Peer Reviewed
Perspectives on orthopaedics

Disc prolapse

Andrew W Leicester
Abstract
Most patients with a disc prolapse will respond to a conservative approach, which includes rest, analgesics, anti-inflammatory agents, physiotherapy and pelvic traction.
Key Points
    Case presentation

    A 41-year-old man presents with acute sciatica following a lifting injury. How is this best managed?

    Discussion

    About 90% of people will experience an acute episode of lower back pain, and many of these episodes are caused by a prolapsed disc. The intervertebral disc is comprised of a thick annulus fibrosis and the gelatinous nucleus pulposus.

    With time, the disc degenerates and this can be associated with a prolapse of disc material, which results in the clinical picture of sciatica. Sciatica is caused by both the mechanical effect of the disc prolapse and an intense inflammatory response.