First- please let me know the level of the herniation. Is it mid back (thoracic spine) or lower back (lumbar spine)?
Any time you have a known preexisting hernation with worsening symptoms, one of the first questions should be if the symptoms are the same but with greater intensity or are the symptoms different. The reason is due to either recurrent herniation or a hernation at a new level.
A recurrent hernation at a previously herniated level will typically intensify preexisting symptoms and a hernation at a new level will typically yield different symptoms.
In either case in my opinion, a new MRI should be considered.
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.