What tests can diagnose lumbar herniation? No single test can diagnose lumbar disc herniation. After the doctor takes a detailed history and clinical physical examination of the patient, the diagnosis is made comprehensively by combining the results of related examinations. CT examination shows the location, size and shape of the herniated disc and the image of the nerve root and dural sac compressed and displaced, and at the same time, it can show the hypertrophy of the vertebral plate and ligamentum flavum, hyperplasia and hypertrophy of the small joints, and the narrowing of the spinal canal and lateral fossa, etc. It can also rebuild the stereoscopic morphology of the spinal canal and the root canal with three-dimensional technology. In addition, the combination of spinal myelography with water-soluble contrast agent and CT examination can improve the accuracy of diagnosis. MRI examination is of great significance in the diagnosis of disc herniation. Through sagittal images at different levels and multi-directional images of the involved discs, the morphology of the herniated disc and its relationship with the surrounding tissues can be observed. For patients who cannot undergo MRI, myelography can also be performed with a high degree of accuracy. Why does my doctor want me to have an X-ray, CT, or MRI? X-ray, CT and MRI have their own advantages and disadvantages and are complementary. Patients with lumbar disc herniation will first undergo X-ray examination to rule out other bone lesions. For patients with lumbar disc herniation, CT examination is considered when there is a suspicion of bony abnormalities (clefts, epiphyseal dislocations). Magnetic resonance imaging (i.e., MRI) is a soft tissue (disc herniation site, direction, and spinal nerve root compression) examination method. In addition to clinical history and physical examination, MRI has been a commonly used diagnostic test for lumbar disc herniation. Can the diagnosis of lumbar herniation be confirmed only by X-ray? X-ray examination cannot confirm the diagnosis of lumbar disc herniation. The diagnosis of lumbar disc herniation can only be made after considering the clinical symptoms, physical examination and imaging results, and differentiating the diagnosis from other diseases. x-ray film can only indicate the changes in the bone quality of the patient, whether there is any abnormal development of the bone, bone destruction, and bone hyperplasia. Can lumbar herniation be ruled out if the imaging is normal? The diagnosis of lumbar disc herniation is based on a combination of clinical symptoms (low back pain and radiating pain in the lower limbs), physical examination (signs of nerve damage, sensory-motor deficits, urinary and fecal abnormalities), and imaging tests (which show the location, direction, and extent of the lumbar disc herniation). A normal imaging test cannot completely exclude lumbar disc herniation. While imaging tests have a certain false-positive rate, MRI has a very low false-positive rate (less than 10%) for the diagnosis of lumbar disc herniation. What conditions are easily confused with lumbar herniation? How to identify? 1. Lumbar spinal stenosis. Intermittent claudication is a typical symptom of lumbar spinal stenosis. Patients complain of soreness, numbness and weakness of the lower limbs after walking for a certain distance, which must be relieved by squatting and resting, and they can continue walking. Cycling can be asymptomatic, and physical examination can be no obvious positive signs, in addition to the symptoms and signs are different, MRI examination can help identify. 2.Lumbar spine tuberculosis. Patients with lumbar spine tuberculosis have symptoms (low afternoon fever, night sweats, emaciation accompanied by long-term persistent dull pain in the lumbar region, physical examination can see the lumbar protective ankylosis of all the activities of activity limitation activities, laboratory examination of hematocrit increase, X-ray radiographs show the degree of bone destruction, the comprehensive symptoms, signs and imaging can be differentiated from lumbar intervertebral disc herniation. 3.Spinal tumor. Generally for the elderly patients, there may be a history of primary tumors in other parts of the body, persistent pain at night, X-ray and CT examination can clarify the bone destruction, MRI examination shows the range of soft tissue invasion, size. 4.Pelvic outlet syndrome. Pelvic outlet syndrome refers to the symptoms similar to lumbar disc herniation caused by irritation or compression of the sciatic nerve when it passes through the pelvic outlet, mainly sciatic nerve trunk irritation symptoms, radiating pain along the sciatic nerve traveling from the buttocks, accompanied by motor, sensory or reflex disorders of its innervated area. Physical examination, imaging findings can help identify, local closure can also identify lumbar disc herniation. 5.Third lumbar transverse process syndrome. The third lumbar transverse process syndrome usually has a history of trauma. Physical examination can find the tip of the third lumbar transverse process tenderness, local muscle spasm or muscle tension. Physical examination, imaging results can help identify, local closure can also identify lumbar disc herniation. 6.Lumbar myofasciitis. The onset of middle-aged people most often due to excessive muscle use or due to strenuous activities after the onset of the disease, the examination due to muscle protective spasm and side bending and movement limitation, obvious pressure points; affective examination is not obvious abnormality. Is it necessary to treat lumbar herniation without symptoms? The diagnosis of lumbar disc herniation without symptoms is not established if it is only a result of imaging tests. If the diagnosis of lumbar disc herniation is made, the symptoms disappear after active conservative treatment. Pay attention to the following points in your daily life: 1. Sleep on a hard board bed. Sleeping on a hard board bed can reduce the pressure on the intervertebral disc . 2, do not do excessive bending movements, do not bend over when lifting heavy objects, you should first squat down to get the heavy objects, and then slowly get up, and avoid long bending and excessive weight bearing. 3, the same position should not be maintained for too long, appropriate in situ activities or low back activities. 4.Swimming (breaststroke), walking backwards, etc. can be carried out to practice the muscle strength of the neck, waist and back. What are the treatment options for lumbar herniation? On the whole, most of the patients with lumbar disc herniation are still treated conservatively, and there are various methods of conservative treatment, which are chosen according to the different conditions of the patients. First of all, bed rest is the most basic and important treatment, because the intervertebral discs play a role in supporting our body weight in normal life, and the discs have to bear a great deal of weight when we are standing upright or sitting down, and the pressure inside the discs is very high at this time, and the pressure on the nerve roots is correspondingly heavier. Most people are not very heavy lumbar disc herniation, such as bulging, herniation through bed rest, the entire spine is completely relaxed, the pressure of the disc to reduce the pressure on the nerve root it reduces the squeeze, at the same time there are patients with disc compression of the nerve root, the nerve root itself will be some inflammation, when you rest in bed, the pressure of the disc is light, the nerve of the swelling will slowly subside, in fact, also achieved The purpose of treatment. There are more than ten ways to treat lumbar protrusion, 80% of them are through conservative treatment, if the conservative treatment can’t solve the problem, we have to seek some other methods. Certain drugs can also play a better role, these drugs are mainly for the inflammatory response, reduce the edema of the nerve root, reduce the local inflammatory response, through these measures to play a role in relieving pain. Various lumbar protrusion therapeutic instrument, is it effective? Television, newspapers and other media have a large number of treatment of lumbar disc herniation instrument advertisements, these advertisements are inaccurate efficacy, most of the over-exaggerated efficacy of the therapeutic instrument may be able to relieve muscle spasm, but for the intervertebral discs, through the instrumentation of the protruding disc recovery is not possible. Generally, patients with herniated discs will feel hardness and muscle spasms in the lower back. Through some instruments more gentle method, may also play a relief muscle spasm, so that the waist feel comfortable, can be for relaxation of muscle tension has a certain effect, for lumbar muscle strain and other diseases can play a certain role,. Some instruments rough treatment process, and even aggravate the symptoms of lumbar disc herniation. Patients should still be used with caution, should consult a regular hospital physical therapy department for formal scientific conservative treatment. Is there a secret recipe for lumbar herniation? For the treatment of lumbar disc herniation, there is no secret recipe, special medicine, prescription. The disease should be diagnosed formally and treated scientifically. Treatment methods are mainly divided into conservative treatment and surgical treatment. Conservative treatment is mainly through drugs, rest, physical therapy to reduce symptoms, but conservative treatment can not solve the problem of lumbar disc herniation from the root. Surgical treatment is suitable for patients with more serious symptoms, ineffective conservative treatment, or patients with recurring symptoms that continue to worsen. There are many different types of surgical methods, and the surgeon will choose a surgical method based on the patient’s age, gender, weight, occupation, subjective requirements, as well as the extent of the herniated disc, the scope of the herniated disc, the degree of nerve damage, and other comprehensive factors.