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Herniated Disc

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by Scholten A

(Disk, Herniated; Herniation of Nucleus Pulposus [HNP]; Prolapsed Disc; Ruptured Disc; Slipped Disc)

 

Risk Factors

These factors increase your chance of developing a herniated disc:
  • Age: 30s and 40s
  • Trauma from a fall, accident, or sudden twisting
  • Strain on the back—either repeated or sudden, as from lifting a heavy weight
  • Certain jobs that require heavy lifting
  • Smoking
  • Obesity
  • Diabetes
 

Treatment

Staying active may be better than bed rest. Treatments may include:

Physical Therapy

The following therapies may be used:
  • Back or neck massage and physical therapy to:
    • Relax the neck or back muscles
    • Decrease pain
    • Increase strength and mobility
  • Back and abdominal exercises
  • Hot or cold packs to reduce pain and muscle spasms
  • Chiropractic care
  • Using weights and pulleys to relieve pressure on the discs and keep you from moving around
  • A neck collar or brace for a herniated disc in the neck to relieve muscle spasms

Medications

Your doctor may advise:
  • Over-the-counter pain medications, such as ibuprofen or naproxen
  • Prescription pain medication
  • Muscle relaxants to reduce muscle spasms

Interventional Spine Care

Interventional spine care treatments may include:
  • Steroid injections into the area around the nerve and disc to reduce pain and inflammation; the injections are used if other medications do not work
  • Minimally invasive procedures may include:
    • Nucleoplasty
    • Intradiscal electrothermy (IDET)
    • Chemonucleolysis

Surgery

Surgery may be used for people who fail to respond to other treatments. Immediate surgery is necessary for cauda equina syndrome. Options include:
  • Laminectomy —removal of some of the bone over the spine and of the problem disc
  • Microdiscectomy —removal of fragments of herniated disc through a small incision; this procedure is also known as intervertebral discectomy
  • Spinal fusion —fusing of vertebrae together with bone grafts or metal rods; this is rarely done for first-time disc problems
 

RESOURCES

American Academy of Orthopedic Surgeons
http://orthoinfo.aaos.org

American Chiropractic Association
http://www.acatoday.org

 

CANADIAN RESOURCES

Canadian Orthopaedic Association
http://www.coa-aco.org

Canadian Orthopaedic Foundation
http://www.canorth.org

 

References


Awad JN. Moskovich R. Lumbar disc herniations: surgical versus nonsurgical treatment. Clinical Orthopaedics & Related Research. 2006;443:183-197.


When you have a herniated disc. Am Fam Physician. 2003 May 15;67(10):2195-2196. Available at: http://www.aafp.org/afp/2003/0515/p2195.html . Accessed November 22, 2013.

 

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