Diagnosis

During the physical exam, your doctor will check your back for tenderness. He or she may ask you to lie flat and move your legs into various positions to help determine the cause of your pain. Your doctor may also perform a neurological exam, to check your:

  • Reflexes
  • Muscle strength
  • Walking ability
  • Ability to feel light touches, pinpricks or vibration

In most cases of herniated disk, a physical exam and a medical history are all that's needed to make a diagnosis. If your doctor suspects another condition or needs to see which nerves are affected, he or she may order one or more of the following tests.

Imaging tests

  • X-rays. Plain X-rays don't detect herniated disks, but they may be performed to rule out other causes of back pain, such as an infection, tumor, spinal alignment issues or a broken bone.
  • Computerized tomography (CT scan). A CT scanner takes a series of X-rays from many different directions and then combines them to create cross-sectional images of your spinal column and the structures around it.
  • Magnetic resonance imaging (MRI). Radio waves and a strong magnetic field are used to create images of your body's internal structures. This test can be used to confirm the location of the herniated disk and to see which nerves are affected.
  • Myelogram. A dye is injected into the spinal fluid, and then X-rays are taken. This test can show pressure on your spinal cord or nerves due to multiple herniated disks or other conditions.

Nerve tests

Electromyograms and nerve conduction studies measure how well electrical impulses are moving along nerve tissue. This can help pinpoint the location of the nerve damage.

Nov. 23, 2016
References
  1. Herniated disc. American Association of Neurological Surgeons. http://www.aans.org/patient%20information/conditions%20and%20treatments/herniated%20disc.aspx. Accessed July 19, 2016.
  2. Herniated disk in the lower back. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=A00534. Accessed July 19, 2016.
  3. AskMayoExpert. Herniated disc. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2016.
  4. Goldman L, et al., eds. Mechanical and other lesions of the spine, nerve roots and spinal cord. In: Goldman-Cecil Medicine. 25th ed. Philadelphia, Pa.: Saunders Elsevier; 2016. http://www.clinicalkey.com. Accessed July 19, 2016.
  5. Hsu PS, et al. Acute lumbosacral radiculopathy: Pathophysiology, clinical features and diagnosis. http://www.uptodate.com/home. Accessed July 19, 2016.
  6. Cauda equine syndrome. American Academy of Orthopedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=A00362. Accessed July 19, 2016.
  7. Robinson J, et al. Treatment of cervical radiculopathy. http://www.uptodate.com/home. Accessed July 19, 2016.
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  9. Low back pain. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/backpain/detail_backpain.htm. Accessed Aug. 3, 2016.
  10. Chronic low-back pain and complementary health approaches: What the science says. National Center for Complementary and Integrative Health. https://nccih.nih.gov/health/providers/digest/chronic-low-back-pain-science. Accessed Aug. 3, 2016.