Nonoperative versus operative treatment of acute disc injuries in athletes.

Many factors contribute to intervertebral disc problems; anatomic, physiologic, and mechanical factors are considered in the literature. Disc pathology as the cause of back or neck pain in the athletic population is primarily seen in acute disc injury. The research connecting degenerative disc disease as a precursor to acute disc injury is limited in scope. The research in discogenic etiology of back and neck injuries in the athletic population is also small in number, therefore resulting in limited information supporting the nonoperative versus operative treatment of disc injury. Treatment convention tends to be a conservative, nonoperative approach. Conservative treatment generally includes three phases: acute (palliative), rehabilitative, and maintenance. The operative approach has received more prospective research, but similar functional outcomes as the nonoperative approach for the majority of disc injuries. Treatment options are discussed, in addition to a brief overview of the biochemical and biomechanical environment of disc injury.