General symptomatology of disk herniation
1. Big picture
Disk herniation is an important cause of low back pain, neck pain, and radicular pain. For the exam, the most important skill is not only to say “disk herniation,” but to decide:
- Is this only local vertebral pain?
- Is there radicular root compression?
- Is there spinal cord compression / myelopathy?
- Is there cauda equina or conus syndrome, which needs urgent surgery?
The classic exam pattern is: back or neck pain + radiating dermatomal pain + sensory symptoms + reflex change + motor weakness. Disk herniation is common, but imaging findings do not always correlate with symptoms, so the diagnosis must be clinical first and imaging-confirmed
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