Lower Back Pain: Don't Lie Down
Back Pain: How Do I Know if I Herniated a Disc?
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Many patients with lower back pain want to know if they have herniated a disc, or if their pain is merely a lower back strain. Here are some tests that can help you differentiate between these two types of lower back injuries. As always, it is a good idea to seek out medical attention with any back pain that will not go away!
1. In general, disc herniations hurt both with bending forward AND with returning from bending up to an upright position. Back strains or sprains tend to hurt less with bending forward, and more with returning from a forward bend.
2. Herniated discs are often associated with shooting pain and numbness that travels down one of the legs. Lower back sprains and strains tend to have "centralized" pain (only in the lower back).
3. Herniated discs can cause weakness in a leg. Sometimes patients will experience repetitive "stubbing" of his or her toes while walking. This is a manifestation of certain muscles losing strength and not being able to adequately clear the foot from the floor while walking. Someone with a herniated disc will also often not be able to walk on his or her toes on one side.
4. Many people with a herniated disc will have a dulled patellar or heel-cord reflex on the involved side. Most people have had this test performed on them during a doctor visit. The patient is seated with the legs dangling off the side of the table. The doctor hits the patellar tendon with a rubber hammer just below the kneecap, and the lower leg momentarily jerks. If one leg has a muted response to this test, the cause may be a herniated disc.
5. In severe cases of disc herniation, bowel and bladder control is compromised. If this happens to you, immediately seek the attention of your doctor.
The good news here is that the vast majority of disc herniations do not require surgery. Medication, diagnostic imaging (such as an MRI), formal physical therapy, and rest are all part of the recovery equation. Do not try to manage this type of diagnosis on your own!
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