What is a Slipped Disc?
Spine Surgeon, Jaslok Hospital, 20 years of experience
English हिन्दी Bengali العربية
What is a Slipped Disc?
The spine is made up of individual bones called vertebrae that interlock with each other to form the spinal column. There is a shock-absorbing disc between each of the vertebrae known as intervertebral discs. These discs play an important role in the absorption of impacts and assisting in movements like walking, running, and lifting weights. These discs have soft jelly-like centers in them. When there is a chronic strain on these discs the central jelly-like part can get displaced and protrude out of the disc and cause it to prolapse. This prolapse and herniation (outpouching) of the disc is called a slipped disc. It can cause further complications due to the compression of a spinal nerve near it.
Let us explain in detail about the slipped disc in this article.
- What are the types of Slipped Disc?
- What are the causes of Slipped Disc?
- What are the symptoms of Slipped Disc?
- What are the investigations for a Slipped Disc?
- What are the treatments for Slipped Disc?
- How to prevent Slipped Disc?
What are the types of Slipped Disc?
There are mainly three types of slipped discs. Depending on these types, different treatment approaches are taken.
- Contained: There is a minor bulge in the disc due to the pressure between the vertebrae. It causes mild back pain and can even go unnoticed.
- Non-contained: It is also known as disc extrusion. There is a major herniation in the disc and causes pain which may be severe at times. This may be neglected in people who have chronic back pain.
- Sequestered: When contained or non-contained slipped discs are ignored they can further progress to sequestered slipped discs. In this, the discs are forcefully compressed and get ruptured. It is usually accompanied by intense pain.
What are the causes of Slipped Disc?
Slipped disc can occur due to the following reasons:
- Age: The older you get the more worn out these discs are, thus there is a higher chance of disc prolapse.
- Weight lifting: Twisting and turning motions while lifting any weight puts strain on the spine. Very heavy weight lifting can also do the same causing the disc to herniate and prolapse.
- Sedentary lifestyle and Obesity: Overweight people are more prone to this since their spine has to carry additional weight and due to inactivity the muscles are weaker and cannot support the spine adequately.
What are the symptoms of Slipped Disc?
Slipped disc usually has an acute onset (occurs suddenly) and is seen right after some trauma or weight lifting. It is most commonly seen in the lower back(lumbar spine) but can also occur in the neck(cervical spine) and the upper back (thoracic spine). The symptoms of the patient may have depended on the location of the slipped disc. They are as follows:
- Backache– It may be acute or chronic and is in the area of the prolapsed disc. Acute back pain is usually severe and accompanied by muscle spasms. Chronic pain is usually dull and diffuse which increases on exertion and staying in one position for a long time. ( Know more about- What is Tailbone pain? )
- Radiating pain– It may be associated with back pain or maybe the only symptom. The pattern of radiation depends on the nerve compressed. In the lower back(lumbar) disc prolapse radiating pain is felt along the gluteal region, back of the thigh, leg, or foot. In cervical(neck) disc prolapse the pain is felt down the shoulder along the outer aspect of the arm, till the thumb.
- Motor function loss– The muscles which the nerve is supplying will be weaker than the same muscles on the opposite side
- Sensory loss– There may be numbness or a pricking feeling along the skin supplied by the nerve. ( Know more about- What is Tingling in hands and feet? )
What are the investigations for a Slipped Disc?
After a thorough examination by a doctor, further investigations are required to confirm the diagnosis.
- X-ray
- CT scan (What are the treatments for Slipped Disc in Arabic)
- MRI
- Electromyography(EMG)- Helps locate the exact nerve which is compressed
What are the treatments for Slipped Disc?
Treatment aims to alleviate the symptoms and reduce compression. According to the level of disc prolapse treatment may be Conservative or Surgical.
Conservative treatment:
Most cases of treatments of slipped disc are resolved without the need for surgery and the patient recovers within 3-6 weeks. It consists of the following-
- Bedrest- usually for not more than 3- 4 days
- Drugs- Strong painkillers and muscle relaxants ( Know more about- What is Naprosyn tablet? )
- Physiotherapy- Gentle arching and stretching exercises that don’t strain the back ( Know more about- What is Physiotherapy? )
- Transcutaneous Electrical Nerve Stimulation(TENS)
Surgical treatment:
If conservative treatment fails to treat the patient, if the patient presents with severe compression of the nerves or if there is severe deformity(sciatic tilt) then operative treatment is indicated.
- Fenestration- In this, a hole is made in the ligament connecting the two vertebrae of the affected disc to relieve the compression of the nerves.
- Discectomy- It is the most commonly performed procedure. The surgeon removes the herniating part of the disc or the entire disc that is affected.
- Laminotomy- A hole is made in the bone for wider exposure.
- Laminectomy- Half of the lamina(Hemi-laminectomy) or the entire lamina on both sides may be removed to alleviate the pressure. ( Know more about- What is Laminectomy? )
- Spinal Fusion- In this, the entire affected disc is removed and the two bones are fused with the help of a bone graft, screws, and plates. This causes permanent immobilization of that joint.
All these procedures are done under general anesthesia.
How to prevent Slipped Disc?
Chances of having a slipped disc increase with age, thus to minimize its chances of happening the following precautions should be taken:
- Use appropriate lifting techniques with the correct form. It is important not to lift heavier weights than one is comfortable with.
- Maintain a healthy weight
- Low impact exercises like walking help strengthen the back muscles and improve stability
- Do exercises that strengthen the abdominal muscles, back and leg muscles • Do not stay immobile for long periods of time, always stretch and walk in between • Avoid the use of high heeled shoes for a prolonged period of time
- Cessation of smoking
We hope that we could answer your questions regarding Slipped Disc through this article.
If you want more information and treatment of Slipped Disc, you can contact an Orthopaedic surgeon.
We only aim to give you information through this article. We do not recommend medication, treatment in any way. Only a doctor can give you the best advice.
