Disk, Ruptered

General Illness Information


Medical Term:

Disk, Ruptured

Common Name: Herniated disk, Slipped Disk

Description: A herniated disk is a spinal disk which has collapsed and is bulging into the spinal cord, pressing on the spinal cord or the nerves emanating from it. This occurs as a result of  degeneration of the ligaments and tissues surrounding a spinal disk (i.e.. the cushion separating bony spinal vertebrae).

The disks of the lower back (lumbar) or neck (cervical) are the most common sites. 80% of cases of lumbar disk protrusion occur at the L5-S1 level. In the neck the commonest site affected is at the C6-C7 level. When it affects the cervical spine, it is called cervical spondylosis.

This condition usually affects middle-aged and older adults.

Causes: Degeneration of ligaments with or without back injury (acute or chronic) leads to slipped disk.

Prevention: Prevent back injury by practicing proper posture when lifting. Also, exercise regularly to maintain good muscle tone.

Signs & Symptoms

  • For lower back – Severe pain in the low back or back of one leg, buttock or foot (sciatica). Pain usually affects one side and worsens with movement, coughing, sneezing, lifting or straining;
  • Weakness, numbness or muscular wasting of the affected leg. In some cases of L5 involvement, the patient may develop a foot drop;
  • Difficulty with passing urine and stools (incontinence);
  • For cervical spondylosis – Pain in the neck, shoulder or down one arm. Pain worsens with movement;
  • Weakness, numbness or muscular wasting of the affected arm.

Risk Factors

  • Previous back or neck injury;
  • Heavy lifting;
  • Poor physical condition;
  • Twisting violently or jumping hard.

Diagnosis & Treatment

To confirm diagnosis, tests may include X-rays of the neck or lower spine, including myelogram (injection of dye, visible on X-ray, into the fluid around the spinal column), discography (dye is injected into the disk), CT scan, MRI and EMG or electromyography, which may help define the level of the nerve root involvement.

General Measures:

  • Apply ice packs to the painful area during the first 72 hours and occasionally thereafter, if they provide relief. Alternately, try to relieve pain with a heat lamp, hot showers or baths, compresses or a heating pad;
  • Traction at home or in the hospital (sometimes). This is mainly useful in neck lesions;
  • Surgery to relieve nerve pressure if bed rest does not relieve symptoms or if symptoms and signs worsen;
  • Rehabilitation to strengthen muscles.

Medications:

  • For minor discomfort, you may use non-prescription drugs such as acetaminophen or ibuprofen;
  • Muscle relaxants, such as diazepam or methocarbamol;
  • No steroidal anti-inflammatory drugs to reduce inflammation around the rupture;
  • Laxatives or stool softeners to prevent constipation.

Activity:

Rest in bed at least 2 weeks during the acute phase. Resume your normal activities, including sexual relations, when symptoms improve. Prolonged bed rest is not recommended.

Diet:

No special diet. Increase consumption of dietary fiber and drink at least 8 glasses of fluid a day to prevent constipation or fecal impaction.

Possible Complications:

  • Loss of bladder and bowel function;
  • Paralysis;
  • Muscle wasting and weakness.

Prognosis

Spontaneous recovery in many cases. At least 2 weeks in bed should be tried before considering other therapy unless complications occur. When necessary, a ruptured disk is curable with surgery.

Other

Nothing Specified.