DISK, HERNIATED

(Ruptured Disk; Slipped Disk)

 Basic information

description

A herniated disk occurs when a tear or crack in a spinal disk's tough outer layer allows the jellylike inner part to leak (or squeeze out) into the spinal canal. The herniated disk can put pressure on the spinal cord and nerves. Disks in the lower back or the neck are affected more often than those in the upper back. Herniated disks occur more frequently in older adults.

FREQUENT SIGNS & SYMPTOMS

• Sharp or shooting pain in the lower back or neck.
• Pain may go from the buttock down the back of one or both legs (sciatica). Movement can make it worse.
• Numbness or tingling in an arm or leg. There may be weakness in one or both legs.
• Unable to bend or straighten the back.
• Back pain may develop over time in some cases. It may occur when getting out of bed or when coughing.

causes

Disks are part of the spine (backbone) and help the back to flex and bend. They act as a cushion between each of the hard bones (vertebrae) of the spine. Disks degenerate (e.g., less flexible and drier) with age. This makes them more prone to injury, such as a tear.

risk increases with

• Heavy lifting.
• Poor physical condition.
• Twisting violently or jumping hard.
• Obesity.
• Older adults.
• Degenerative disk disease (disk changes with aging).

PREVENTIVE MEASURES

• None specific.
• Use proper posture when lifting.
• Exercise regularly to maintain muscle strength and flexibility. Maintain ideal weight.

expected outcomes

Recovery usually takes about 6 weeks and is helped with simple treatment measures. If needed, surgery can relieve serious symptoms.

possible complications

• Loss of bladder and bowel function.
• Muscle loss and weakness.

 diagnosis & treatment

general measures

• Your health care provider will do a physical exam and ask questions about your symptoms and recent activities. To confirm diagnosis, tests may include MRI, CT, bone scan, and x-rays.
• For most patients, treatment with simple measures is all that is needed. This can include drug therapy for relief of pain and inflammation.
• Use ice packs to the painful area during the first 72 hours. After that, try using heat. Take warm showers or baths. Use warm compresses or a heating pad.
• Treatment may include physical therapy, traction, ultrasound, electrical stimulation, bracing, or massage.
• Chiropractic care or acupuncture are other options.
• Surgery may be needed if the disk is causing any loss of body function (such as bowel function) or nerve damage. Different procedures are available depending on the individual problem. Physical therapy is often needed after surgery to restore full function to the back.

medications

• For minor pain, you may use nonprescription drugs such as acetaminophen or ibuprofen.
• Other drugs may be prescribed:
  • Oral or injected pain reliever (e.g., epidural steroid).
  • Muscle relaxant.
  • Drugs to reduce swelling.
  • Laxative or stool softener to prevent constipation.

activity

• Activities may need to be limited, but stay as active as you can. Avoid any activities that worsen pain. If needed, rest in bed for 1 to 2 days. Longer bed rest is not helpful in recovery.
• Follow any exercise or stretching program prescribed by your health care provider or physical therapist.
• Your health care provider will advise you about resuming sports or other athletic activities.

diet

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

 notify our office if

• You have symptoms of a herniated disk.
• The following occur during treatment:
  • Increased pain or weakness in the back or legs.
  • Problems with bladder or bowel control.
  • Fever or stomach pain occurs.
  • Symptoms don't improve with self-care.

Special Notes: