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Disk Herniation? Maybe, Maybe Not. When Do I need an MRI?

Posted Jun 02 2009 4:34pm

San Francisco Chiropractor and Herniated Disk Specialist comments:

How do you know if you have a herniated disk in the neck, or a herniated disk in the low back?

Axiom_marketing_dvd_114 Just because you have severe low back pain, or severe neck pain, does not mean you have a ruptured disk, or even a bulging disk. You can even have the classic symptoms of a herniated disk, such as arm or leg pain, weakness, numbness /tingling in the arms or legs, and it still does not mean the disk are herniated. Sure, these signs and symptoms suggest there MAY be disks that are bulging or protruding into the spinal cord or nerve roots, but it is not conclusive evidence.

So how do you know then? 

A cervical or lumbar MRI is considered the gold standard for confirming the existence of a herniated disk in the spine. Is an MRI necessary if I have neck or back pain, or arm/leg pain? Well, not at first. If conservative treatments such as chiropractic care, physical therapy, or medical care, does not provide relief after a reasonable period of time (determined by severity), an MRI should be ordered to rule out bulging or herniated disks, as well as spinal stenosis. 

Why not just have the MRI right away?

Well, most cases of back or neck pain resolve with conservative treatment. And, it may not even be the disk herniations that are causing the symptoms. By treating the patient with conservative care at first, it gives the back or neck condition a chance to heal without subjecting the patient to unnecessary testing and expense. It's what has shown to work the best over time.

Now, if someone can't get up off the floor, or has trouble controlling their bladder, or has a sudden onset of excruciating, unrelenting, unbearable back pain, it is probably best to go to the emergency room, and then get an MRI. The doctor will decide based on the individual circumstances.

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