A herniated disc often presents with sciatica, but other symptoms such as persistent back pain, tingling in the lower limbs, muscle weakness, and limited mobility should not be ignored. If you’re experiencing these warning signs, you may be wondering: What tests are necessary for an accurate diagnosis?

What Is a Herniated Disc and Who Can Help?

Understanding the Role of the Neurosurgeon – Insights from Dr. Franco Caputi, Neurosurgeon at Ars Medica Clinic

The spine is made up of a series of vertebrae separated by intervertebral discs, which act as shock absorbers to cushion impact and support movement. When a disc degenerates or becomes damaged, its inner core may protrude and compress nearby nerves. This can result in pain, inflammation, and, in more severe cases, impaired nerve function.

If you suspect a herniated disc, your first step should be consulting your general practitioner. Based on your symptoms, they will refer you to the most appropriate specialist:

• Orthopedic Specialist → if the issue is related to poor posture or joint degeneration.

• Neurosurgeon → if the herniation is advanced and may require surgical intervention.

• Physiatrist → for conservative treatments such as physical therapy and pain management.

Among these, the neurosurgeon plays a key role due to their in-depth understanding of the spine and nervous system. They can accurately assess the severity of the herniation and determine whether significant nerve compression is present. However, it’s important to note that not all herniated discs require surgery—the specialist will recommend the most suitable treatment based on your individual clinical case.

What Tests Are Needed to Diagnose a Herniated Disc?

To confirm the diagnosis, the most effective tests include:

• MRI (Magnetic Resonance Imaging) → the gold standard for visualizing intervertebral discs and nerve structures.

• CT Scan (Computed Tomography) → useful for detailed assessment of spinal bone structure.

• X-rays → do not show the herniation directly but help evaluate spinal alignment and vertebral mobility.

• EMG (Electromyography) → used to detect nerve conduction issues caused by spinal root compression.

When Is Surgery Necessary?

In most cases, conservative treatment—including physical therapy, medications, and pain management—is enough to relieve symptoms. However, surgical intervention may be considered when:

• Pain is severe and unresponsive to conservative therapies.

• Neurological deficits occur, such as leg weakness or difficulty walking.

• There is a cauda equina syndrome, characterized by numbness in the perineal area and motor weakness in the foot. Though rare, this condition requires immediate surgical intervention.

If you’re experiencing persistent back or leg pain, don’t ignore the symptoms. Early diagnosis is essential for identifying the most effective treatment.

A herniated disc can significantly affect your quality of life, but with timely diagnosis and appropriate care, it can be effectively managed. If you’re showing signs of a herniated disc, don’t wait—consult a specialist to receive the care that best fits your needs.