One common symptom of a disc problem is lower back pain that shoots down the back of one or both legs. Called "sciatica," this pain usually arises from a herniated, or ruptured, disc; a tear in the fibrous outer layer of a disc allows fragments of the soft inner material to protrude and press against a nerve. . Other signs that a nerve may be pinched are tingling or a burning sensation anywhere in the buttocks or legs, numbness, or a feeling that part of the leg or foot is "asleep." More serious signs that demand immediate medical attention include weakness in the legs or loss of bladder or bowel control. If any of these are present, the odds are greater that a disc is ruptured. In contrast, if symptoms are limited to a mild tingling down the leg, it's likely that a disc is simply pushing out, or bulging, against a nerve.
3. What position makes the pain worse?
Sitting and standing are worse for a disc injury since more pressure from the upper body is placed on the lower back, whereas lying down helps relieve the pain. The same is often true of vertebral compression fractures, which frequently arise from osteoporosis, or thinning of the bones. In contrast, people with back pain that involves an inflammatory condition (see below) may be uncomfortable in any position. And in yet another condition, gluteal bursitis, pain in the buttocks grows worse when a person sits or lies down. The pain is caused by inflammation in one of the fluid-filled sacs (bursae) between muscles in the area (see below).
4. How old is the person?
When someone younger than 50 suddenly develops back pain, there is a good chance of it being a disc injury. . But in older patients, the gelatin inside a spinal disc is often more dried out than in younger people. Older discs tend to cause fewer problems in general, although occasionally even patients older than 70 can rupture a disc.
Osteoarthritis is another source for back pain in the above-50 population. The bones in the back are stacked, separated by discs, but joined together by small bridges that form joints. These wear out over time, leading to abnormal bone formations called osteophytes.
