Pain in the lower back can be difficult to diagnose, especially when symptoms are fairly generic or felt elsewhere as radiating nerve pain. Possible sources of this type of discomfort may include muscle strain, spinal joint fractures, and damage to one or more of the discs that cushion the backbone as it moves. To determine if lumbar (lower back) degenerative disc disease (DDD) is the cause of the pain, Los Angeles back surgeons often take several steps to achieve a positive diagnosis.
1. Reviewing Patient History
Everybody has different experiences with back pain that could provide clues to determine if lumbar DDD is what’s causing it. During a typical assessment, you will likely be asked to describe your pain in as much detail as possible and discuss when it often occurs, how long it lasts, and where it’s felt.
Patient evaluations may also include identification of any underlying conditions that may be a contributing factor, such as cancer, diabetes, or high blood pressure, and discussions about what treatments have already been attempted and the results experienced. Write down your answers to these questions ahead of time so you won’t forget any important details.
2. Conducting a Thorough Physical Exam
A physical exam gives a doctor an idea of what may be causing the pain, or at least narrows possible sources down. Even if your pain is felt elsewhere, the focus of the exam will be on your lower back since this is where the actual source of the discomfort originates. A physical exam to identify lumbar degenerative disc disease often involves:
- Range of motion testing
- An assessment of muscle strength and sensation
- Evaluating the curvature and alignment of the spine
- A test of reflexes
- Identification of any tenderness in the lower back
- A gait assessment
3. Performing Various Image Tests
If a positive diagnosis can’t be made after a physical exam and a review of your medical history, image tests may be performed. Such tests may also be done to confirm a suspected condition or to identify the specific problem area in the lower back. X-rays are typically the first test performed. Since X-rays can only show bones and joints but not soft tissues, MRI and CT scans may be performed as well to rule out or confirm related issues.
X-rays may also be taken after MRI and CT scans or reevaluated to further pinpoint the true source of your discomfort after other scans are done. MRIs can help a doctor identify which nerves or nerve roots are irritated. Image testing may help confirm or identify:
- Collapsed disc spaces
- ]Sciatic nerve irritation
- Spinal deformities like scoliosis or spinal stenosis
- Issues with muscles, tendons, or ligaments
- Bony growths on the spine (osteophytes)
- Spinal fractures
Degenerative disc disease rarely requires surgery unless other treatment attempts have failed to provide significant relief. The condition is unique because discomfort sometimes subsides or goes away entirely over time. It’s also possible to have worn discs that aren’t the true source of your pain. If disc degeneration is the suspected cause of your discomfort, non-surgical techniques like physical therapy, chiropractic care, epidural injections, and exercise to strengthen spine-supporting muscles may help manage the condition.
Dr. Hyun Bae and his team of expert spinal surgeons at The Spine Institute can determine if your pain is the result of lumbar DDD or another condition. Depending on the diagnosis, there are a variety of treatment options, including fusion surgery and Mobi-C disc replacement. Los Angeles residents seeking a diagnosis for their pain as well as an effective solution for relief should call 310-828-7757 today.