Your doctor will evaluate your
symptoms of leg and back pain using a
medical history and physical exam. Your
diagnosis will be based on any features that point to irritation of one or more
spinal nerves and to the loss of strength, sensation, or reflexes that are
normally associated with the nerve or nerves. If your medical history and
physical exam suggest you have a
herniated disc, you will probably not need additional
tests during your first medical visit.
Follow-up tests sometimes used
Imaging tests may
help confirm a diagnosis of a herniated disc or may be needed when nonsurgical
treatment has not worked to relieve pain. If you still have symptoms after 4
weeks of nonsurgical treatment, your doctor may recommend imaging tests. If the
results of an imaging test are not expected to change a treatment decision, the
test is probably not needed.
For many people, back pain seems like an unavoidable discomfort. But you may have more control than you think.
You can wreck your back in any number of ways, but a few major offenders stand out: Not stretching, not paying attention to your movements, and years of wear and tear, says Nick Shamie, MD, associate professor of orthopedic neurosurgery at UCLA and a spokesman for the American Academy of Orthopaedic Surgeons.
Here are five habits that put your spine at risk and simple strategies to stop...
Magnetic resonance imaging (MRI) may be done to confirm a diagnosis as well as the location
and severity of a herniated disc or to look for another serious condition, such
as an infection or tumor. An MRI provides detailed images of the soft tissues
of the spine, such as the muscles, spinal nerves, tendons, ligaments, discs,
and the softer inner part (marrow) of the bones of the spine.
Computed tomography (CT) scan may be done to help
confirm a diagnosis as well as the location and severity of a herniated disc
and to look for any other problems in the bones of the spine. This test may be
done if you cannot have an MRI (for example, if you have a pacemaker) or if the
results of an MRI are not clear. A CT scan can provide detailed images of bony
structures of the spine.
An MRI is generally preferred over a CT scan for
diagnosing a suspected herniated disc in the lower back (lumbar spine).
X-rays generally are not useful or needed for
diagnosing a herniated disc. But if your medical history and physical exam
suggest a more serious condition (such as a tumor, infection, fracture, or
severe nerve damage), or if your leg pain and other symptoms do not get better
after 4 weeks of nonsurgical treatment, your doctor may order X-rays. Other
tests, such as blood tests, may be done to rule out other conditions.
Follow-up tests occasionally used
imaging tests are not used as often as an MRI or a CT scan, but they may give
your doctor additional information:
X-ray study of the spinal canal that uses dye to more clearly outline the space
containing the spinal cord. When myelography is used, it is almost always
combined with a CT scan. This test may be done if you cannot have an MRI (for
example, if you have a pacemaker) or if the results of an MRI are not
Discography, which involves the
injection of a dye into the jellylike center of a spinal disc to help diagnose