Prolapsed Disc Flashcards
What is a prolapsed disc?
Herniation of the intervertebral Nucleus Pulposus through the Annulus Fibrosus
What does this do?
The bulging disc can press on nearby nerves and cause inflammation and pain e.g Sciatica
Why does it happen?
It is generally caused by weakness in the Annulus Fibrosus that is aggrevated by stress
Which vertebrae are affect?
Any intervertebral disc can herniate but it most commonly occurs between L3-L5
Is it common?
1 in 20 back pains are caused by a prolapsed disc
Who is affected?
Herniation usually occurs below the age of 40, but herniation due to degeneration usually occurs in older patients. Affects twice as many men as women
Risk Factors (7)
General weakness in the Annulus Fibrosus, lifting, sitting, weight bearing, smoking, obesity, increasing age
Symptoms (7)
Acute severe pain, sudden onset, pain eased by lying flat, pain exacerbated by moving/coughing/sneezing, numbness, pins and needles, weakness
Signs (2)
Sciatica (pain extends down below the knee), Positive straight leg raise test
What are the red flags?
Saddle anaesthesia, urinary retention, faecal incontinence
What are the red flags indicative of?
Cauda Equina Syndrome-compression of the Spinal COrd
Treatment (8)
*If red flags needs urgent secondary care, NSAIDs/weak opiate, encourage to keep active, Benzodiazapine if muscle spasm, physiotherapy, heat packs, massage, may need surgery to repair a protruding disc
Complications (3)
Permanent nerve root damage, psychosocial problems, loss of employment
Is there a good prognosis?
60% tend to regress naturally and resolve, 30% have pain for 1 year or longer
What can we do to prevent it?
Regular exercise, weight loss, safe lifting techniques, correct sitting/posture
