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Understanding Spinal Disk Problems -- Diagnosis & Treatment

How Do I Know I Have Disk Problems?

Because there are many causes of back pain, it is important for your doctor to do a thorough history and physical examination to determine if a spinal disk problem is the root of your back pain. A herniated or slipped disk may press on the nerves coming out from the spinal cord, and it may show up in a targeted neurological exam. Your doctor will check your reflexes, muscle strength, and sensation for abnormalities or changes, especially those that involve the lower extremities.

A spinal X-ray may eliminate other potential causes of pain, but X-rays don't show soft tissue very clearly. It may be necessary for your doctor to order magnetic resonance imaging (MRI) or computed tomography (CT) scans to get a more detailed image of the soft and bony tissues around the spine. Another helpful medical test is a myelogram, which enables the doctor to see the spinal cord and spinal nerve roots and perhaps to identify and determine the extent of a herniated disk. This test may be done in conjunction with a CT scan. Doctors sometimes also do an electromyogram (EMG), which is an electrical test that may help determine the exact nerves involved.

Keep in mind that not everyone needs to have expensive tests such as CT scans, MRIs, or even plain X-rays to diagnose the exact cause; the treatment will be the same for most cases of back pain caused by a disk problem. It is when you don’t respond to treatment, or there are findings on your physical examination such as weakness or loss of sensation, that sophisticated testing is necessary.

What Are the Treatments for Spinal Disk Problems?

Treatment calls for pain relief, reduced activity, steps to reduce inflammation, and measures to restore strength and normal activity. Severe cases of disk degeneration that put pressure on the spinal nerve roots may permanently affect the nerves that control muscle movement or sensation in an extremity. Herniated disks generally heal themselves, and surgery is rarely necessary.

If the disk is just temporarily distorted, the potential for complete recovery is excellent. If the outer membrane actually breaks or ruptures and loses some of its gelatinous center, the damage to the disk may be permanent.

Rest 

Although in the past, bed rest was universally recommended as a treatment for back pain, many doctors now recommend modified activity rather than bed rest. Bed rest for two days can be helpful for sudden, severe back pain, but prolonged bed rest may actually delay healing. People with backaches should remain active, but be careful not to perform movements that cause pain or discomfort. Your doctor may suggest a back brace or neck collar to limit movement and ease the pressure on sensitive nerves while the disk heals. 

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