Page 119 - ASOP ROT Study Guide

Management
A spinal corset may help to relieve pain, otherwise management strategies are similar to those for the
mechanical back pain sufferer. Most sufferers do not require surgery unless they are experiencing
severe pain, when surgical fusion of the two affected vertebrae may be required. A pars interarticularis
defect such as a fracture, as described above, may be seen on a radiograph without a forward slipping of
the vertebra. This is known as spondylolysis and this defect can exist without causing pain. If pain is
experienced, conservative measures are usually successful, but if the pain is severe, spinal fusion
may be required.

4 . 2 Backache and Neckache Related to the Nervous Tissues
It is essential from the outset to allay the commonly held view in the general population that most back
and leg ache is caused by a "slipped disc". The intervertebral disc does not "slip", the disc contents
prolapse, and in fact this is a relatively rare condition.
4 . 2 . 1 Prolapsed intervertebral disc
Disc prolapse was first described in the late nineteen forties but first became a popular diagnosis in the
early sixties. It is true to say that since then the diagnosis has become somewhat overused. Disc prolapse
may occur in the lumbar or cervical spine but the description below relates to the lumbar spine.
Clinical presentation
The classical symptoms occur in people under forty, more commonly in men. They are acute backache
and legache, or sometimes legache alone with backache developing later. Sufferers may describe a single
event of lifting or strain, but there is not necessarily a correlation between this and the condition; it may
arise spontaneously.
The characteristic symptom is of legache passing down the back of the thigh and leg to the foot. This is
in contrast to referred backache which usually goes no further than the knee or upper calf.

http://physioworks.com.au/injuries-conditions-
1/bulging_disc

Etiology
The cause is an abnormality in the intervertebral disc which leads to prolapse (extrusion) of the
nucleus pulposus material through the annulus fibrosis. If it extrudes backwards and laterally it