When you least expect it, back pain can sneak up on you. You may be sitting at the TV all day, but the next thing you know, you are struggling to get up. A sharp pain radiates from your lower back. Are you at risk of a herniated or slipped disc? You might. The adult spine is composed of 24 bones known as vertebrae. Soft discs of a jellylike substance cushion some of the vertebrae. These soft discs enable you to bend and move your spine. If a disc between two vertebrae begins to slip out of its place, it can cause severe pain and irritation to the surrounding nerves. This is known as a herniated, ruptured or slipped disc.
Signs of a Herniated Disc
The location of the pain may be one sign. While herniated discs can occur in any part of your spine, most often they occur in the lower portion of your backbone (the Lumbar spine), right above your hips. The pain could spread to your lower back, buttocks, thighs and even your calves.
A herniated disc can cause discomfort that is more severe when you are active than when you rest. Because they place pressure on nerves, even sitting, coughing, or sneezing can make your symptoms worse. You may feel tingling or numbness due to a herniated disc. You may feel weak in the affected area of your back. Age plays an important role. Your discs become less cushioned as you age. This makes herniated discs more common.
Diagnosis of Herniated Disc
Your doctor is the best way to determine if you have an herniated disc. To determine the cause of your pain, they will likely perform a physical exam.
This is usually the only test that will confirm your diagnosis. Your doctor will examine your back for any sores or pain spots. You may be asked to lie down on your back, lift your legs or move your legs in specific ways. A herniated disc is likely to cause pain.
They might also be able to check:
- Reflexes at the ankle and knee
- Your leg strength
- How to walk on your heels, and toes
- Feel light touch or vibrations
Further testing may be required by your doctor if they want to rule out any other causes of pain or identify irritated nerves.
- X-rays. A standard X-ray cannot show if your disc is herniated, but it can show your doctor your spine outline and rule out other causes, such as a tumor or fracture.
- Myelogram. This test involves injecting dye into your spinal fluid and using an X-ray for the location of pressure on the spine cord.
- CT scan. CT scan (or CAT scan) takes multiple X-rays at different angles and combines them into images of your spine and structures around it.
- MRI. An MRI uses radio waves and a magnetic field to create 3D images of the spine and surrounding areas. MRI images are used to locate the location of the herniated disc, examine it inside, and determine the affected nerves.
- Electromyogram (EMG) These tests may be used by your doctor to determine if nerves are compressed or damaged. An EMG test measures the amount of electricity that muscle cells produce when stimulated by nerves. An electrode placed into the muscle records electrical activity and detects any abnormalities.
- Nerve conduction studies (NCS), are often performed simultaneously with the EMG. This test involves stimulating the nerves with tiny electrical impulses using an electrode at one end of the body. Other electrodes detect the impulses at another point. Your doctor will know if nerve damage is present by the time it takes for electrical impulses between electrodes.
What is the Difference Between MRI, CT Scan, and X-Ray? Which is best for herniated discs?
To diagnose a herniated cervical disc, do I need an xray, CT scan or MRI? What is the best way to diagnose a herniated cervical disc? What is the difference between MRI, CT, and x-rays? Dr. Seth Neubardt is a cervical spine surgeon who explains that while x-rays can be used to examine the bones of the neck, they cannot show a herniated disc. A CT scan or MRI is required to see the disc.
An MRI is the most sensitive. It will be ordered if there are persistent neck pains radiating down your arm and arm tingling and weakness. A cervical or neck x-ray may reveal fractures, tumors, arthritis, or instability. The CT scan uses x-rays to look at the bones. However, it takes thin slices of bone and is more detailed that a simple x-ray.
It is extremely useful to detect fractures using CT scans. The CT scan is not better than an MRI to diagnose a herniated disc. The MRI is the best method to evaluate the soft tissues in the neck and spine. It is also the most effective way to locate the slipped disc. Unless you have been experiencing symptoms for several weeks, the MRI is not usually performed. The CT myelogram (cervical spine CT) is another less commonly used test. This test can also show the extent of the herniated disc.