The Essence of Clinical Practice Guidelines for Lumbar Disc Herniation, 2021: 3. Diagnosis

The disease name "lumbar disc herniation" may be used without careful consideration by patients based on subjective symptoms and by healthcare professionals on the basis of imaging data. In reality, however, it is difficult to diagnose that "lumbar disc herniation is the cause of clinical disorders" based solely on clinical symptoms, such as radiating pain in the lower legs, or imaging findings, such as lumbar disc herniation (including intervertebral disc bulging) on MRI. Moreover, diagnosis of the affected levels and damaged nerve roots on the basis of only clinical findings is not very accurate. This is attributable to many factors, such as the presence of a wide variety of pathological conditions manifested as radiating pain in the lower legs, morphological varieties of lumbar disc herniation (with/without extrusion, localization), and frequent detection of asymptomatic intervertebral disc herniation, particularly in elderly patients because of advances in image analyzers, such as MRI. Therefore, lumbar disc herniation/damaged nerve roots should be diagnosed comprehensively based on medical interviews, physical findings, and diagnostic imaging.