Exams And Tests to Diagnose A Herniated Disc

Your doctor will inspect your back for tenderness during the physical exam. Your doctor may ask you to lie flat on your back and to move your legs in various ways to determine the cause. A neurological exam may be performed by your doctor to verify that you are healthy.

1. Reflexes
2. Muscle strength
3. Walking ability
4. Ability to feel vibrations, pinpricks, and light touches

For most herniated disk cases, a physical exam is sufficient.

Questions to Expect

• If there was a traumatic injury, questions regarding the origin and duration of pain are common. Others questions could include:
  The type of pain. The patient might be asked to describe their pain, including where it is located and what activities or places make it worse.
• Conditions medical. Other medical conditions might also play a role. For instance, osteoporosis increases the likelihood of a broken bone.
• You have to balance work and home. A physically demanding job or performing strenuous repairs at home can place pressure on the lumbar disc.
• A medical history. Your doctor may ask about your past injuries and treatments.
• Medical history. An individual with a lumbar herniated spine is more likely to have it.
• It is important to include any experiences with anxiety and depression in the discussion. This may help you plan treatment.

One or more of these tests may be ordered by your doctor if you suspect another condition or need to assess the nerves affected.

Imaging tests

• X-rays. Plain Xrays won’t show herniated discs but can rule out other causes like an infection, tumor or spinal alignment issue.
• CT scan. CT scan takes a series X-rays in different directions and then combines them into cross-sectional images to show the spinal column and surrounding structures.
• MRI. To create images of internal structures, radio waves and a strong magnet field are used. This test is used to locate the herniated disk, and which nerves it affects.
• Myelogram. Before a CT scanner is performed, a dye is injected to the spinal fluid. This test can detect pressure in the spinal cord and nerves caused by multiple herniated discs, or other conditions.

Lumbar Herniated Disk – Physical Exam

The physical examination is critical to diagnosing the condition. This usually includes bending and stretching of the patient. These are the most common types of assessments:

Neurological checks. A doctor usually looks for signs such as loss of sensation and weakness in the leg or foot to determine if there’s a neurological problem. For the condition of foot drop, where the muscles responsible for flexing the ankles or toes are weakened, the patient might be asked to walk normally and on tiptoes. Other areas of muscle strength and reflexes may also need to be examined. Reflexes could be slower than usual or absent entirely.

There are many motion tests. A patient might be asked to lean forward or back, and to bend from one side to the other.

• Leg raise test. The straight leg raise, also known as LaSegue test, is one common test to determine if a herniated disc has developed. To perform this test, the patient is asked to lie flat on their back. The doctor then gently raises the affected knee until it feels pain. Lumbar disc herniation is when the leg is raised at least 30 to 70 degrees. If the affected leg is hurt by the raised leg of the unaffected one, this could indicate that a nerve root has been damaged or impinged. There are many variations to these stretches. You can do the test sitting down or cross-legged. According to medical literature, the straight-leg raise test is not as useful in diagnosing lumbar herniated discs in those over 60.1
• Vital signs check. An increase in pulse rate and blood pressure could indicate pain. A high temperature could also be a sign you have an infection.
• Gait monitoring. The doctor will assess whether the patient is walking slowly because of pain or has an abnormal gait.
• Lumbar spine area exam. The skin can appear sensitive or abnormal if there is inflammation at the lumbar spinal area.

Imaging tests may not be required if there are no signs of a severe problem. Some doctors prefer to wait for six weeks before determining if the symptoms disappear. This is the case with most people.

Nerve tests

An electromyogram and nerve conduction study measure how electrical impulses travel along nerve tissue. This is useful in locating nerve damage.

• Nerve conduction studies. Through electrodes on the skin, this test measures the electrical nerve impulses as well as nerve function. When a small current passes through a nerve, the study measures the electrical impulses found in these nerve signals.
• Electromyography (EMG). A doctor inserts a needle electrode into the skin and into different muscles during an EMG. The test assesses the electrical activity in muscles at rest and contraction.

Additional tests that can be used to diagnose a herniated disk

For the most precise diagnosis, your spine specialist might order additional tests such as:

• Discogram (or discography): This is a sterile procedure where dye is injected into one vertebral disc and then viewed under special conditions (fluoroscopy). This is done to determine which disc(s), if any, may be causing you pain.
• Bone scan: This is a technique that creates digital or film images of bone. A very small amount of radioactive material is injected into blood vessels, and then through the bloodstream. A scanner can detect the radioactive material in your bones. This helps doctors diagnose spinal problems such as arthritis, fractures, tumors or infections.
• Lab tests: In order to test the normality of blood cells, venipuncture is used. If there are chemical changes in blood, it could indicate a metabolic disorder. This could lead to back pain.