Leg pain continues to be the primary presenting symptom in this group of patients and is often not recognized as the radicular pain of a herniated disk by the primary care physician. [ncbi.nlm.nih.gov]

A 29-year-old woman presented to the spine clinic with new-onset pain in her right leg, accompanied by paresthesia. There were no bowel or bladder symptoms. [nejm.org]

• Disability

  However, our data demonstrated that the MMP1 2G allele was associated with both pain and disability, that is, increased visual analog scale score, McGill Pain Questionnaire score, and Oswestry Disability Index score. [ncbi.nlm.nih.gov]

• Asymptomatic

  The incidence of positive CAT scans in an asymptomatic group of patients. Spine 9:549–551 PubMed Google Scholar 9. Wilberger JE Jr, Pang D (1983) Syndrome of the incidental herniated lumbar disc. [link.springer.com]

  The child recovered uneventfully and was asymptomatic 7 years postsurgery. This child is one of the youngest patients with a herniated disc reported in the world literature. [thejns.org]

  Bulging disks usually are assumed to be asymptomatic lesions because they are common in the general asymptomatic population (52% of asymptomatic people have at least one [11]); one could therefore argue about their clinical relevance. [ajronline.org]

  Evaluation of asymptomatic individuals. J Bone Joint Surg Am. 1995;77(11):1631-1638. [massagetoday.com]

  The value of magnetic resonance imaging of the lumbar spine to predictlow-back pain in asymptomatic subjects. J Bone Joint Surg Am. 2001;83-A:1306–11. 4. Andersson G. Epidemiology of spinal disorders. [aafp.org]

• Fever

  INDICATIONS Lumbar spondylitis sciatica Disc herniation Compressed discs and spinal nerves Scoliosis Back sprain Disc bulge ankylosing spondylitis Spina bifida CONTRAINDICATIONS Fever: As the temperature might increase during the therapy Acute Inflammation [healingearth.co.in]

  Symptoms that should prompt a call to your doctor right away include developing a fever, chills, flu-like symptoms or a rash when your back symptoms start. You should also contact your doctor if you have significant or progressive weakness. [newsnetwork.mayoclinic.org]

  Seek medical care for any back or neck pain that limits activity, last for a few days, is accompanied by chest pain, abdominal pain, fever, loss of bladder control, numbness, or weakness. [emedicinehealth.com]

  You may also need any of following: NSAIDs, such as ibuprofen, help decrease swelling, pain, and fever. NSAIDs can cause stomach bleeding or kidney problems in certain people. [drugs.com]

• Wound Infection

  Infection Infection following spine surgery occurs rarely. [orthoinfo.aaos.org]

  Persistent drainage from the wound 4-7 days after surgery usually means an infection is present. The patient might also have fever or chills, but this is not a reliable indication of an infection. [thesteadmanclinic.com]

  The reoperation consisted of 5% fusion and 95% discectomy. 7% reported postoperative complications such as wound hematoma, wound infection, cerebrospinal fluid leak, deep venous thrombosis, and new neurologic deficit. [physio-pedia.com]

• Limb Pain

  Review Topic QID: 3706 1 Equal limb pain and equal functional outcomes 2 Improved limb pain and improved functional outcomes 3 Worsened limb pain and worsened functional outcomes 4 Worsened limb pain but improved functional outcomes 5 Improved limb pain [orthobullets.com]

• Constipation

  Very large disc herniations may result in urinary difficulty and constipation. In cervical disc herniation, the spinal cord as well as the nerve roots may be compressed. [uclahealth.org]

  Constipation is a common side-effect from codeine. This may make back pain worse if you need to strain to go to the toilet. To prevent constipation, have lots to drink and eat foods with plenty of fibre. [patient.info]

  Side effects include sedation, nausea, and constipation. Epidural steroid medication (injected into the space just outside of the sac of spinal fluid), reduces swelling, inflammation, and pain. [innerbody.com]

  When digestion is weak or constipation present, even those beans listed under small amounts should be avoided. Mung beans, Aduki beans, red lentils, black gram, black lentils, pinto, soy beans, tofu. Yellow lentils, chick peas, kidney beans. [ayurvedabodycure.com]

• Fecal Incontinence

  If the anal sphincter is not working, fecal incontinence may occur. This means the patient loses the ability to control the passage of stool from the bowels. If the urethral sphincter is not working properly, urine leaks from the bladder. [livestrong.com]

  incontinence as well as sexual dysfunction. [physio-pedia.com]

• Prolapse

  Any disc in the spine can prolapse. However, most prolapsed discs occur in the lower back (the lumbar spine). The size of the prolapse can vary. As a rule, the larger the prolapse, the more severe the symptoms are likely to be. [patient.info]

  However, little is known about acute disc prolapse in the elderly. OBJECTIVE: We aimed to define the features of acute disc prolapse in the elderly. [read.qxmd.com]

  The improvements were even more marked in patients with protrusion or prolapse type herniation. [ncbi.nlm.nih.gov]

• Back Pain

  “Red flags” for potentially serious underlying causes of low back pain. Adapted from ACR Appropriateness Criteria: Low Back Pain. 3 Figure 3. “Red flags” for potentially serious underlying causes of low back pain. [jaoa.org]

  The patient initially suffered from unilateral low back pain and nonradicular/nonlancinating referral to the ipsilateral lower extremity. [ncbi.nlm.nih.gov]

• Low Back Pain

  “Red flags” for potentially serious underlying causes of low back pain. Adapted from ACR Appropriateness Criteria: Low Back Pain. 3 Figure 3. “Red flags” for potentially serious underlying causes of low back pain. [jaoa.org]

  The patient initially suffered from unilateral low back pain and nonradicular/nonlancinating referral to the ipsilateral lower extremity. [ncbi.nlm.nih.gov]

• Spine Pain

  Thoracic disc herniation presents most commonly as chest pain or spine pain, and occasionally in numbness, weakness, or spasticity. [uclahealth.org]

  Low back pain and/or leg pain (sciatica) are the most common symptoms of a herniated disc in the lumbar (lower) spine. Pain may vary from mild to severe. [treatingpain.com]

  […] the waist down Bulging disc in your cervical spine: Pain moving your neck Deep pain near or over your shoulder blade Radiating pain in your upper arm, forearm, and possibly your fingers Pain from a bulging disc may start slowly and get worse over time [depuysynthes.com]

  It can help lessen the pain by strengthening the muscles that support your spine. [patient.info]

• Acute Low Back Pain

  Familial predisposition to discogenic low-back pain. An epidemiologic and immunogenetic study. Spine. 1988;13:1403–6. 6. Bigos SJ. Acute low back problems in adults. Rockville, Md.: U.S. [aafp.org]

  DC, PT: Comparison of Classification-Based Physical Therapy With Therapy Based on Clinical Practice Guidelines for Patients with Acute Low Back Pain: A Randomized Clinical Trial. Spine. 2813:1363-1371, July 1, 2003. [hss.edu]

  Spinal Manipulative Therapy and Mobilization - Spinal manipulative therapy and mobilization leads to short-term pain relief when suffering from acute low back pain. [physio-pedia.com]

• Paravertebral Muscle Spasm

  On physical examination a compensatory gait, paravertebral muscle spasm, and a restricted right straight-leg raising test were demonstrated. Plain x-ray films revealed a narrowed L4–5 intervertebral space. [thejns.org]

  Weight Loss Weight loss is observed during initial phase because of loss of appetite secondary to chronic pain Clinical Signs- Lumbar Disc Bulge Paravertebral Muscle Spasm Muscle Spasm- Muscle spasm is often reflex spasm of paravertebral muscles secondary [epainassist.com]

• Suggestibility

  Retrospectively, the CT appearance was well in accordance with the findings at operation, but further examination, preferably MR imaging, is suggested in cases of atypical masses in the spinal canal. [ncbi.nlm.nih.gov]

  Data from clinical trials suggest that patients who have herniated lumbar disks have similar long-term outcomes whether they undergo surgery or elect conservative management. [nejm.org]

• Sciatica

  Ng and Sell 45 proposed a threshold for the duration of sciatica of 12 months. Some of the reported thresholds of the duration of sciatica, which is associated with poor outcome, are listed in Table 3. [healio.com]

  Sciatica is a common diagnosis in the general population. Sciatica is most frequently caused by LDH. [sogacot.org]

  Sciatica due to a herniated lumbar intervertebral disk is common and has an estimated point prevalence of roughly 5% in the general adult population.1 Numerous prospective studies have reported excellent recovery of acute sciatica in the absence of significant [cmaj.ca]

  Secondary outcomes included sciatica severity as measured by the Sciatica Bothersomeness Index, satisfaction with symptoms, self-reported improvement, and employment status. [ncbi.nlm.nih.gov]

• Paresthesia

  A 29-year-old woman presented to the spine clinic with new-onset pain in her right leg, accompanied by paresthesia. There were no bowel or bladder symptoms. [nejm.org]

  CLINICAL FEATURES: A 31-year-old man presented with severe lower back pain and pain, paresthesia, and plantar flexion weakness of the left leg. [ncbi.nlm.nih.gov]

  His history was significant only for a spontaneous onset of lumbar back pain noted immediately after awkward bending six months prior, followed two to three days later by severe leg pain, paresthesias and ankle weakness, consistent with an L5 radiculopathy [cmaj.ca]

• Foot Drop

  Foot drop is defined as inability to dorsiflex the foot at the ankle joint. [ncbi.nlm.nih.gov]

  Neurological symptoms caused by the herniation may include difficulty lifting the foot when walking or standing on the ball of the foot, a condition known as foot drop. See What Is Foot Drop? Article continues below Lower back pain. [spine-health.com]

  In those with severe extensor weakness, especially painless foot-drop, diskectomy does not improve the outcome.” Discrimination between foot drop and severe extensor weakness may not be possible or reasonable. [healio.com]

  […] w/ or w/o surgery; - of all patients who sustain acute sciatica, less than 25% will require surgery; - despite the generally good prognosis, some patients will not recover such as this patient who had chronic anterior compartment atrophy and a mild foot [wheelessonline.com]

• Limb Weakness

  Additions symptoms of lumbar spondylosis include: Localized pain Pain after prolonged sitting Worsening pain after repeated movement Muscle spasms Regional tenderness Tingling, numbness in the limbs Weakness of affected limb due to possible nerve compression [bodhiwellnesscentre.com]

  We report a 45-year-old male who presented with sudden onset right lower limb weakness after lifting heavy weight. Magnetic resonance imaging of the cervical spine showed C5/6 disc prolapse with intradural extension. [read.qxmd.com]

• Neuralgia

  Community Wiki Code: M54.16 Code Name: ICD-10 Code for Radiculopathy, lumbar region Block: Other dorsopathies (M50-M54) Excludes 1: current injury - see injury of spine by body region discitis NOS (M46.4-) Details: Radiculopathy, lumbar region Excludes1: neuralgia [aapc.com]

  […] non-draft ICD-10-CM) 2017 (effective 10/1/2016) : No change 2018 (effective 10/1/2017) : No change 2019 (effective 10/1/2018) : No change Disorder (of) - see also Disease disc (intervertebral) M51.9 Neuritis (rheumatoid) M79.2 ICD-10-CM Diagnosis Code M79.2 Neuralgia [icd10data.com]

[…] invasive Plain lumbar films: Generally not helpful in the diagnosis, except to rule out other diseases and to evaluate for possible skeletal etiology as the cause of the patient's symptoms Bone scanning: To rule out tumors, trauma, or infection See Workup [emedicine.medscape.com]

In group A, treatment was a success (excellent or good outcome) in 70.3% and deemed a failure (poor outcome or recourse to surgery) in the remaining 29.7%. In group B, treatment was a success in 78.3% and deemed a failure in the remaining 21.7%. [ncbi.nlm.nih.gov]

However, since Weber 2 published his landmark paper in 1983, the pendulum with regard to the best treatment for LDH has shifted from surgery toward nonsurgical treatment options. [healio.com]

Postoperative treatment and follow-up visits The routine postoperative anti-inflammatory treatment with a glucocorticoid and dehydration treatment with mannitol was followed for 5-7 days. [scielo.br]

In patients with chronic or recurrent disk herniation, the prognosis for recovery from pain or dysfunction is often poor. [ncbi.nlm.nih.gov]

Please suggest me the best possible treatement and the prognosis. [practo.com]

used to diagnose L5 and S1 radiculopathy; - femoral stretch test: used to diagnose L4 radiculopathy; - this test is performed by raising the leg while the patient is prone; - wt relief flexion test: - MRI of Disc Herniation : - Natural History: - prognosis [wheelessonline.com]

Prognosis for sphincter recovery after operation for cauda equina compression owing to lumbar disc prolapse. Br Med J (Clin Res Ed). 1981; 282(6279):1852-1854. Tay EC, Chacha PB. [healio.com]

Abstract The authors have retrospectively studied the trends in etiology, symptoms, and rate of recurrence for adolescents with disk herniations to determine the age at onset of symptoms, mechanism of injury, familial history, pattern of symptoms, level [ncbi.nlm.nih.gov]

Discal etiology can be suggested by clinical observation in patients complaining of classical lower back pain, but not excluded even without musculoskeletal pain. [read.qxmd.com]

Potential Etiologies Lumbar disc herniations can occur as a result of direct trauma or gradual degeneration over time. [morphopedics.wikidot.com]

[…] scanning: Useful but less sensitive than MRI Myelography: May provide definitive diagnosis itself, but technique is invasive Plain lumbar films: Generally not helpful in the diagnosis, except to rule out other diseases and to evaluate for possible skeletal etiology [emedicine.medscape.com]

It is important for both patients and spine surgeons to understand epidemiology trends and outcomes of revision surgery for real recurrent lumbar disk herniation (real-RLDH). [ncbi.nlm.nih.gov]

An epidemiological study of the relationship between occupations and acute herniated lumbar intervertebral discs. Int J Epidemiol 1975;4:197-205. [ PUBMED ] 37. Stairmand JW, Holm S, Urban JP. [dx.doi.org]

Epidemiology of spinal disorders. In: Frymoyer JW, Ducker TB, Hadler NM, et al., eds. The adult spine: principles and practice. New York: Raven Press, 1997:93–141. 5. Heliovaara M. Epidemiology of sciatica and herniated lumbar intervertebral disk. [aafp.org]

Lumbar disc degeneration: epidemiology and genetics. J Bone Joint Surg AM. 2006;88(2):3-9. Institute for Quality and Efficiency in Health Care (IQWiG). Slipped disk: overview. 2014; n.pag. [paindoctor.com]

Epidemiology The lifetime prevalence of low back pain is 80%, with disk disorders being the most common cause of adult low back pain. [emedicine.medscape.com]

Abstract To better understand the pathophysiologic mechanisms underlying spinal nerve root injury induced by lumbar disk herniation (LDH), comparative proteomic analysis of cerebrospinal fluid (CSF) between patients with LDH (the experiment group) and [ncbi.nlm.nih.gov]

Pathophysiology The disc consists of the annulus fibrosus (a complex series of fibrous rings) and the nucleus pulposus (a gelatinous core containing collagen fibers, elastin fibers and a hydrated gel)[10]. [physio-pedia.com]

To obtain more insight into the pathophysiology of the disease, several association and candidate gene analyses have been performed. [asbmr.onlinelibrary.wiley.com]

It is essential to pay careful attention to prevent a dural tear. Patients may expect clinical outcomes similar to those following primary discectomy. [ncbi.nlm.nih.gov]

Another important step for preventing disk issues is changing positions frequently throughout the day. Sitting or standing in the same position for long periods can irritate a disk injury. [medicalnewstoday.com]

Cleaning up the intervertebral disc tissue within the intervertebral space is an effective way to prevent recurrence, but excessive removal should be avoided to prevent significantly decreasing the height of the vertebrae interval. [scielo.br]

Prevention Techniques for proper lifting, sitting, standing, and posture may prevent herniated discs. When lifting heavy objects, people should use their leg muscles instead of their backs and avoid twisting while lifting. [innerbody.com]