Herniated nucleus pulposus (slipped disk)

Injury	Disease	Nutrition	Poison

Symptoms	Surgery	Test	Special Topic

Skeletal spine

Sciatic nerve

Herniated nucleus pulposis

Herniated disk repair

Lumbar spinal surgery - series

Overview

Symptoms

Treatment

Prevention

Herniated nucleus pulposus (slipped disk)

Alternative Names:

Lumbar radiculopathy; Cervical radiculopathy; Herniated intervertebral disk; Prolapsed intervertebral disk; Slipped disk; Ruptured disk

Symptoms:

SYMPTOMS OF HERNIATED LUMBAR DISK

severe low back pain
pain radiating to the buttocks, legs, and feet
pain made worse with coughing, straining, or laughing
tingling or numbness in legs or feet
muscle weakness or atrophy in later stages
muscle spasm

SYMPTOMS OF HERNIATED CERVICAL DISK

neck pain, especially in the back and sides
deep pain near or over the shoulder blades on the affected side
pain radiating to the shoulder, upper arm, forearm, and rarely the hand, fingers or chest
pain made worse with coughing, straining, or laughing
increased pain when bending the neck or turning head to the side
spasm of the neck muscles
arm muscle weakness

Signs and tests:

A physical examination and history of pain may be sufficient to diagnose the disorder. A neurological examination will be performed to evaluate muscle reflexes, sensation, and muscle strength. Often, examination of the spine will reveal a decrease in the spinal curvature in the affected area.

Straight-leg-raising test that reveals leg pain is diagnostic of a herniated lumbar disk.

A "foraminal compression test of Spurling" will be performed to diagnose cervical radiculopathy. This is performed by bending the head forward and to the sides while downward pressure is applied to the top of the head. Increased pain or numbness during this test is usually indicative of cervical radiculopathy.

DIAGNOSTIC TESTS

A spine X-ray may be performed to rule out other causes of back or neck pain. However, it is not possible to diagnosis herniated disk by spinal X-ray alone.
A spine MRI and/or spine CT will show spinal canal compression by the herniated disk.
A myelogram may be performed to define the size and location of disk herniation.
An EMG may be performed to determine the exact nerve root(s) that is (are) involved.
A nerve conduction velocity test may also be performed.

Review Date: 4/28/2004
Reviewed By: Andrew L. Chen, M.D., M.S., Steadman-Hawkins Sports Medicine Foundation, Vail, CO. Review provided by VeriMed Healthcare Network.

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