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Disc herniation can occur in any disc in the spine, but the two most common forms are lumbar disc herniation and cervical disc herniation. The former is the most common, causing low back pain (lumbago) and often leg pain as well, in which case it is commonly referred to as sciatica .
The presence of the Fajersztajn sign is a more specific finding for a herniated disc than Lasègue's sign. [15] Maneuvers that increase intraspinal pressure, such as coughing, flexion of the neck, and bilateral compression of the jugular veins , may transiently worsen sciatica pain.
National guidelines vary; some recommend the therapy for those who do not improve with other treatment. [49] It may be effective for lumbar disc herniation with radiculopathy , [ 50 ] [ 51 ] as effective as mobilization for neck pain, [ 52 ] some forms of headache, [ 53 ] [ 54 ] and some extremity joint conditions.
Microdiscectomy (or microdecompression) is a minimally invasive surgical procedure in which a portion of a herniated nucleus pulposus is removed by way of a surgical instrument. [2] The purpose of this procedure is to relieve the pressure and reduce the local inflammatory reaction around a nerve root, caused by the herniated nucleus pulposus.
Ideally, effective treatment aims to resolve the underlying cause and restores the nerve root to normal function. Conservative treatment may include bed rest , physical therapy , or simply continuing to do usual activities; for pain, nonsteroidal anti-inflammatory drugs , nonopioid or, in some cases, narcotic analgesics may be prescribed. [ 3 ]
Lumbar disc disease is the drying out of the spongy interior matrix of an intervertebral disc in the spine. Many physicians and patients use the term lumbar disc disease to encompass several different causes of back pain or sciatica. In this article, the term is used to describe a lumbar herniated disc.
Causes can be bone fragments from a vertebral fracture, a tumor, abscess, ruptured intervertebral disc or other lesion. When acute it can cause a medical emergency independent of its cause, and require swift diagnosis and treatment to prevent long-term disability due to irreversible spinal cord injury.
A 2012 systematic review suggested that the use of spine manipulation in clinical practice is a cost-effective treatment when used alone or in combination with other treatment approaches. [168] A 2011 systematic review found evidence supporting the cost-effectiveness of using spinal manipulation for the treatment of sub-acute or chronic low ...
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