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Herniated nucleus pulposus - Symptom

Alternative Names

Lumbar radiculopathy; Cervical radiculopathy; Herniated intervertebral disk; Prolapsed intervertebral disk; Slipped disk; Ruptured disk

Symptoms:

SYMPTOMS OF HERNIATED LUMBAR DISK

SYMPTOMS OF HERNIATED CERVICAL DISK

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

Signs and tests:

A physical examination and history of pain may be all that is needed to diagnose a herniated disk. A neurological examination will evaluate muscle reflexes, sensation, and muscle strength. Often, examination of the spine will reveal a decrease in the spinal curvature in the affected area.

Leg pain that occurs when you sit down on an exam table and lift your leg straight up usually suggests a herniated lumbar disk.

A foraminal compression test of Spurling is done to diagnose cervical radiculopathy. For this test, you will bend your head forward and to the sides while the health care provider provides slight downward pressure to the top of the head. Increased pain or numbness during this test is usually indicative of cervical radiculopathy.

DIAGNOSTIC TESTS

  • EMG may be done to determine the exact nerve root(s) that is (are) involved.
  • Nerve conduction velocity test may also be done.
  • Myelogram may be done to determine the size and location of disk herniation.
  • Spine MRI or spine CT will show spinal canal compression by the herniated disk.
  • Spine x-ray may be done to rule out other causes of back or neck pain. However, it is not possible to diagnosis herniated disk by spinal x-ray alone.
  • Reviewed last on: 5/12/2008
  • Thomas N. Joseph, MD, Private Practice specializing in Orthopaedics, subspecialty Foot and Ankle, Camden Bone & Joint, Camden, SC. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.