History and physical examination in patients with herniated lumbar discs.

To outline the usefulness of the medical history and physical examination in the diagnosis of herniated lumbar discs, and to review the essential properties of a test, including sensitivity, specificity, and clinical value. None of the tests that are part of a history and physical examination of a patient with a disc herniation has a high diagnostic accuracy by itself. This is because positive and negative predictive values of common clinical indicators are limited. Confirmatory tests are necessary for a definitive diagnosis when making management decisions. Combining the results of history and physical findings will increase the predictive value of these basic diagnostic tools.