Do I Have a Herniated Disk?

Back pain can sneak up on you when you least expect it. One minute you're sitting comfortably in front of the TV, and the next you try to stand up, and -- ouch! -- a sharp pain radiates through your lower back.

What’s causing it? Could you have a slipped or herniated disk? Chances are you might.

Your spine is made up of 26 bones called vertebrae that are cushioned by soft disks made of a jellylike substance. These disks are what allow you to move your spine around and bend over.

But if a disk between two vertebrae starts slipping out of place, it can irritate the surrounding nerves and cause extreme pain. The condition is called a slipped, ruptured, or herniated disk.

Signs of a Herniated Disk

So how do you know if you have a herniated disk and not just regular old back pain?

One sign may be where the pain is located. Although they can occur in any part of your spine, herniated disks are most common in the lower part of your backbone (the lumbar spine), just above your hips. And the pain may spread from your back to your buttocks, thighs, even to your calves.

Discomfort from a herniated disk usually worsens when you're being active and lessens when you're resting. Even coughing, sneezing, and sitting can aggravate your symptoms because they put pressure on the pinched nerves.

Age also plays a factor. As you get older, your disks tend to break down and lose their cushioning.

Diagnosis

The best way to tell if you have a herniated disk is to see your doctor. He will likely do a physical exam to find the source of your pain. This usually is the only test you’ll need to confirm a diagnosis. But if your doctor wants to rule out other sources of your pain, or pinpoint specific nerves that are aggravated, he may do further testing, including:

X-rays. While a standard X-ray can't show if you have a herniated disk, it can show your doctor the outline of your spine and rule out whether your pain is caused by something else, such as a fracture or tumor.

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Myelogram. This test uses dye injected into your spinal fluid, and an X-ray for to locate the pressure on the spinal cord.

CT scan. A CT (or CAT) scan takes several X-rays from different angles and combines them to create images of your spinal cord and the structures surrounding it.

MRI: An MRI uses radio waves, a magnetic field, and a computer to create detailed 3-D images of the spinal cord and surrounding areas. MRI images can locate the position of the herniated disk, look inside it, and also determine which nerves are affected.

Electromyogram and nerve conduction studies (EMG/NCS). Your doctor might use these tests to see if any nerves are damaged or compressed. The EMG test uses a device to detect the tiny amount of electricity muscle cells make when they're stimulated by nerves connected to them. A needle electrode placed into a muscle records its electrical activity and looks for anything that isn’t as it should be.

The NCS test is often done at the same time as the EMG. In this test, the nerves are stimulated with tiny electrical impulses by an electrode at one point on the body while other electrodes detect the impulses at a different point. The time it takes for the electrical impulses to travel between electrodes lets your doctor know whether there is nerve damage.

WebMD Medical Reference Reviewed by Laura J. Martin, MD on October 9, 2016

Sources

SOURCES:

Medline Plus: "Herniated Disk."

Mayo Clinic: "Herniated Disk: Symptoms."

Weill Cornell Brain and Spine Center: "Herniated Disk."

American Association of Neurological Surgeons: "Herniated Disk."

Radiological Society of North America: "Myleography," "Computed Tomography (CT) – Spine," "Magnetic Resonance Imaging (MRI) – Spine."

North American Spine Society: "Specialized Nerve Tests: EMG, NCV and SSEP."

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