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Tests and diagnosis
By Mayo Clinic staff
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.
References
- Chad DA. Disorders of nerve roots and plexuses. In: Bradley WG, et al. Neurology in Clinical Practice. 5th ed. Philadelphia, Pa.: Butterworth Heinemann Elsevier; 2008. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-0-7506-7525-3..50117-5&isbn=978-0-7506-7525-3&sid=1063623544&type=bookPage§ionEid=4-u1.0-B978-0-7506-7525-3..50117-5--cesec12&uniqId=221226396-3#4-u1.0-B978-0-7506-7525-3..50117-5--cesec12. Accessed Oct. 5, 2010.
- Herniated disk. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=A00334. Accessed Oct. 5, 2010.
- Herniated disc. American Association of Neurological Surgeons. http://www.aans.org/Patient%20Information/Conditions%20and%20Treatments/Herniated%20Disc.aspx. Accessed Oct. 5, 2010.
- Herniated lumbar disc. North American Spine Society. http://www.spine.org/Documents/herniated_lumbar_disc_2006.pdf. Accessed Oct. 6, 2010.
- Herniated cervical disc. North American Spine Society. http://www.spine.org/Documents/herniated_cervical_disc_2006.pdf. Accessed Oct. 6, 2010.
- JAMA patient page: Herniated lumbar disks. Journal of the American Medical Association. 2006;296:2512.
- Cauda equina syndrome. American Association of Neurological Surgeons. http://www.aans.org/Patient%20Information/Conditions%20and%20Treatments/Cauda%20Equina%20Syndrome.aspx. Accessed Oct. 6, 2010.
- Neurological diagnostic tests and procedures. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/misc/diagnostic_tests.htm. Accessed Oct. 6, 2010.
- Chou R, et al. Diagnosis ad treatment of low back pain: A joint clinical practice guideline from the American College of Physicians and the American Pain Society. Annals of Internal Medicine. 2007;147:478.
- Robinson J, et al. Treatment of cervical radiculopathy. http://www.uptodate.com/home/index.html. Accessed Oct. 7, 2010.
- Levin K, et al. Lumbosacral radiculopathy: Prognosis and treatment. http://www.uptodate.com/home/index.html. Accessed Oct. 7, 2010.
- Dworkin RH, et al. Pharmacologic management of neuropathic pain: Evidence-based recommendations. Pain. 2007;132:237.
- Shelerud RA (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 13, 2010.
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