A slipped disc – known as a prolapsed or herniated disc – occurs when one of the discs that sit between the bones of the spine (the vertebrae) is damaged and presses on the nerves.
The sciatic nerve.its bunch of nerve roots emanating from different spinal level and finally present as cord-known as sciatic nerve and is often affected in cases of slipped disc. It is the longest nerve in the body and runs from the back of the pelvis, through the buttocks and down both legs to the feet.
If pressure is placed on the sciatic nerve (sciatica), it can cause mild to severe pain in the leg, hip or buttocks. pain may even radiate toward foot.depending on affected level,usually in lumbar region affected level is L4-5 OR L5S1 level.similarly in cervical region its C5-6,6-7 levels.
90 are spine disc protrusion,extrusion,or sequestered pathology can be appreciated radiologically in these segments.
only your clinical sign and symptoms,in addition to radiological evidence can be only indicator to established your diagnosis as slipped disc.
in slipped disc problem nucleus pulpous is displaced from vertebral disc,from main place this gelatinous material reach to spinal canal or foramen,where it put pressure on nerves.
never correlate any back pain as slipped disc unless not evident by clinical and radiological evidence.
Read more about the symptoms of a slipped disc.
What causes a slipped disc?
Slipped Disc problem is usually happened because of mechnical factors,that influence our spine curvature associated mechanical stress over vertebra and nerve roots too.
A slipped disc occurs when the outer case of the disc splits, resulting in the gel inside the disc annulus, bulging out of the disc.and putting pressure over spinal cord ,and exiting or traversing nerve roots,
The damaged disc can put pressure on the whole spinal cord or on a single nerve root (where a nerve leaves the spinal cord).
This means a slipped disc can cause pain both in the area of the protruding disc and in the area of the body controlled by the nerve that the disc is pressing on.always see the affected dermatome to ruled out neurological involvement.
It is not always clear what causes a disc to break down, although age as degenerative change is a common factor in many cases. As you get older, your spinal discs start to lose their water content, making them less flexible and more likely to rupture.
Smoking also plays a role as it causes the discs to lose their natural flexibility.
It’s important to note not all slipped discs cause symptoms such as pain, weakness or tingling. Many people will go their whole life and not know they have a slipped disc, even though they have one.
Read more about what causes a slipped disc.
Diagnosing a slipped disc
Your GP will usually be able to diagnose a slipped disc from your symptoms and medical history. They may also carry out a physical examination to test your neurological status.but radiological evidence and their interpretation by qualified spine surgeon like Neurosurgeon,Pain physician,Ortho peadic surgeon and other neurophysician,
very strange most of the patients when seen initially by any physician,just only see the X-rays of spine.it must be keep in mind in plain x-rays your doctor can only see the bony structure,their alignment ,fracture,displacement or some gross,pathology like cancer of bone.its impossible to see soft structure like disc,nerve spinal cord and other vascular structure of spine..
xrays has no access to nerve compression at all.its impossible to see nerve and disc in X-rays.for exact morphology you have to get an CT scan or more precisely with MRI study.
- muscle strength
- walking ability
- sensation in your limbs
Read more about how a slipped disc is diagnosed.
Treating a slipped disc
It can take about four to six weeks to recover from a slipped disc. 90% of Treatment usually involves a combination of physical therapy, such as massage and exercise, and medication to relieve the pain.if red flag sign are absent-bowl and bladder involvement as well as motor power compromise .
one important advisory for patients with spine pathology should not consider any physiotherapy as sole treatment,unwanted advise and manuevers in physiotherapy exercise may be catastrophic or life threating.
important advise for patients -who are being advise to follow only medicine ,exercises,or bed rest.if their clinical status not improve with passage of time,conservative treatment duration must be time bound.beyond that duration ,undoubtedly your patient may require surgery,that can be manage by Endoscopic Discectomy,Minimal invasive Spine surgery too.
Surgery to release the compressed nerve and remove part of the disc may be considered in severe cases, or if the pain continues for longer than six weeks.
In many cases, a slipped disc will eventually shrink back away from the nerve and the pain will ease as the disc stops pressing on the affected nerve.
Often the slipped disc will stay pressing on the nerve, but the pain goes away because the brain learns to “turn down the volume” on the pain messages coming from the nerve.
If you have a slipped disc, it is very important to keep active.if clearance given to by qualified neurosurgeon or spine doctor. Initially moving may be difficult, but after resting for a couple of days you should start to move around.
This will help keep your back mobile and stop the joints becoming stiff and the muscles that support the spine becoming weak. Keeping moving will speed up your recovery.
Any exercise you do should be gentle and not put too much strain on your back. Exercises that involve high impact, such as running, jumping or twisting, should be avoided at first as they may cause a flare-up of the pain.
in many cases ignorance by you or your doctor ,who is not a specialist in spine,may aggravate your life threatening situation like bowl,bladder incontinence.may present as caudal equine syndrome,a emergency situation,leads to irreversible neurological deficit.
Read more about treating a slipped disc.
Preventing a slipped disc
Taking a few sensible precautions, such as leading a healthy lifestyle, can help prevent back pain and lower your risk of getting a slipped disc. For example, you should:
- take regular exercise
- use a safe technique when lifting heavy objects
- always maintain a good posture when sitting and standing
- quit smoking if you smoke
Read more about preventing a slipped disc.
how common are slipped discs?
Slipped discs are most common in people aged between 30 and 50 years old. The condition affects twice as many men as women.
Slipped discs often occur in the lower back.and cervical region, While around a third of adults in the world have lower back pain, fewer than 12 in 20 people have a Slipped Disc Back pain.