A clinical diagnosis of pain from a herniated disc is based on more than just the
findings from a diagnostic test, such as an MRI or CT scan. Therefore, a Physical
Medicine and Rehab specialist arrives at a clinical diagnosis of the cause of the
patient's pan through a combination of findings from a comprehensive medical history,
physical examination, and if appropriate, proceeding with one or more diagnostic
test. These can include MRIs, CT scan's, or EMG/NCV tests.
The medical history will detail the description of when the low back pain, sciatica,
or other symptoms occur, how the pain feels, and what positions, activities, or treatments
make the pain feel better.
The physical examination will focus on testing nerve function, muscle strength, and
possible sensory deficits in different parts of the arms or legs. Usually, these
tests will provide a good idea of the type of back problem the patient has.
Diagnostic testing is then used to confirm the presence of an anatomical lesion in
the spine. These tests can give a detailed picture of the location of the herniated
disc and impinged nerve roots.
A herniated disc, also known as a slipped disc or ruptured disc can occur anywhere
in the spine, although most commonly in the Cervical or Lumbar spine and will usually
occur in adults. When a disc ages or is injured, the outer portion (annulus fibrosus)
of the disc may tear and the inner potion (nucleus pulposus) can herniate or extrude
out of the disc. When disc material leaks out and comes in contact with a nerve it
can cause pain that can travel down the length of the nerve.
Symptoms of herniation will vary from patient to patient, severity of the herniation,
and the location of the herniation. In general, disc herniations can cause pain in
the arms or legs, numbness or tingling, weakness, or a burning sensation. Your Physical
Medicine and Rehab specialist will discuss your specific symptoms based on location
and severity of the disc herniation you may be suffering from.