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Check out the article in Spine, 1997, vol 22, no.10. A Prospective Study of Centralization of Lumbar and Referred Pain. Authors: Donelson, April, Medcalf and Grant. Study Design: The presence or absence of rapidly centralizing, peripheralizing or abolishing low back and radiating pain, as identified during a McKenzie mechanical lumbar assessment of patients with chronic lumbar pain, was compared prospectively with discographic pain provocation and annular competency. Methods: Patients with chronically disabling low back pain who were referred for discography underwent preliminary blinded McKenzie clinical assessment and were categorized into three groups by their pain response. Patterns, or lack therof, of pain response were then compared with blinded discographic pain provocation and anular findings. Conclusion: The McKenzie assessment process reliably differentiated discogenic from nondiscogenic pain (P<0.001) as well as competent from incompetent anulus )P<0.042) in symptomatic discs and was superior to magnetic resonance imaging in distinguishing painful from nonpainful discs. Kevin Olson, PT On Fri, 12 Jan 2001, Lorraine Flaherty wrote: > Is your friend better or worse? > Its important to remember that though he may have a "prolapsed disc" that > may not be what is causing his symptoms. > > At 07:14 PM 1/11/01 -0500, you wrote: > >An old friend has phoned me tonight "furious" that he has been treated for a > >"muscular" injury to his back which he has now been told is in fact a > >"prolapsed disc". Apparently he was seen by a clinic specialist who said he > >should not have been doing the exercises he had been advised to do. > > > >It all sounds very odd but my question is mainly concerned with diagnosis. > >Specifically, does anyone know of any clinical assessment techniques which > >can unequivicably (hope I spelt that right) diagnose a prolapsed > >intervertebral disc. Everything I have read in the past would suggest not > >but I thought I would check before I get back to my friend. > > > >Your collective wisdom is appreciated. > > > >Stewart Harrison > > > Lorraine M. Flaherty, P.T. > Staff Physical Therapist > The Pennsylvania State University > Room 3 Ritenour Building > University Park, PA 16802 > (814) 865-7381 >