If you’ve been having back or neck pain, especially pain shooting down your arms or legs, you might be asking yourself if you have a herniated disc – and if an X-ray can confirm it. It’s a question we hear all the time at Accurate Imaging Diagnostics.
The short answer is: an X-ray can’t show a herniated disc directly, but it can still play a valuable role in your diagnosis.
What Is a Herniated Disc?
Between the bones in your spine (vertebrae) are cushioning discs made of cartilage and soft gel. The discs serve as shock absorbers and enable your spine to move freely. A herniated disc happens when the inner gel bulges through a tear in the outer layer. This can irritate or put pressure on nearby nerves, causing pain, tingling, or weakness.Symptoms vary based on the site of the herniation. For example:
- In the lower back (lumbar spine), it can lead to pain that shoots down your leg.
- In the neck (cervical spine), it can go down your shoulder or arm.
Here’s the thing, though: you can’t visualize the disc itself on an X-ray—at least, not very easily.
What Can an X-ray Show?
Although X-rays do not show soft tissues like discs or nerves, they do show bones in detail. An X-ray, therefore, can still help your doctor by showing:
- Disc space narrowing: Decreased space between vertebrae may point to disc degeneration.
- Bone spurs (osteophytes): These are sometimes formed because of disc wear and tear.
- Alignment problems: Abnormalities like spondylolisthesis (slipping of one vertebra over another) are readily apparent.
- Signs of instability: Seen in special bending views (flexion-extension X-rays), which can help detect abnormal movement between bones.
- These are not direct signs of a herniated disc—but they can support the suspicion that a disc problem is present.
What Can’t an X-ray Do?
It is important to understand what X-rays cannot do, especially if you’re expecting them to answer everything.
- They cannot show the disc material itself—the gel that bulges when a disc herniates is not visible on plain film.
- They cannot show nerves or the spinal cord and thus won’t show if a nerve is being pinched.
They cannot confirm or rule out a herniated disc with certainty.
That is why physicians don’t base a disc diagnosis on X-rays alone. Rather, they use the X-ray to search for other potential explanations for your symptoms, or to determine whether more sophisticated imaging might be necessary.
Why Would Doctors Order an X-ray First?
Although X-rays don’t visualize herniated discs directly, they are commonly the initial imaging study ordered for back pain. Here’s why:
- They are quick, non-invasive, and low radiation.
- They help to rule out serious conditions like fractures, tumours, or infections.
They are typically ordered if a patient presents with “red flag” symptoms, which include:
- Sudden onset of severe back pain after trauma
- History of cancer
- Unexplained weight loss or fever
- Night pain or pain on resting
- Loss of bladder or bowel control
In these cases, an X-ray provides important information that determines the next step.
Do I Still Need an X-ray if I’m Getting Referred for MRI?
Perhaps, yes. A majority of physicians use X-rays to rule out other causes of pain or to confirm the overall health of your spine before going on to more detailed imaging. Occasionally, if your symptoms are improving, your doctor might hold off on additional scans altogether.
Our Role at Accurate Imaging Diagnostics
At AID, we offer fast, concise, and accurate X-ray imaging to help your physician make the appropriate decisions for your care. We use digital X-ray technology, delivering high-quality images with low exposure to radiation. If you have been referred to us for a spine X-ray, we will get you in, out, and on your way—usually in 15 minutes or less.
Your X-rays will be interpreted and sent to your doctor promptly, who will use them—along with your symptoms and history—to decide if further testing or treatment is warranted.
