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A ruptured disk in the back occurs when all or part of a vertebral disk is forced through the bones of the spinal column.
What is going on in the body?
The vertebrae of the spinal column are separated by vertebral disks that act like shock absorbers. A disk 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 disk occurs when the outer ring tears or breaks, allowing the jelly-like material to poke through the crack. The disk may press on nerves, causing pain and loss of function.
What are the causes and risks of the condition?
There are many causes of a ruptured disk. Repeated heavy lifting is the most common cause, especially when improper lifting techniques are used. Many people who have a ruptured disk are involved in manual labor jobs. Other risk factors for disk rupture include:
_ activities, such as driving a car, that pass vibrations along the spine
_ lack of physical activity
_ obesity
_ old age
_ smoking
What are the treatments for the condition?
A ruptured disk is generally treated conservatively at first. Initial treatments include:
_ activity limitations
_ anti-inflammatory pain medicine, such as ibuprofen, ketoprofen, flurbiprofen, or naproxen
_ application of heat
_ massage
_ muscle relaxants, such as carisoprodol
_ a specialized exercise program
If conservative treatment is not successful, the healthcare provider may recommend surgery. The following operations may be helpful for people with a ruptured disk:
_ diskectomy or laminectomy, which allows the surgeon to remove the ruptured disk and relieve nerve pressure
_ injection of chymopapain, an enzyme, into the disk to dissolve it
_ nucleoplasty, which involves inserting a needle into the disk and applying heat with a special instrument
_ spinal fusion, which involves the joining of two or more vertebrae
What are the side effects of the treatments?
Side effects of medicines include allergic reactions and stomach upset. Surgery is associated with a risk of infection, bleeding, and allergic reaction to anesthesia.
What happens after treatment for the condition?
After conservative treatment of a ruptured disk, a person can usually resume activity as tolerated. Symptoms may recur every now and then, requiring repeated treatment. Ninety percent of the time, surgery relieves symptoms, and the person can slowly resume normal activities. Physical therapy 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 healthcare provider.
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