BACK CONDITIONS: SLIPPED DISK

A slipped disk is a common back disorder in which the rupture of the backbone disk through its protective cartilage covering creates painful pressure on spinal nerves. A slipped disk also may be called a herniated disk or disk prolapse. It usually occurs in the lower back but may also take place in other areas of the back including the cervical, or neck, region. The soft pads of cartilage that lie between and cushion the vertebral bones of the spine have a highly elastic, jellylike center that helps the disk absorb the shock of the back's normal movements.

Causes

There are several possible causes of the displacement of the disk's center that may produce a slipped disk. The aging process, improper posture or an injury may result in the outer fibrous rings of cartilage becoming worn and cause the soft, jellylike center of the disk to bulge out into the cartilage surrounding it. Sudden movements or overuse of the back may cause the disk's pulpy center to herniate through the cartilage. Typically, the disk's center protrudes toward the spinal cord and the spinal nerves. When the herniated, or slipped, disk exerts pressure, irritates or pinches the spinal nerves, it produces sudden, severe and often disabling lower back pain. Numbness and restriction of movement also may be felt with a slipped disk. If the sciatic nerve is pinched, the pain and numbness can radiate down into the buttocks, into the back of the thigh and calf, and even into the foot. This type of pain is called sciatica. If the bulging center of the disk puts pressure on the spinal cord, nerve tissue may be damaged. If left untreated, a slipped disk can cause the destruction of spinal nerves by constant pressure on the nerve root. Diagnosis and treatment

The condition of the disks is evaluated by X-ray, CT (computed tomography) scan, myelogram, MRI (magnetic resonance imaging), a diskogram, or a combination of these diagnostic aids. The first line of treatment for a slipped disk may include bed rest and taking nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen. Prescriptions for muscle relaxant and painkilling medications may be given. It may be necessary to wear a back brace or a cervical collar. Traction may be used to open intervertebral spaces. Applications of heat or cold may be advised. When the pain subsides, physical therapy, including exercise, may be prescribed to help strengthen weakened back muscles and restore mobility of the back. If pain, numbness, and disability persist, surgery to remove the herniated disk to relieve pressure on the spinal nerves may become necessary.