There are 4 stages to disc injury. Disc injuries are commonly misdiagnosed or under diagnosed. The result of this misdiagnosis is long term worsening of the condition.
Stage 1 – Disc swelling/bulging – Can also be referred to as degeneration. Disc swelling and degeneration can result from wear and tear, aging or trauma. This condition often goes undiagnosed because it will usually resolve itself if the person removes the irritant. It is common for x-rays (which do not show disc swelling) to show “nothing is wrong”. It is also common for people to be told they have a “weak core” and need to do abdominal exercises. This misunderstanding to the true nature of the problem exposes the patient to a lifetime of chronic and recurring lower back pain. If treated properly chronic pain can be avoided.
Stage 2 – Disc Protrusion – Can also be called a prolapsed. A disc protrusion results from repetitive movements such as repeated bending and twisting or can result from a specific moment in time trauma. This injury will usually cause nerve pain that will radiate in a very specific pattern into your thigh and possibly all the way to your foot. X-rays are not useful in helping to diagnose the severity of the protrusion but MRI’s are. If treated properly the protrusion can be reduced and the associated pain eliminated but if left unchecked or treated improperly the patient can and will progress to stage 3.
Stage 3 – Disc Herniation – A disc herniation is the area between a disc protrusion and extrusion. It is a severely debilitating lower back injury that causes nerve pain in very specific pain patterns. These patterns are predictable and reproducible if tested properly. X-rays are useless in the diagnosis of a disc herniation. MRI can be useful in diagnosing the severity of the disc herniation and helping the doctor and patient decide on a proper course of treatment whether that be conservative or surgical.
Stage 4 – Disc Extrusion – This is a severe condition that usually results from years of the person suffering from repeated bouts of lower back pain. A typical patient will present with an antalgic lean, pain radiating down their leg and a history of progressive lower back pain. A disc extrusion is often likened to squeezing the jelly out of a jelly doughnut. This condition is not reversible and is usually severely debilitating and limits the patient’s ability to function normally.
How do you accurately Diagnose Lower Back Disc Injuries?
The most important way to diagnose lower back disc conditions is to LISTEN to the patient’s history and description of their symptoms. Secondly a thorough orthopedic assessment should be performed. These orthopedic tests are commonly taught worldwide in medical schools, chiropractic schools and physical therapy colleges. These tests allow the doctor to differentiate where the pain is coming from by stressing various tissues and nerves.
Seated Leg Raise
Supine Straight Leg Raise