Slipped Disc

What is a slipped disc?

Firstly, in order to understand what a slipped disc is, let’s look at some anatomy.

Your spinal column is made up of a series of bones stacked on top of each other. These bones are cushioned by disks that make up about a third of the height of the spine. The disks, therefore, protect the bones by absorbing shocks from daily activities such as walking, running, lifting and twisting. They are made of a hard cartilage-like tissue on the outside (annulus fibrosus) and a jelly-like material in the middle. (Nucleus pulposus).

They have been compared to a donut.

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, ligaments, and muscles around it.

Symptoms of a slipped disc may include:

  • pain and numbness, most commonly on one side of the body
  • symptoms and pain may extend to your arms or legs
  • worsens at night or with certain movements
  • Aggravated or 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. In addition, not all symptoms will be present.

What causes a slipped disc?

A slipped disk occurs when the outer ring becomes weak or torn and allows the inner jelly like portion to slip out. A disk (jelly) can slip out 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 disk. If you have a very physically demanding job that requires a lot of lifting, you may be at increased risk for slipped disks.

Disks do not “slip back” because the jelly is under pressure, as it is a shock absorber. Traction may be indicated for these patients because it lowers the pressure inside the disk and helps with healing

Overweight individuals are also at increased risk for a slipped disk because their disks must support the additional weight. Weak muscles and a sedentary lifestyle may also contribute to the development of a slipped disk.

As you get older, you are more likely to experience a slipped disk. This is because your disks 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 also more common in men than women.

How are slipped discs diagnosed?

Your therapist will first perform a case history and then an examination. 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. You will also be asked you about your medical history and your symptoms. This will include when you first felt symptoms and what activities cause your pain to worsen.

Imaging tests can also be performed if indicated.

Examples of imaging scans include:

  • X-rays
  • CT scans
  • MRI scans
  • discograms

You will be referred to your GP for these tests if indicated.

Complications of a slipped disc?

An untreated, severe slipped disc can lead to permanent nerve damage. This can result in permanent muscle weakness and a loss of sensation along the nerve pathway.  This is usually felt in the arm or leg.

In very rare cases, a slipped disc can cut off nerve impulses to your front and back passage and cause cauda equina. If this occurs, you may lose bowel or bladder control. This is also known as saddle anesthesia. In this case, the slipped disc compresses nerves and also causes you to lose sensation in your inner thighs, the back of your legs, and around your rectum.

Please be aware that practitioners are very aware of these complications and trained to recognise them.

While the symptoms of a slipped disc may improve, they also can worsen. So, accurate physical therapy and care can greatly improve any outcome.

How are slipped disks treated?

Treatments for a slipped disk range from conservative to surgical. Thankfully the vast majority of disk problems respond well to physical therapy and do not require surgery. This is something that we specialize in, so please call us for advice and help.

Treatment depends on the level of pain and if other symptoms such as numbness are present. The vast majority of disc problems clear up with gentle physical therapy, rehabilitation, and exercise therapy. Drug treatment may also be used.

If your slipped disk pain does not respond to over-the-counter treatments, you may prescribe stronger medications. These include:

  • muscle relaxers to relieve muscle spasms
  • Analgesia, to relieve pain
  • nerve pain medications like gabapentin or duloxetine

Your GP may also recommend surgery if your symptoms do not subside in six weeks. If your slipped disk is affecting your muscle or “saddle” function you need urgent care.

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