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Lumbar disk disease: pathophysiology, management and prevention

H S Gilmer1, S M Papadopoulos, G F Tuite

  • 1University of Michigan Medical School, Ann Arbor.

American Family Physician
|April 1, 1993
PubMed
Summary

Symptomatic lumbar disk disease often causes leg pain and weakness. Conservative treatments like physical therapy are effective for most, with surgery reserved for severe or persistent cases.

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Area of Science:

  • Neurology
  • Orthopedics
  • Radiology

Background:

  • Lumbar disk disease presents with diverse symptoms including back pain, referred or radicular leg pain, sensory changes, and weakness.
  • Neurologic deficits commonly affect the L5 or S1 nerve roots, necessitating focused evaluation of corresponding dermatomes and muscle groups.

Purpose of the Study:

  • To outline the diagnostic approaches and management strategies for symptomatic lumbar disk disease.
  • To emphasize the importance of conservative treatment and preventive measures for recurrent symptoms.

Main Methods:

  • Review of diagnostic imaging modalities including myelography, computed tomography (CT), postmyelogram CT, and magnetic resonance imaging (MRI).
  • Description of conservative management involving physical therapy, activity modification, mobilization, and exercise.
  • Discussion of indications for surgical intervention and strategies for preventing symptom recurrence.

Main Results:

  • Diagnostic studies like MRI and CT are crucial for evaluating lumbar disk disease.
  • Conservative treatment is effective for the majority of patients.
  • Surgical intervention is indicated for those unresponsive to conservative care or with significant neurologic deficits.

Conclusions:

  • Most patients with symptomatic lumbar disk disease benefit from conservative management.
  • Patient education, exercise, weight control, and posture correction are key to preventing recurrent herniation and pain.

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