Having only a single test performed during a physical exam isn't enough to accurately diagnose a herniated disc, according to new findings published in the February 2010 issue of The Cochrane Library.

Low back pain can be caused by a variety of factors. Although most people who have back pain, regardless of the cause, respond well to non-surgical treatments, a small amount of people do need surgery. To determine the severity of the back pain and if further testing is necessary, doctors rely upon the results of a physical exam.

In this study, the researchers assessed how well tests done during a physical exam accurately diagnosed patients with low back pain and sciatica caused by a herniated disc.

The researchers reviewed 19 studies that, in total, included approximately 8,000 participants. The studies compared physical exam test results with those of diagnostic imaging (such as MRI or CT scans).

Though the researchers reviewed a large number of records, there was not an abundance of solid research on this subject, according to the study's lead author, Dr. Danielle van der Windt. Most notably, only 1 of the 19 studies was carried out in a primary care setting, which means that the patients in the rest of the studies had already undergone numerous tests. Additionally, the participant group was almost entirely made up of surgical patients.

The single study conducted in a primary care setting highlighted the benefits of performing multiple tests. In the study, the researchers asked the participants about their pain, and this was followed by an extensive physical exam that included multiple tests. All the patients then received an MRI scan. The results showed that the combination of questions about the patients' medical history, thorough physical exam, and diagnostic testing most accurately diagnosed patients with a herniated disc.

This study is important because it highlights the consequences of a lack of proper testing—both for people who don't need surgery and those who do. More testing better confirms the cause of your back pain, which will allow your doctor to make the best treatment recommendations.

Dr. van der Windt said that more research must be conducted to definitively conclude that performing multiple tests during a physical exam most accurately diagnoses herniated discs.

To learn more about this study, you may read the abstract here.