Is there an accurate herniated disc test that can determine if a spinal problem exists or not? Yes, in fact, there are several tests that can accurately visualize the existence of herniated discs, as well as other common intervertebral abnormalities, such as degeneration, bulging, rupture, extrusion and sequestration.
Unfortunately, some care providers still propagate mythologies when it comes to diagnosing herniated discs and claim to be able to identify them with practices that are not at all effective or even scientific. Patients are strongly advised to avoid such healthcare workers, as they have already proven their incompetence if they claim to be capable of diagnosing a herniated disc on the basis of physical exam or other unproven method alone.
This dialog is written in response to great reader demand, since so many of you have written to us asking which tests can actually identify a herniated disc and which are a waste of time. If you are unsure about the manner in which herniated discs can be identified, this is one of several articles that you must read. The rest can be found in the herniated disc diagnosis section of this website.
Herniated Disc Test for Diagnosis
Diagnosis a herniated disc can be easily achieved using CT scan or MRI technology. MRI is definitely the gold standard when it comes to herniated disc testing, since it can not only visualize the disc itself from a 360 degree perspective, but can also document how the disc may be influencing the surrounding neurological tissues, including the spinal cord and spinal nerve roots. CT scans are still very useful, but lack the full spectrum of diagnostic abilities that are provided by MRI.
X-rays may reveal many abnormalities in the intervertebral space, but might not be able to differentiate degenerated discs from herniated discs. X-rays only accurately visualize bony tissues, so unless the disc has ossified, this type of traditional imaging is far less useful in the diagnosis of disc conditions. Some disc abnormalities will not visualize at all on x-ray imaging, which is why we no longer report the test to be useful for preliminary diagnostic evaluation of potentially disc-related back pain conditions.
Test for Disc Pathology
Discogram is often used to establish that a particular disc abnormality is indeed the true source of pain. This is accomplished by injecting the disc with a needle and pressurizing it, which is a terribly painful ordeal in many instances. Of course, this torture will cause worsened pain. Discogram is not a reliable diagnostic tool, demonstrates high levels of patient discomfort and even has many risks for spinal injury. We do not recommend discography and have been speaking out against its use for many years already.
Meanwhile, MRI films are much more useful for potentially confirming or eliminating disc abnormalities as possible sources of pain. Quality MRI images combined with a knowledgeable and enlightened radiologist can really help to judge the pathological potential of any herniated disc.
Symptomatic correlation might not be an actual test, but is a process that should be inherently part of the diagnostic process for all types of back and neck pain. Unfortunately, symptoms often do not correlate in actuality from what clinical expectation would suggest. Since so many patients rely on non-neurologist caregivers as their primary diagnosticians, these oversights are either overlooked or purposefully ignored in order to advance the patient into profitable treatment for a disc which might not even be the logical origin of pain. We witness this travesty daily.
Herniated Disc Test Myths
Some care providers (some chiropractors have a bad reputation for this) claim to be able to diagnose herniated discs by physical exam alone. This often involves the ridiculous straight leg raising test, which only proves that the doctor is a sadist, since this motion tends to produce back pain in 98% of people with an existing lower back issue. In no way is it possible to accurately diagnose a herniated disc using a straight leg raising test or any type of physical exam. Any care provider who claims this is a quack, plain and simple.
All doctors who claim these wondrous feats know that they are full of crap. However, since the majority of people have herniated discs, it is a safe assumption for them to predict a disc abnormality knowing that “supportive evidence” based MRI or CT scan will demonstrate herniations in MOST adults and disc degeneration in ALL adults.
If your doctor claims that you have a herniated disc without proper diagnostic evaluation and confirmation, then go elsewhere, at the very least, and consider reporting them to their local regulatory board for review if you feel a bit pissed off from their attempt to treat you like a fool and an easy mark.
Herniated Disc > Herniated Disc Diagnosis > Herniated Disc Test
