How is a Herniated Disc Diagnosed?

Question: How is a Herniated Disc Diagnosed?

Diagnosing a herniated disc, whether it's a lumbar herniated disc (i.e., a herniated disc in your low back) or a cervical herniated disc (a herniated disc in your neck) requires a doctor examine your back pain, posture and other things. If you herniate a disc, most likely you'll know immediately that something is wrong. Herniated disc symptoms include pain in your back or neck with possible pain, weakness, tingling, numbness or other symptoms down your leg (sciatica) or arm (depending on the location of the disc herniation.) To get the right treatment for your symptoms, you need an accurate diagnosis. Here's how.

Answer:

Herniated Disc Diagnosis: Medical History

To diagnose a herniated disc, your doctor will take a medical history (interview you) and give you a physical exam. During the history, the doctor will ask you to describe your symptoms and will ask you questions like:

• How long have you had the pain and/or symptoms?
• Was there an injury or trauma that preceded the pain?
• What makes your symptoms worse?
• Do You smoke?
• What is your occupation?
• Have any of your family members had a herniated disc?

Herniated Disc Diagnosis: Physical Exam

The doctor will also check your spinal alignment, reflexes and muscle strength. As a critical part of the diagnostic process, she will thoroughly check the sensations you have at each dermatome. By locating the symptoms affecting a spinal nerve root (called radicular symptoms) in the dermatome, she can trace those symptoms back to the specific spinal nerve root or roots that are affected.

Manual tests often given to diagnose a herniated disc include the straight leg raise test for a lumbar herniated disc and the Spurling test and compression tests for a herniated disc in the neck. These tests put pressure on the injury in an attempt to reproduce the pain. A successful reproduction of the pain confirms for the doctor that it is due to a herniated disc.

The information gleaned from your medical history, physical exam and manual tests for herniated disc will likely give the doctor a pretty good understanding of what's causing your pain.

Diagnostic Tests for Herniated Disc

Your doctor may also order one or more diagnostic imaging tests. These tests may help confirm the cause of your pain. They are especially useful if you are considering back surgery. An x-ray can show any degenerative changes in your vertebrae and/or discs. An MRI or CT scan may be used to confirm which disc or discs are damaged. A discogram may be used to confirm which specific spinal disc or discs are causing your pain, but this is a controversial test because it works by eliciting your pain and because it is subjective (that is, you have to report your symptoms).

_Sources

_{Medline Plus. Herniated Disk. NIH website. Jul 09. Accessed Aug 2010.http://www.nlm.nih.gov/medlineplus/ency/article/000442.htm}

_{Herniated Disk. Your Orthopedic Connection. AAOS website. Accessed: Aug 2010 http://orthoinfo.aaos.org/topic.cfm?topic=a00334}

_{MD Consult. Herniated Intervertebral Disk. Elsivier. July 2010. Accessed August 2010. http://www.mdconsult.com/das/pdxmd/body/215814010-2/1040215818?type=med&eid=9-u1.0-_1_mt_1014932&printing=true#Contributors}

_{Vaccaro, A. Spine: Core Knowledge in Orthopaedics. Elsevier Mosby. Philadelphia. 2005.}