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Herniated Disc (Slipped Disk)

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 Herniated Disc

What works? Research summarized

Evidence reviews

Pain Management Injection Therapies for Low Back Pain [Internet]

Low back pain is common and injections with corticosteroids are a frequently used treatment option. This report reviews the current evidence on effectiveness and harms of epidural, facet joint, and sacroiliac corticosteroid injections for low back pain conditions.

Physical examination for lumbar radiculopathy due to disc herniation in patients with low‐back pain

Background: Low‐back pain with leg pain (sciatica) may be caused by a herniated intervertebral disc exerting pressure on the nerve root. Most patients will respond to conservative treatment, but in carefully selected patients, surgical discectomy may provide faster relief of symptoms. Primary care clinicians use patient history and physical examination to evaluate the likelihood of disc herniation and select patients for further imaging and possible surgery.

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.

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Summaries for consumers

Physical examination for lumbar radiculopathy due to disc herniation in patients with low‐back pain

Background: Low‐back pain with leg pain (sciatica) may be caused by a herniated intervertebral disc exerting pressure on the nerve root. Most patients will respond to conservative treatment, but in carefully selected patients, surgical discectomy may provide faster relief of symptoms. Primary care clinicians use patient history and physical examination to evaluate the likelihood of disc herniation and select patients for further imaging and possible surgery.

The effects of surgical treatments for individuals with 'slipped' lumbar discs

Prolapsed lumbar discs ('slipped disc', 'herniated disc') account for less than five percent of all low‐back problems, but are the most common cause of nerve root pain ('sciatica'). Ninety percent of acute attacks of sciatica settle with non‐surgical management. Surgical options are usually considered for more rapid relief in the minority of patients whose recovery is unacceptably slow.

Surgery for leg and back pain caused by damage to spinal discs

When the discs between vertebrae in the spine become damaged (herniated), the soft gel inside them pushes through the wall of the disc and presses against the nerves or the spinal cord, causing a burning pain in legs and pain in the back. When this happens in the lower back, it i s known as lumbar disc herniation.

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More about Herniated Disc

Photo of an adult

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

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

Related articles:
How the Spine Works

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