Herniated disc nerve damage is often pronounced by doctors who can not relieve disc pain concerns blamed on central spinal stenosis, or more commonly, foraminal stenosis. Nerves can certainly suffer lasting and even permanent damage, but this event is just not statistically likely to occur due to a typical herniated disc. Nerve injury may take place, but only in the most extreme cases of acute or chronic compression.
Even in rare cases when a herniation does compress a spinal nerve root or the actual spinal cord, appropriate treatment will almost always return the nerve to full function without any lingering effects. In my experience, the number one cause of actual and verified spinal nerve damage is failed herniated disc surgery and the many complications which result from it.
This article will help patients to better understand how nerve injury can occur in relation to an intervertebral herniation or the surgical treatment of a bulging disc.
Many doctors use a speculative and unproven nerve damage diagnosis to get themselves off the hook when it comes to unsuccessful disc pain treatment. The patient wants to know why all the treatments have failed and the doctor will often theorize that the nerves have somehow been damaged, causing the continuation of symptoms, despite "successful" treatment. This is an utterly ridiculous and unfounded explanation in most patients. No wonder the diagnosis is seldom verified by an objective neurologist.
In reality, the nerve is usually fine and the herniated disc was never truly to blame for enacting the pain to begin with. The treatment failed because the diagnosis was incorrect and the doctor does not even realize it. It is a sad situation to be sure, but I see it on a daily basis.
In other cases, the disc may be causative or contributory, but the nerve is not damaged; just still affected by some alternate symptom-generating mechanism.
Spinal discs are difficult to treat, even when they are the actual source of pain. They can re-herniate after surgery, cause continuing symptomatic issues through chemical nerve irritation or may simply be involved in idiopathic pain symptoms even after seemingly successful treatment.
Most cases of actual and verifiable nerve damage do not result from herniations or ruptured discs. These occur due to iatrogenic error on the operating table when the patient is being cut open during spinal surgery.
So many cases of failed herniated disc surgery syndrome exist and these are always heartbreaking occurrences. Patients have invested all their hopes into one last attempt for a cure, but instead of enjoying symptomatic resolution, they have been permanently doomed to suffer chronic pain and lasting functional impairment. This is precisely why I strongly caution patients not to fall into this trap. Even the best spinal surgeons often warn back pain victims to avoid surgery, unless it is truly a matter or life or death. I advise patients to exhaust all the alternatives to herniated disc surgery before even considering undergoing an operation.
I have seen drastic cases of cauda equina syndrome resolve completely after appropriate surgery. If any condition is likely to enact nerve damage, it would be this one.
The inference that a herniation is compressing a nerve root is often suspect to begin with, but the thought that permanent damage may be done to the nerve structure is almost unheard of in verifiable medical literature. Remember that disc material is soft and pliable, unless calcified, and is not likely to permanently injure nerves under typical circumstances. Do not buy into this often unproven excuse for continuing pain without demanding objective neurological evaluation. If your orthopedic doctor or chiropractor says "nerve damage", demand nerve testing by a specialist.
If a deficit is shown, this still does not necessarily prove damage. Instead, it might indicate regional ischemia or disease, since these culprits may be the source of reduced nerve function and not any structural damage enacted by the scapegoat disc.
In a few truly terrible scenarios, your doctor might be 100% right and you may have suffered a permanent trauma to nerve fibers which may leave functional or sensory impairments for life. However, I have only come across few of these in over 2 decades of active international involvement in back pain patient advocacy work.