The Role of Inflammation in Back Pain and Herniated Discs

A herniated disc can look significant on an MRI and cause surprisingly mild symptoms, while a smaller disc problem may lead to intense pain. One reason is that herniated disc symptoms are not caused by pressure alone. At Northwest Spine Surgery in Portland, OR, we look at the full clinical picture rather than relying on an imaging result by itself. Dr. Kendrick Khoo completed spine fellowship training at UC Davis and brings an evidence-based, shared decision-making approach to spine care.

Pressure and Inflammation Can Both Matter

A disc herniation happens when material from inside a spinal disc pushes through a weakened or damaged outer layer. If that material crowds a nearby nerve root, the physical pressure can cause pain, numbness, tingling, or weakness. Disc material may also contribute to inflammation around the nerve, making an already irritated area more sensitive.

That combination helps explain why the size of a herniation does not always predict how someone will feel. Where the problem is located, whether a nerve is involved, and how much it affects movement, sensation, or strength all influence the experience.

Why the MRI Is Only Part of the Picture

An MRI can show the location of a herniated disc, but it cannot tell us everything about how that finding is affecting you. We also consider where pain travels, changes in sensation, muscle strength, reflexes, and how the problem has changed over time.

A lumbar disc that irritates a nerve root, for example, may contribute to sciatica, with discomfort or abnormal sensations extending into the buttock or leg. Comparing the physical exam with imaging helps us determine whether a disc finding actually fits what you are experiencing.

When Conservative Care Is Not Enough

Many people improve with nonsurgical measures such as medication, physical therapy, or injections. Our team generally begins with conservative care unless severe pain or progressive loss of function calls for a faster response.

If those measures are not helping, or muscle weakness is worsening, surgery may be considered. In some cases, a laminectomy can create more room around a compressed nerve. The treatment plan depends on the location of the problem, neurologic findings, and how much it interferes with daily life.

New or worsening weakness, increasing numbness, or persistent radiating pain should be checked. New loss of bowel or bladder control requires urgent medical attention. If back or leg problems are not improving, contact us at Northwest Spine Surgery in Portland, OR. Call 503-253-4000 to discuss an evaluation with our spine team.