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Slipped Disk (Herniated Disc)

A potentially painful problem in which the hard outer coating of the disk is damaged, allowing the disk's jelly-like center to leak and cause irritation to adjacent nerves.

PubMed Health Glossary
(Source: NIH - National Institute of Arthritis and Musculoskeletal and Skin Diseases)

About Slipped Disks

The spine is made up of a chain of bones called the vertebrae. The front part of each of the vertebrae is called the vertebral body. Soft spinal disks are found between the vertebrae. The disks have a hard, multilayered casing and a gel-like center (nucleus pulposus). It is thanks to these disks that the spine is flexible and we are able to lean forward or to turn our upper body from side to side. They also absorb shocks that are transferred to the spine when we are running or jumping, for instance.

Having a slipped disk means that one of the spinal disks is bulging beyond the edges of the vertebral bodies above and below it. There are three types of slipped disk:

Prolapse: The disk is bulging out between the vertebrae, but its outermost layer is still intact... Read more about Slipped Disk

What works? Research summarized

Evidence reviews

Surgery versus conservative management of sciatica due to a lumbar herniated disc: a systematic review

The effectiveness of surgery in patients with sciatica due to lumbar disc herniations is not without dispute. The goal of this study was to assess the effects of surgery versus conservative therapy (including epidural injections) for patients with sciatica due to lumbar disc herniation. A comprehensive search was conducted in MEDLINE, EMBASE, CINAHL, CENTRAL, and PEDro up to October 2009. Randomised controlled trials of adults with lumbar radicular pain, which evaluated at least one clinically relevant outcome measure (pain, functional status, perceived recovery, lost days of work) were included. Two authors assessed risk of bias according to Cochrane criteria and extracted the data. In total, five studies were identified, two of which with a low risk of bias. One study compared early surgery with prolonged conservative care followed by surgery if needed; three studies compared surgery with usual conservative care, and one study compared surgery with epidural injections. Data were not pooled because of clinical heterogeneity and poor reporting of data. One large low-risk-of-bias trial demonstrated that early surgery in patients with 6-12 weeks of radicular pain leads to faster pain relief when compared with prolonged conservative treatment, but there were no differences after 1 and 2 years. Another large low-risk-of-bias trial between surgery and usual conservative care found no statistically significant differences on any of the primary outcome measures after 1 and 2 years. Future studies should evaluate who benefits more from surgery and who from conservative care.

Effectiveness and safety of different injection sites of collagenase for lumbar intervertebral disc protrusion: a systematic review

Bibliographic details: Mao X, Wang L, Meng Y, Sun L, Li YP.  Effectiveness and safety of different injection sites of collagenase for lumbar intervertebral disc protrusion: a systematic review. Chinese Journal of Evidence-Based Medicine 2007; 7(1): 53-60

Ozone therapy as a treatment for low back pain secondary to herniated disc: a systematic review and meta-analysis of randomized controlled trials

This review concluded that percutaneous ozone therapy for treatment of chronic low back pain appeared to yield positive results and low morbidity rates. These conclusions accurately reflect the findings of the included evidence but the evidence consisted of a small number of studies with several methodological limitations.

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Summaries for consumers

Can rehabilitation therapy help after slipped disk surgery?

Rehabilitation programs that are started four to six weeks after slipped disk surgery can speed up the recovery process. Whether rehabilitation programs that start immediately after surgery have any advantages or disadvantages remains unclear.

Slipped disk: Overview

When most people hear "slipped disk" they think of very sudden, severe back pain. But most slipped disks go unnoticed and do not have to be treated. What happens if a slipped disk causes pain and how do you know whether you should see a doctor?

Slipped disk surgery

Under certain circumstances, surgery is an option for treating a slipped disk. This usually involves the removal of spinal disk tissue to relieve pressure on irritated nerves. Surgery can often provide long term relief from symptoms, but there are risks.Surgery is always performed if the slipped disk is an emergency, for example if prolapsed disk tissue is affecting nerves so severely that the bladder or bowel no longer function properly, or certain muscles have become very weak. But this only happens rarely.The far more common reason to have surgery is that it has not been possible to relieve severe and chronic pain enough by using other treatment options. The question of whether to go through with surgery is often difficult to answer, though. For surgery to be considered, imaging techniques and the symptoms must clearly show that a slipped disk is causing the pain. Before deciding to go ahead with the procedure, it is important to carefully weigh the pros and cons together with your doctor. Your individual circumstances will also be part of this discussion because they can influence the success of the treatment as well.

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More about Slipped Disk

Photo of an adult

Also called: Herniated disk, Slipped disc, Spinal disc herniation, Spinal disk herniation

Other terms to know:
Sciatic Nerve, Sciatica, Spinal Disk (Intervertebral Disc)

Related articles:
How the Spine Works

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