DISK, RUPTURED

General Information

DEFINITION--Sudden or gradual break in the supportive ligaments surrounding a spinal disk (cushions separating bony spinal vertebrae).

BODY PARTS INVOLVED--Disks of the neck or lower spine (most common sites).

SEX OR AGE MOST AFFECTED--Adults of both sexes.

SIGNS & SYMPTOMS

Lower back:

• Severe pain in the low back or back of one leg, buttock or foot (sciatica). Pain usually affects one side and worsens with movement, coughing, sneezing, lifting or straining.
• Weakness, numbness or muscular wasting of the affected leg.

Neck:

• Pain in the neck, shoulder or down one arm. Pain worsens with movement.
• Weakness, numbness or muscular wasting of the affected arm.

CAUSES--Weakening and rupture of the disk material, creating pressure on nearby spinal nerves. Rupture of the disk is caused by sudden injury or chronic stress, such as from constant lifting or obesity.

RISK INCREASES WITH

• Heavy lifting.
• Poor physical condition.

HOW TO PREVENT

• Practice proper posture when lifting.
• Exercise regularly to maintain good muscle tone.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• X-rays of the neck or lower spine, including myelogram (See Glossary).
• CT scan, MRI (See Glossary for both) or diskography (dye is injected into the disk).

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's treatment.
• Rest at home or in the hospital (sometimes).
• Surgery to relieve nerve pressure if bed rest does not relieve symptoms.
• Rehabilitation to strengthen muscles. You may work with a physical therapist, chiropractor, osteopath, acupuncturist or others in finding the best therapy methods.
• Psychotherapy or counseling to learn coping methods for enduring pain and frustration.

POSSIBLE COMPLICATIONS

• Loss of bladder and bowel function.
• Paralysis.
• Muscle wasting and weakness.
• Disk may be prone to re-injury.

PROBABLE OUTCOME--Spontaneous recovery in many cases. At least 2 weeks in bed should be tried before considering other therapy, unless complications occur. When necessary, a ruptured disk is often curable with surgery.

How To Treat

GENERAL MEASURES--

• Apply ice packs to the painful area during the first 72 hours and occasionally thereafter, if they provide relief. Alternately, try to relieve pain with a heat lamp, hot showers or baths, compresses or a heating pad.
• Be patient about your recovery. It will take time and energy and often will mean some life-style changes.

MEDICATION--

• For minor discomfort, you may use non-prescription drugs such as aspirin.
• Your doctor may prescribe: Pain relievers. Muscle relaxants, such as diazepam or methocarbamol. Nonsteroidal anti-inflammatory drugs to reduce inflammation around the rupture. Laxatives or stool softeners to prevent constipation.

ACTIVITY--Rest in bed during the acute phase. Resume your normal activities, including sexual relations, when symptoms improve.

DIET--No special diet. Increase consumption of dietary fiber and drink at least 8 glasses of fluid a day to prevent constipation or fecal impaction.

Call Your Doctor If

• You have symptoms of a ruptured disk.
• The following occurs during treatment: Increased pain or weakness in the extremities. Loss of bladder or bowel control.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.