Slipped Disc
At times, in public gatherings, you may notice a person beside you is uncomfortable in his chair. He continuously changes his position or tries to sit with his back erect and straight. These kinds of actions are usually unintentional responses to terrible back pain. Having back pain doesn't always mean you have a slipped disc, but when the pain worsens while sitting or standing and extends to your arms or legs, it may be related to a slipped disc.
Our spine is made of bones (vertebrae) that are stacked one above the other, with the discs cushioning between them. These discs are round with a tough and rubbery outer layer (annulus) and a gel-like center (nucleus), acting as shock absorbers for spinal bones. A slipped disc occurs when some of the nucleus is pushed through a rupture in the annulus. It is also known as a herniated, bulging, or ruptured disc.
It can occur in any part of the spine, depending on which the symptoms vary. It occurs more frequently in your lower back, though. Sometimes, a slipped disc may pinch a nearby nerve, causing severe pain.
What are the symptoms of slipped disc?
The signs and symptoms depend on the area where the affected disc is situated in your spine and whether it is compressing the nearby nerve. The majority of slipped discs occur in the lower back; however, they may also occur in the neck.
A slipped disc in your lower back (Lumbar Herniated disc) may cause:
- Pain in the lower back.
- Sharp and burning pain that radiates from your buttocks down to your thigh, calf, and sometimes foot.
- Pain that may worsen while standing, sitting, or walking.
- Pain that worsens while you cough, sneeze, or move in certain positions.
- One side of the body is typically affected by the pain
- Loss of bladder and bowel control in severe cases.
A slipped disc in your neck (Cervical Herniated disc) may cause:
- Mild pain in your neck.
- Pain that radiates to your shoulder, arm, or hands and fingers.
- Pain that worsens with certain positions or movements of neck.
Other symptoms may include numbness, tingling, and weakness of the muscles in the area where the affected nerve is meant to serve.
What are the causes of slipped disc?
A slipped disc often results from the natural process of age-related wear and tear of the disc, known as degeneration. As you age, the disks are deprived of their water content and begin to shrink. This makes them less flexible and more prone to rupture with a minor strain.
However, it can also occur due to a sudden, extensive injury or trauma.
Other factors that may increase your risk of slipped disc may include
- Being a male
- Having a family history for the condition
- Using improper lifting technique
- Staying seated for longer periods, such as driving
- Performing repetitive actions that may strain your spine
- Living a sedentary lifestyle
- Being overweight
- Being a smoker
How is a slipped disc diagnosed?
After reviewing your medical history and symptoms, a physical examination is performed. Your physician may ask you to lie straight on your back while he carefully lifts your leg. Feeling pain down your leg and below the knee could be a strong indication of a slipped disc. A neurological examination is also done to determine if there is any weakness or loss of sensation. Your physician may also test your reflexes, as they may be affected due to nerve compression in your spine.
Usually, a physical exam along with the medical history is sufficient for a diagnosis. However, if the physician suspects other conditions or wants to determine the nerve affected by the slipped disc, he may recommend the following examinations:
- X-ray: X-rays help produce images of your vertebrae and the outline of your joints. They help in determining the causes of back pain, such as infection, tumors, or fractures.
- Computed Tomography (CT): A CT scan helps to produce images of structures like spinal canal, nerves, and other soft tissues around your spine.
- Magnetic Resonance Imaging (MRI): MRI helps obtain detailed images of the spinal cord and soft structures surrounding it. It helps in determining the location of the slipped disc and the nerve that is affected.
- Myelogram: In this test, a special dye is injected into the spinal fluid before performing an imaging test. It helps in revealing the pressure on your spinal cord or nerves due to a slipped disc, a bone spur (overgrowth), or tumors.
- Nerve conduction studies: This helps in measuring how well your nerves can carry electrical impulses when a small current is passed through the electrodes placed on your skin.
- Electromyography (EMG): This test evaluates the electric activity of your muscles through needle electrodes that are inserted through your skin.
How is a slipped disc treated?
The type of treatment is determined by how severe the symptoms are. The majority of people experience improvement after a few days or weeks of treatment.
The typical treatment for slipped disc includes:
- Rest: Adequate rest, at least for a couple of days helps relieve back pain. It is recommended to avoid movements that aggravate pain and to limit activities, such as bending forward or lifting. Additionally, sitting for longer periods should also be avoided.
- Physical therapy: Physical therapy includes exercises that strengthens your lower back and abdominal muscles.
- Medications: Using non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen to relieve pain.
- Injections: Administrating steroid injections near the affected nerve may provide relief from pain and inflammation.
- Surgery: Surgery is usually recommended if other options fail to provide relief from symptoms. It may also be inevitable for patients with severe symptoms like muscle weakness, trouble walking, and loss of bowel or bladder function.
Surgery involves removing the herniated part of the disc and other fragments that are compressing the nerve through small incisions known as microdiscectomy. Rarely, an entire disc may be removed, followed by fusing the vertebrae with the help of screws or bone implants.
How can we prevent a slipped disc?
The following steps may help in preventing slipped disc.
- Physical exercise: These exercises involve strengthening of the trunk muscles to stabilize and support your spine.
- Posture correction: Maintaining correct postures while sitting or standing helps reduce pressure on your spine and discs. It is important to sit with your back straight, especially while sitting for longer periods, and take regular breaks to move. Knowing and following proper lifting techniques remains a fundamental rule.
- Control your weight: It is also important to maintain healthy weight, as excess weight may increase pressure on your spine and discs.
- Quit smoking: Smoking cessation and the use of other tobacco products is beneficial.