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(Disk, Herniated; Herniation of Nucleus Pulposus [HNP]; Prolapsed Disc; Ruptured Disc; Slipped Disc)
|Herniated Lumbar Disc|
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- 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
- May be sharp, dull, piercing, aching, burning, or throbbing, depending on the disc and size of herniation
- May spread over the back, buttocks, down the back of one thigh, and into the calf
- May be in one leg or both legs
- Numbness, tingling, or weakness in the legs, feet, or in one or both arms
- In severe cases, inability to find comfort even lying down
- Sudden aching or twisted neck that cannot be straightened without severe pain
Cauda equina syndrome—involves bowel or bladder changes and/or numbness in the groin
- Note: This is an emergency, call for medical help right away.
- CT scan
- Bone scan
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
- Over-the-counter pain medications, such as ibuprofen or naproxen
- Prescription pain medication
- Muscle relaxants to reduce muscle spasms
Interventional Spine Care
- 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:
- Intradiscal electrothermy (IDET)
- 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
- Practice good posture. Stand and sit straight, and keep your back straight when lifting.
- Maintain a healthy weight.
- Exercise regularly. Ask your doctor about exercises to strengthen your back and stomach.
- Don't wear high-heeled shoes.
- If you sit for long periods of time, use a stool to bring your knees above your hips.
American Academy of Orthopedic Surgeons http://orthoinfo.aaos.org
American Chiropractic Association http://www.acatoday.org
Canadian Orthopaedic Association http://www.coa-aco.org
Canadian Orthopaedic Foundation http://www.canorth.org
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.
- Reviewer: John C. Keel, MD; Michael Woods, MD
- Review Date: 11/2013
- Update Date: 11/22/2013