There many terms that can describe as spinal disc pathology or herniated disc, “pinched a nerve and bulging discs” all are used different and times people use them interchangeably.
Even today, Healthcare professionals do not agree on the precise definitions of any of these terms, which can lead to frustration for patients as they may be diagnosed with different conditions. There are a wide variety of ways that people may describe spinal disc problem. For example:
- Slipped disc
- Ruptured disc
- Torn disc
- Collapsed disc
- Disc protrusion
- Black disc
- Disc disease
All are contributing to this confusion.
Rather than be concerned about the term that is used to describe the disc, it would be helpful for you to gain an understanding of the specific medical diagnosis.
The medical diagnosis identifies the actual cause of the patient’s back, or leg pain, along with any additional symptoms.
Medical professionals determine the cause of a patient pain by looking at a combination of exams and test, including:
A complete physical exam
Review the patient’s medical history
Diagnostic test if needed.
Two cause of Pain: pinched nerve vs. disc pain
Pinched nerve- This is when the patient has symptoms of herniated disc, the disc itself may not be painful. However, there is material that is leaking out of the disc and is pinching or irritating a nerve nearby. This pathology type creates pain called radicular pain, or nerve root pain. IN radicular pain, pain may radiate to other parts of the body, such as the lower back down the leg or from the neck down the arm. Leg pain from a pinched nerve is usually defined as sciatica.
Disc pain occurs when a patient has a symptomatic degenerated disc( one that causes the lower back or leg to have pain). It is the disc space itself that is painful and is the source of suffering. This is called axial pain.
Pinch Nerve or Disc pain can occur in thoracic (upper), lumbar (lower) spine or cervical (neck). They are the most common in the lower back because the lower back has most of the torque force on a daily basis.
It is also important to note that terms such as building, disc, slipped disc or herniated disc reference radiographic conclusions seen on a CT scan or MRI scan. Although these test results are essential, they are not as important in determining the cause of pain as the patient’s particular symptoms and the doctor’s physical exam results.
A medical diagnosis or clinical diagnosis focuses on determining the underlying cause of a patients’ back nerve pain, neck pain, or other symptoms. Four steps occur before arriving at a clinical diagnosis for a pinched nerve or disc pain.
Physical examination – depending on the patients Symptoms a physical examination may include one or more of these test.
Nerve function in particular parts of the leg or arm. This test involves topic specific areas with a reflex hammer If the patient has little or no reaction it is possibly characteristic of a compressed nerve root in the spine.
Muscle Strength. To get a better understanding of where a herniated disc squeezes the spinal nerve root, the physician will likely conduct a neurological exam to evaluate muscle strength. The doctor may also ask the Opa Trin ETB to undress partially to view the muscle tissue, mainly to discover if there is muscle twitching, atrophy or any abnormal movements.
Pain with palpation or motion. Palpating (touching) certain structure can give some understanding of what is generating pain
1Pain over the scrolling joint – at the very bottom of the spine – to palpation may mean the patient has sacroiliac joint dysfunction
Pain with straightening the leg can be suggestive of a pinched nerve.
Pain with the pressure off on the low back may indicate pain from a degenerative disc.
2. Review of specific symptoms – A complete review of symptoms will include the location of pain, as well as classification of how the pain feels such a searing vs. dull pain or ache) Your doctor will determine if certain positions or treatments make pain feel better or worse.
3. Review medical history – The doctor will do a full check of your medical background and to identify ay possible conditions that may cause the patient pain. The history includes information and recurring health problems, previous diagnosis, prior treatment or surgeries, along with reaction to this treatment, and family history of illness
4. A diagnostic test is completed after the an opinion is formed about the patients’ pain. The diagnostic test may be ordered to confirm any disc problems or gain additional information, such as the location of the impinged nerve roots or herniated disc. There are multiple options for diagnostic test including:
- CT Scan – Computerized tomography (CT) scans functions similar to X-rays in that X-ray beam is out through the body – Computer reformatting the image access sections of the spine.
- Discourse- If surgery for disc pain is considered, some doctors may recommend a discogram for the purpose of verifying which disc is painful, In this test, the radiographic dye is injected into the disc is painful. In this test, the radiographic dye is inserted into the disc, with the knowledge that a patient is hurting from disc pain (degenerative disc disease) if the injected dyes recreate the normal pain. This test is controversy as to whether or not is valid, accurate analysis, and many doctors do note use discography except in rare situations.
- MRI Test findings of an MRI scan or other diagnostic test are a definite diagnosis of a herniated or degenerated disc. Many individuals over the age of 30 will have some level of disc problems, but fewer people experience pain.
Physical exams and symptoms should be aligned with the MRI and other test findings to develop an accurate medical diagnosis. This will allow the doctor to create an effective treatment plan.
It is important for the physician to diagnose the cause of the patients accurately back pain.
Surgery may be an option when non-surgical options such as pain medication, injections. Physical therapy and chiropractor care are not effective to provide relief.
Spine surgery can only alleviate pain if the herniated or degenerative disc observed in the MIR is the actual cause of pain. If this is the case, Then the following surgery may be an option.
Microdiscectomy for a herniated disc which the herniated portion of the disc is removed.
Spinal fusion is from degenerative disc disease when the intent is to fuse the disc space is remove the motion.