Orthopedics-Online

How do I distinguish a herniated disc from a lumbago?

introduction

The herniated disc is a suddenly onset "disease" that occurs when the core of an intervertebral disc, which is located between the individual vertebrae of the spine, loosens from its anchorage and begins to press on the spinal cord.
This causes a sudden onset of pain and, depending on where the nucleus presses on the spinal cord, can also lead to motor and sensory disorders in the arms or legs - depending on where the nucleus hits the spinal cord.

Read more about the symptoms of a herniated disc at:

disc prolapse

Lumbago, technically also called lumbago, is also a sudden onset of "illness".
It usually affects the lumbar region and is caused by a vertebral blockage or muscle strain.
The pain can also radiate upwards into the chest area.
As a rule, the affected person is unable to move at first and falls into a relieving posture to relieve the back.

Read more detailed information about lumbago at:

Lumbago

What is the difference between a herniated disc and lumbago?

The biggest difference between a herniated disc and lumbago is the damaged structure:

While the problem with lumbago is cramped muscles or blocked vertebrae, which convey the pain via intact nerves, irritated nerves are the problem with herniated discs.
Due to their irritation, they give the feeling that one also has pain in the leg, without a pain-causing wound or the like on the leg itself. can be determined.
Furthermore, the two injuries differ in the way the pain spreads:

While the pain in lumbago is clearly localized in the back and can also occur on both sides, the pain in a herniated disc usually only radiates on one side, usually along a line.
In addition, there may be impaired sensitivity within this line.
The two diseases also differ in their treatment:

While the herniated disc usually has to be treated surgically in order to bring the leaked core of the intervertebral disc back to its original location, conservative methods are usually sufficient for treatment in the case of lumbago.
Starting with protection and warmth, through physiotherapy to loosen blockages, to injecting painkillers and muscle relaxants, this therapy differs significantly.
Furthermore, the behavior after the acute event is completely different:

While you should make sure to move as little as possible before the operation with a herniated disc, movement helps, especially with lumbago, to loosen the cramped muscles again and to escape the usually accustomed relieving posture.

These symptoms suggest a herniated disc

Typical signs of a herniated disc are, in addition to the sudden onset of pain, the connection with motor and sensory deficits.
In concrete terms, this means that an arm or a leg can no longer be moved as easily as one was used to.
In extreme cases, it can even happen that one arm or leg is completely paralyzed.

The decisive criterion for a herniated disc, however, is that this failure occurs only on one side.
If both sides were equally affected, then 99% of the time it is not a stroke.

Furthermore, there are sensory disorders in certain areas of the body - but again only on one side.
These disorders run along the so-called dermatome lines. Using this line, the doctor can also draw conclusions about the height of the spinal cord at which the herniated disc must have occurred, since each dermatome line corresponds to a nerve outlet from the spinal cord.

Furthermore, certain muscles can be assigned to each of these exiting nerves, which they mainly control.
For example, the nerves from the L4 spinal cord segment mainly innervate the large thigh muscle, which is responsible for stretching the leg - the quadriceps femoris muscle.
In the case of a herniated disc in the corresponding area, the reflexes that the key muscles check are weakened or sometimes no longer exist.
In the specific example, this would mean that a blow under the kneecap would no longer cause reflex leg extension. In this sense, reflexes on the arms or others on the legs can also be tested.

Still not sure how to identify a herniated disc without a doubt? Find out more at:

Recognizing a slipped disc - these are the symptoms

Appointment with a specialist for a herniated disc?

I would be happy to advise you!

Who am I?
My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
Various television programs and print media report regularly about my work. On HR television you can see me every 6 weeks live on "Hallo Hessen".
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A herniated disc is difficult to treat. On the one hand it is exposed to high mechanical loads, on the other hand it has great mobility.

Therefore, treating a herniated disc requires a lot of experience.
The aim of any treatment is treatment without surgery.

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

You can find me in:

Lumedis - your orthopedic surgeon
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60311 Frankfurt am Main

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Further information about myself can be found at Dr. Nicolas Gumpert

These symptoms suggest lumbago

The signs of lumbago or lumbago are usually a little less specific.
Typically, lumbago results from movement or exertion that involves the back.
Often the back muscles are not warmed up and therefore not “able” to cope with the strain.

The lumbago occurs suddenly more clearly than with a herniated disc.
Those affected can name a very specific posture within the movement just performed, when the pain in the back began.
Those affected then fall into a so-called relieving posture, in which the back pain is most bearable.

As a rule, there is no loss of sensitivity in the lumbago along certain dermatome lines or a reduction in strength in the arms or legs. The primary focus here is really the pain in the back.

When the muscles running next to the spine are touched, they are usually as hard as a board, as a result of tension in order to protect the person's back. If the doctor feels the vertebral processes of the spine, this provokes a pain that usually extends over several spinal cord segments.
In lumbago, patients also respond very well to painkillers that are applied to the back near the tense muscles. In addition, so-called muscle relaxants can ensure that the hardened back muscles loosen up again.

Read more detailed information on the symptoms of lumbago on the main page:

Lumbago

Is there a test to distinguish a herniated disc from lumbago?

There is no one hundred percent test to separate the two phenomena.
However, a series of small tests or pieces of evidence make one or the other event more likely or less likely.

If back pain and the sudden onset of a movement are in the foreground for the person affected, this strongly suggests lumbago.
However, if the patient complains of impaired sensitivity and can no longer move arms or legs properly, this is a very strong indication of a herniated disc. In the same way, weakened or no longer triggerable reflexes are the most likely to indicate a herniated disc.

An imaging test (a CT or MRI) also helps differentiate. If in doubt, the intervertebral disc can be identified here.

You might also be interested in:

MRI for a herniated disc

This is how the pain differs:

The pain in lumbago is strongly dependent on movement and posture and can usually be massively increased by light pressure on the spine or the muscles next to it.
In the case of a herniated disc, on the other hand, the pain usually radiates into an arm or leg and cannot be precisely localized. Pressure on the arm or leg does not increase the pain any further.

While the pain in lumbago can be relieved by a local anesthetic, in the case of a herniated disc this usually does not bring any real improvement in pain.

Your back pain is different than described in the article? Find out what else could be behind your back pain: