Review article MANAGEMENT OF HERNIATION OF THE LUMBAR DISC

The natural history of lumbar disc herniation Clinical evolution. It is extremely difficult to study clinically the natural history of a condition causing pain, since patients almost inevitably undergo some form of treatment. This may explain the paucity of information on the natural evolution of the clinical symptoms and signs of disc herniation. In a multicentre prospective study, Weber, Holme and Amlie1 analysed 208 patients who presented with the clin-ical features of lumbar radiculopathy probably due to disc herniation. In no case was herniation diagnosed by imaging studies. All the patients were examined between two and four weeks after the onset of symptoms and a questionnaire was used to evaluate their clinical status at three and 12 months. All were instructed to observe complete bed rest for one week. Some were treated with piroxicam, wherea