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Tests and diagnosis
By Mayo Clinic staffTo determine whether you have a herniated disk, your doctor reviews your medical history and performs a physical examination, including these tests:
- Straight-leg-raising test. You lie flat and your doctor raises your symptomatic leg.
- Cross straight-leg-raising test. You lie flat and the doctor raises your unaffected leg.
- Screening neurological examination. Your doctor will perform this test if the leg-raising tests cause pain in your leg or back, which may indicate a herniated disk. This thorough screening includes testing your reflexes, muscle strength, walking ability and sensation. The doctor may include a test for sensation in the area around the rectum, because this area can be affected by a herniated disk.
Additional possible tests
In most cases of herniated disk, the physical exam is all that's needed to make a diagnosis. If your doctor suspects another condition or needs to see which nerves are affected, or if there is no symptom improvement after four weeks of conservative treatment, one or more of these diagnostic tests may be performed:
- Magnetic resonance imaging (MRI) scan. A magnetic field is used to create images of your body. This test can be used to confirm the location of the herniated disk and to see which nerves are affected.
- Computerized tomography (CT) scan. An X-ray unit creates cross-sectional images of your spinal column and the structures around it.
- 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.
- 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 or a broken bone.
- 1. Herniated Disc. NeurosurgeryToday.org. http://www.neurosurgerytoday.org/what/patient_e/herniated.asp. Accessed Oct. 5, 2008.
- 2. Chou R. Patient Information: Low back pain. http://www.uptodate.com/home/index.html. Accessed Oct. 2, 2008.
- 3. Wheeler SG, et al. Approach to the diagnosis and evaluation of low back pain in adults. http://www.uptodate.com/home/index.html. Accessed Oct. 2, 2008.
- 4. What is back pain? National Institute of Arthritis and Musculoskeletal and Skin Diseases. http://www.niams.nih.gov/Health_Info/Back_Pain/back_pain_ff.pdf. Accessed Oct. 5, 2008
- 5. Hu SS, et al. Disorders, diseases and injuries of the spine. In: Skinner HD. Current Diagnosis and Treatment in Orthopedicas. 4th ed. New York, N.Y.: McGraw-Hill; 2006. http://www.accessmedicine.com/content.aspx?aID=2319599. Accessed Oct. 5, 2008.
- 6. Herniated disk. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=A00334&return_link=0. Accessed Oct. 5, 2008.
- 7. Chou R. Subacute and chronic low back pain: Pharmacologic and noninterventional treatment. http://www.uptodate.com/home/index.html. Accessed Oct. 2, 2008.
- 8. Knight CL, et al. Treatment of low acute back pain. http://www.uptodate.com/home/index.html. Accessed Oct. 2, 2008.
- 9. Health care guideline: Adult low back pain. Bloomington, Minn.: Institute for Clinical Systems Improvement. http://www.icsi.org/low_back_pain/adult_low_back_pain__8.html. Accessed Oct. 15, 2008.
- 10. Shelerud RA (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 12, 2008.
- 11. Heliovaara M. Body height, obesity, and risk of herniated lumbar intervertebral disc. Spine. 1987;12(5):469-472.
