22/05/2019
Slipped (Herniated) Disc
Medically reviewed by William A Morrison MD on May 9, 2016 — Written by Rachel Nall, RN, BSN, CCRN
Symptoms
Causes
Diagnosis
Complications
Treatment
Outlook
Prevention
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What is a slipped disc?
Your spinal column is made up of a series of bones (vertebrae) stacked onto each other. From top to bottom, the column includes seven bones in the cervical spine, 12 in the thoracic spine, and five in the lumbar spine, followed by the sacrum and the coccyx at the base. These bones are cushioned by discs. The discs protect the bones by absorbing the shocks from daily activities like walking, lifting, and twisting.
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Each disc has two parts: a soft, gelatinous inner portion and a tough outer ring. Injury or weakness can cause the inner portion of the disc to protrude through the outer ring. This is known as a slipped, herniated, or pr*****ed disc. This causes pain and discomfort. If the slipped disc compresses one of your spinal nerves, you may also experience numbness and pain along the affected nerve. In severe instances, you may require surgery to remove or repair the slipped disc.
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What are the symptoms of a slipped disc?
You can have a slipped disc in any part of your spine, from your neck to your lower back. The lower back is one of the more common areas for slipped discs. Your spinal column is an intricate network of nerves and blood vessels. A slipped disc can place extra pressure on the nerves and muscles around it.
Symptoms of a slipped disc include:
pain and numbness, most commonly on one side of the body
pain that extends to your arms or legs
pain that worsens at night or with certain movements
pain that worsens after standing or sitting
pain when walking short distances
unexplained muscle weakness
tingling, aching, or burning sensations in the affected area
The types of pain can vary from person to person. See your doctor if your pain results in numbness or tingling that affects your ability to control your muscles.
What causes slipped discs?
A slipped disc occurs when the outer ring becomes weak or torn and allows the inner portion to slip out. This can happen with age. Certain motions may also cause a slipped disc. A disc can slip out of place while you are twisting or turning to lift an object. Lifting a very large, heavy object can place great strain on the lower back, resulting in a slipped disc. If you have a very physically demanding job that requires a lot of lifting, you may be at increased risk for slipped discs.
Overweight individuals are also at increased risk for a slipped disc because their discs must support the additional weight. Weak muscles and a sedentary lifestyle may also contribute to the development of a slipped disc.
As you get older, you are more likely to experience a slipped disc. This is because your discs begin to lose some of their protective water content as you age. As a result, they can slip more easily out of place. They are more common in men than women.
How are slipped discs diagnosed?
Your doctor will first perform a physical exam. They will be looking for the source of your pain and discomfort. This will involve checking your nerve function and muscle strength, and whether you feel pain when moving or touching the affected area. Your doctor also will ask you about your medical history and your symptoms. They will be interested in when you first felt symptoms and what activities cause your pain to worsen.
Imaging tests can help your doctor view the bones and muscles of your spine and identify any damaged areas. Examples of imaging scans include:
X-rays
CT scans
MRI scans
discograms
Your doctor can combine all these pieces of information to determine what is causing your pain, weakness, or discomfort.
What are the complications of a slipped disc?
An untreated, severe slipped disc can lead to permanent nerve damage. In very rare cases, a slipped disc can cut off nerve impulses to the cauda equina nerves in your lower back and legs. If this occurs, you may lose bowel or bladder control.
Another long-term complication is known as saddle anesthesia. In this case, the slipped disc compresses nerves and causes you to lose sensation in your inner thighs, the back of your legs, and around your re**um.
While the symptoms of a slipped disc may improve, they also can worsen. If you cannot perform the activities you once could, it’s time to see your doctor.
How are slipped discs treated?
Treatments for a slipped disc range from conservative to surgical. The treatment typically depends on the level of discomfort you’re experiencing and how far the disc has slipped out of place.
Most people can relieve slipped disc pain using an exercise program that stretches and strengthens the back and surrounding muscles. A physical therapist may recommend exercises that can strengthen your back while reducing your pain.
Taking over-the-counter pain relievers and avoiding heavy lifting and painful positions can also help.
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While it may be tempting to refrain from all physical activity while you’re experiencing the pain or discomfort of a slipped disc, this can lead to muscle weakness and joint stiffness. Instead, try to remain as active as possible through stretching or low-impact activities such as walking.
If your slipped disc pain does not respond to over-the-counter treatments, your doctor may prescribe stronger medications. These include:
muscle relaxers to relieve muscle spasms
narcotics to relieve pain
nerve pain medications like gabapentin or duloxetine
Your doctor may recommend surgery if your symptoms do not subside in six weeks or if your slipped disc is affecting your muscle function. Your surgeon may remove the damaged or protruding portion of the disc without removing the entire disc. This is called a microdiskectomy.
In more severe cases, your doctor may replace the disc with an artificial one or remove the disc and fuse your vertebrae together. This procedure, along with a laminectomy and spinal fusion, adds stability to your spinal column.
What is the outlook for someone with a slipped disc?
Most people with a slipped disc respond well to conservative treatment. Within six weeks their pain and discomfort will gradually lessen.
Is it possible to prevent a slipped disc?
It may not be possible to prevent a slipped disc, but you can take steps to reduce your risk of developing a slipped disc. These steps include:
Use safe lifting techniques: Bend and lift from your knees, not your waist.
Maintain a healthy weight.
Do not remain seated for long periods; get up and stretch periodically.
Do exercises to strengthen the muscles in your back, legs, and abdomen.
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