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ruptured disc

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Herniated disk

Alternative Names
slipped disc, herniated disc, ruptured disc, slipped disc, HNP

A ruptured disc in the back occurs when all or part of the soft, gelatinous central part of the vertebral disc is forced through the bones of the spinal column.

What is going on in the body?
Sandwiched between the vertebra of the spinal column are discs that act like shock absorbers. A disc is made up of two parts. The outer ring or annulus is a tough, fibrous material. The inner part or nucleus is a soft, jelly-like material. A ruptured disc occurs when the outer ring tears or break, allowing the jelly-like material to poke through the crack. This can result in pressure on nerves, often causing pain.

What are the signs and symptoms of the condition?
The location of the ruptured disc determines where a person will have symptoms. Most ruptured discs are in the lower back, and cause low back pain. If the ruptured disc presses on a nerve, pain may be felt in the buttocks, legs, and feet. This pain, which usually affects only one leg, is known as sciatica. Coughing, sneezing or bending may increase the pain. There may be numbness, weakness, and loss of muscle mass. If the ruptured disc is in the upper back, the symptoms may be in the shoulder, arm, or hand.

What are the causes and risks of the condition?
There are many causes of a ruptured disc. Repeated heavy lifting is the most common cause, especially when improper lifting techniques are used. Many people who have a ruptured disc are involved in manual labour jobs. Smoking, obesity, and old age also increase the person's risk of rupturing a disc.

What can be done to prevent the condition?
Proper lifting techniques are important to avoid a ruptured disc. These techniques can be enhanced by the use of an abdominal support belt. Living a healthy lifestyle by eating and exercising regularly can help prevent a back injury.

How is the condition diagnosed?
A ruptured disc is diagnosed by a complete physical examination combined with special imaging techniques of the spine. The tests used to diagnose a ruptured disc include:
  • myelogram, an x-ray of the spine taken after a contrast agent has been injected
  • CT scan
  • MRI
X-rays of the spine can be used to rule out any abnormalities, but do not diagnose a ruptured disc.

What are the long-term effects of the condition?
Chronic pain from an untreated ruptured disc can result in depression, lack of productivity, and drug abuse. If the ruptured disc presses on a nerve, the person may have weakness, numbness, and loss of muscle mass.

What are the risks to others?
A ruptured disc is not contagious, and poses no risks to others.

What are the treatments for the condition?
Initial treatment for a ruptured disc consists of several weeks of bedrest, applications of heat and massage, and an exercise program. Anti-inflammatory analgesia, such as ibuprofen, and muscle relaxants may be prescribed. These conservative treatments often result in improvement.

A laminectomy is an operation in which the surgeon removes the ruptured disc, and relieves pressure on the nerve. Surgery may be recommended if:
  • there is no improvement with conservative treatment
  • the ruptured disc is causing nerve problems such as numbness, weakness, and loss of reflexes
  • the back pain is severe and cannot be tolerated
What are the side effects of the treatments?
Side effects of medications include allergic reactions and stomach upset. Surgery is associated with a risk of infection, bleeding, and allergic reaction to anaesthesia.

What happens after treatment for the condition?
After conservative treatment of a ruptured disc, a person can usually resume activity as tolerated. Symptoms may recur every now and then, requiring repeated treatment. After surgery, the signs and symptoms usually disappear and a person will slowly resume normal activity after proper recovery. Physiotherapy can be helpful to teach appropriate body mechanics and lifting techniques.

How is the condition monitored?
Any new or worsening symptoms should be reported to the doctor.

Author: Vincent J. Toups, MD
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Potential conflict of interest information for reviewers available on request

This website and article is not a substitute for independent professional advice. Nothing contained in this website is intended to be used as medical advice and it is not intended to be used to diagnose, treat, cure or prevent any disease, nor should it be used for therapeutic purposes or as a substitute for your own health professional's advice.  All Health and any associated parties do not accept any liability for any injury, loss or damage incurred by use of or reliance on the information.


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