Herniated Disk, (Slipped Disk) A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

By Kenneth Kee

Herniated Disk or Prolapsed Inter-vertebral Disk is the medical disorder of prolapse of the inter-vertebral disk (which is the disk between 2 vertebrae) as a result of protrusion of the nucleus pulposus of the disk out of its weakened ligamentous ring (annulus fibrosus).
The disk may protrude in a posterior or posterolateral direction producing pressure to the nerve roots particularly at L4, L5 and S1 vertebrae.
Many doctors use the phrase “prolapsed disk” synonymously with terms such as “herniated disk,” “slipped disk,” and “ruptured disk.”
While this is fine for common usage, a prolapsed disk medically refers to the second of four stages of disk rupture.
Along the route to fully rupturing, the disks in the spine may pass through four distinct stages.
1. Disk Degeneration
During this stage, the outer walls of the inter-vertebral disks are weakened, but no visible external alterations have occurred.
2. Disk Prolapse
The outer wall of the disk begins to change shape and bulge out into the spinal canal.
The patient may begin to feel symptoms at this stage if the distended disk exerts pressure on the spinal cord or the nerve roots that extend from it.
3. Disk Extrusion
At this stage, the gel-like inner core of the disks has burst through a tear in the disk’s outer wall, but has not leaked out into the spinal canal.
4. Disk Sequestration
At this final stage, the gel-like substance has left the disk and has leaked into the spinal canal.
It is almost certain that the patient will feel symptoms at this stage, as the inner gel contains proteins that will inflame nerves that they come into contact with.
1. The most common symptom is Low Backache with pain in the lumbar region.
Pain may so bad that the person cannot stand erect.
2. There is a Sciatica or pain shooting down one leg
Physical Examination in a patient with suspected lumbar (lower back) inter-vertebral disk disease may feature the following:
a. Abnormal gait
b. Abnormal postures
c. Decreased lumbar range of motion
d. Positive straight leg raising test: Indicative of nerve root involvement
Spine MRI or CT will indicate that the herniated disk is pressing on the spinal canal.
The first treatment for a slipped disk is a short period of rest with medicines for the pain.
Initial phase:
1. Bed rest with a hard board below the mattress- straighten the back
2. Physiotherapy such as traction, shortwave diathermy
Mobilization phase:
1. Wearing a corset to straighten the back and help the traction of the spinal bones
2. Gradual mobilization and exercises to improve the strength of the spinal extensor muscles
Maintenance phase:
1. Exercises to strengthen the back muscles.
2. Wear a corset
3. Avoid postural strain on the back
Surgery is required if there are:
1. Persistent pain and neurological symptoms remain after conservative treatment
2. Progressive neurological symptoms
3. Disk has protruded more than 75% out of its inter-vertebral space as seen on MRI images
Surgery can be:
1. Laminectomy - removal of the disk and prolapsed material.
2. Microdiskectomy- insertion of a titanium disk to replace the removed prolapsed disk

TABLE OF CONTENT
Introduction
Chapter 1 Herniated Disk
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Treatment
Chapter 6 Prognosis
Chapter 7 Sciatica
Chapter 8 Neck Injury
Epilogue

• Language: English
• Publisher: Kenneth Kee
• Release date: Nov 7, 2016
• ISBN: 9781370895281

Kenneth Kee

Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

Book preview

Herniated Disk,

(Slipped Disk)

A

Simple

Guide

To

The Condition,

Diagnosis,

Treatment

And

Related Conditions

By

Dr Kenneth Kee

M.B.,B.S. (Singapore)

Ph.D (Healthcare Administration)

Copyright Kenneth Kee 2016 Smashwords Edition

Published by Kenneth Kee at Smashwords.com

Dedication

This book is dedicated

To my wife Dorothy

And my children

Carolyn, Grace

And Kelvin

This book describes the Herniated Disk, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

(What You Need to Treat Herniated Disk)

This eBook is licensed for the personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.

If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

Thank you for respecting the hard work of this author.

Introduction

I have been writing medical articles for my blog http://kennethkee.blogspot.com (A Simple Guide to Medical Condition) for the benefit of my patients since 2007.

My purpose in writing these simple guides was for the health education of my patients.

Health Education was also my dissertation for my Ph.D (Healthcare Administration).

I then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.com.

This autobiolographical account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Conditions into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

From which many free articles from the blog was taken and put together into 700 amazon kindle books and some into Smashwords.com eBooks.

Some people have complained that the simple guides are too simple.

For their information they are made simple in order to educate the patients.

The later books go into more details of medical conditions.

The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

Since 2013, I have tried to improve my spelling and writing.

As I tried to bring you the latest information about a condition or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

I apologize if these repetitions are irritating to some readers.

Chapter 1

Herniated Disk (Slipped Disk)

What is Herniated Disk (Slipped Disk)?

Herniated Disk or Prolapsed Inter-vertebral Disk is the medical disorder of prolapse of the inter-vertebral disk (which is the disk between 2 vertebrae) as a result of protrusion of the nucleus pulposus of the disk out of its weakened ligamentous ring (annulus fibrosus).

The disk may protrude in a posterior or posterolateral direction producing pressure to the nerve roots particularly at L4, L5 and S1 vertebrae.

Many doctors use the phrase prolapsed disk synonymously with terms such as herniated disk, slipped disk, and ruptured disk.

While this is fine for common usage, a prolapsed disk medically refers to the second of four stages of disk rupture.

Along the route to fully rupturing, the disks in the spine may pass through four distinct stages.

Disk Degeneration

During this stage, the outer walls of the inter-vertebral disks are weakened, but no visible external alterations have occurred.

It is unlikely that the patient will have any symptoms at this stage.

Disk Prolapse

The outer wall of the disk begins to change shape and bulge out into the spinal canal.

The patient may begin to feel symptoms at this stage if the distended disk exerts pressure on the spinal cord or the nerve roots that extend from it.

Disk Extrusion

At this stage, the gel-like inner core of the disks has burst through a tear in the disk’s outer wall, but has