray, tomography and MRI). This distinguishes leg pain caused by a herniated disc from other diseases. Sometimes two diseases can occur together (such as hip arthritis and herniated disc); In these cases, whichever disease is more prominent should be treated first.
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