Acute symptomatic disk prolapse. Clinical manifestations and therapeutic considerations

Intervertebral disk prolapse is a relatively common cause of acute low back dysfunction. The resultant symptoms and signs can be explained by the pathomechanics and pathophysiology of the intervertebral disk. Clinical manifestations should be used to differentiate the prolapse from more severe disk protrusions and from other types of spinal pathology, for treatment must be pathology-specific. Primary goals of management should include: resolution of the acute problem, restoration of optimal segmental mechanics, restoration of an optimal activity level, prevention of recurrent physical dysfunction, and prevention of chronic pain behavior patterns.