Patients often ask: Does lumbar pain mean a herniated disc? Is a herniated disc and a lumbar strain the same thing? How to distinguish between the two? Clinically, there are some similarities between lumbar disc herniation and lumbar muscle strain in terms of symptoms: for example, both of them will have symptoms such as back pain and weakness, but they are two completely different diseases. The following four methods can help you distinguish between lumbar disc herniation and lumbar muscle strain: one of the differences: whether the activity is restricted In patients with lumbar back strain, their lumbar mobility is generally not greatly affected, usually when they get up in the morning or when they are sedentary, the lumbar back pain is triggered to intensify, but on the contrary, the activity can be significantly relieved. However, patients with lumbar disc herniation often have difficulty bending in at least one direction, such as forward, backward, left and right. The pain of lumbar disc herniation is divided into three types: first, only lumbar pain, second, only leg pain, and third, both lumbar pain and leg pain. Since lumbar disc herniation mostly occurs in the lumbar 4/5 and lumbar 5/sacral 1 intervertebral spaces, and the sciatic nerve comes from the lumbar 4, 5 and sacral 1-3 nerve roots, patients with lumbar disc herniation mostly have sciatica, or some have leg pain that starts from the buttocks and gradually radiates to the posterior lateral thigh, lateral calf, dorsal foot and lateral plantar and toe. The difference is that lumbar strain usually only has lumbar pain, so the first thing to look at to distinguish between the two is whether the patient has leg pain. Difference No. 3: whether the pressure point is in the middle or on both sides For patients with pure lumbar pain, some patients with lumbar disc herniation have pressure pain in the spinous process or spinous space, and the pressure pain point is mainly located next to the spinous process, 1.5-3.0 cm from the midline, that is, in the middle of the back. When pressure pain is present, there may be radiating pain in the lower extremities along the nerve root course. Patients with lumbar back strain usually have no pressure pain between the spinous processes of the lumbar vertebrae, while there is localized pressure pain in the lumbar back muscles, that is, in the muscles on either side of the lumbar back away from the midline of the back. In particular, if the location of the pain is not clear and there is no obvious pressure point, it is more likely to be low back pain caused by lumbar intervertebral discs, professionally known as lumbar discogenic low back pain. In terms of pain, lumbar discogenic low back pain is a vague pain, while lumbar back strain is a sore and swollen pain, or even a severe pain. Difference No. 4: Imaging examination Use X-ray, CT or MRI to differentiate. The frontal and lateral X-rays of the lumbar spine in patients with lumbar disc herniation often show lumbar scoliosis, narrowing of the corresponding vertebral space, unequal width on both sides, and bone formation. Lumbar back strain is a chronic injury to the muscles, fascia and ligaments of the lumbar region, which is mainly characterized by lumbar pain and a normal spinal profile. In contrast, CT or MRI can accurately detect the degree of degeneration of the lumbar disc and clarify whether the lumbar disc is herniated.