SYMPTOMS OF HERNIATED LUMBAR DISK

• severe low back pain
• pain radiating to the buttocks, legs, and feet
• pain made worse with coughing, straining, or laughing
• tingling or numbness in legs or feet
• muscle weakness or atrophy in later stages
• muscle spasm

SYMPTOMS OF HERNIATED CERVICAL DISK

• neck pain, especially in the back and sides
• deep pain near or over the shoulder blades on the affected side
• pain radiating to the shoulder, upper arm, forearm, and rarely the hand, fingers or chest
• pain made worse with coughing, straining, or laughing
• increased pain when bending the neck or turning head to the side
• spasm of the neck muscles
• arm muscle weakness

A physical examination and history of pain may be sufficient to diagnose the disorder. A neurological examination will be performed to evaluate muscle reflexes, sensation, and muscle strength. Often, examination of the spine will reveal a decrease in the spinal curvature in the affected area.

Straight-leg-raising test that reveals leg pain is diagnostic of a herniated lumbar disk.

A "foraminal compression test of Spurling" will be performed to diagnose cervical radiculopathy. This is performed by bending the head forward and to the sides while downward pressure is applied to the top of the head. Increased pain or numbness during this test is usually indicative of cervical radiculopathy.

DIAGNOSTIC TESTS

• A spine X-ray may be performed to rule out other causes of back or neck pain. However, it is not possible to diagnosis herniated disk by spinal X-ray alone.
• A spine MRI and/or spine CT will show spinal canal compression by the herniated disk.
• A myelogram may be performed to define the size and location of disk herniation.
• An EMG may be performed to determine the exact nerve root(s) that is (are) involved.
• A nerve conduction velocity test may also be performed.