Slipped Disc

Nerves extend from your brain through the spinal cord and relay important messages between the body and the brain. When you have a slipped disc and that disc is causing a nerve to be compressed or pinched, your body may send warning signals such as pain. If not diagnosed and promptly treated, that pain can become chronic and impact your quality of life.

Anatomy

The spinal cord runs from the base of the brain, through the cervical and thoracic spine and exits at the lumbar spine. The nerve roots at the lumbar and sacral levels exit the spinal canal in a horse’s tail formation. There are 33 stacked, interlocking spinal vertebrae that make up the spinal column and house the spinal canal.

Between each vertebra is an intervertebral disc that acts as a shock absorber and cushions the spine. Each disc has a soft center, the nucleus pulposus, composed of a gelatinous substance, and hard outer ring, the annulus fibrosus. It is the discs’ cushioning of the vertebrae that allows the spine to flex and bend without pain.

What Is a Slipped Disc?

Also known as a herniated or bulging disc, a slipped disc occurs when one or more disc has “slipped” out of place. An injury or weakness in the disc can cause the inner nucleus pulposus to protrude through the outer annulus fibrosus. While some slipped discs go unnoticed, when one compresses a spinal nerve, or nerve root root, they cause pain and discomfort.

Causes of a Slipped Disc

A slipped disc occurs if the annulus fibrosus becomes weakened and the nucleus pulposus slips out. It is most often the result of age-related wear-and-tear on the spine. As you age, the nucleus pulposus loses some of its water content, making the disc less flexible and more prone to tearing. Although a part of the normal aging process, there are some instances in which a ruptured disc is more likely to happen, such as:

Improperly lifting heavy objects

Obesity

Trauma or injury to the spine

Physically demanding work

High-impact sports

Osteoarthritis or rheumatoid arthritis

Symptoms of a Slipped Disc

A slipped or herniated disc can occur at any level of your spine. The lumbar spine is the most common area for a slipped disc. A slipped disc can put pressure on the nerves and muscles that surround it, causing pain and other symptoms such as:

Numbness and pain, usually on one side of the body

Pain that radiates through the arms and legs, depending on the level of the torn disc

Pain intensifies with certain movements or at night

Pain intensifies after standing or sitting

Pain that occurs when walking short distances

Burning, tingling, or aching sensations in the affected area

Unexplained muscle weakness

Diagnosing a Slipped Disc

See your doctor if the signs and symptoms of a slipped disc last for more than a few weeks and don’t respond to rest and over-the-counter pain relievers and the symptoms are impacting your quality of life. Your physician will review your medical history, take a complete inventory of your symptoms, and examine your back for tenderness.

Exams & Tests

During the physical exam, your doctor may also perform a neurological exam to check your muscle strength, reflexes, balance, walking ability, and the ability to feel vibration, pinpricks, and light touches.

Your doctor may order imaging studies to rule out other possible causes for your slipped disc and confirm the diagnosis. These tests include:

X-rays to rule out the possibility of infection, tumor, broken bones, or spinal alignment issues

CT scan to better visualize your spine and the structures around it

MRI to confirm the location of the herniated disc and the nerves affected by it

Myelogram to determine the pressure on your spinal cord or nerves due to multiple herniated discs or other conditions

Risk Factors

While normal age-related generation of the spine is the main cause of a slipped disc, there are risk factors that may increase their occurrence, such as:

Obesity as excess weight puts additional stress on your spine

Occupations that are physically demanding and require repetitive lifting, pushing, pulling, bending and twisting

Bone spurs that develop when two bones rub against each other and cause narrowing of the spine

Smoking can speed up disc degeneration and slow down healing

Hereditary tendency of disc degeneration that can increase the risk of a slipped disc

Treatment for a Slipped Disc

Most physicians begin with conventional, non-surgical treatments to provide pain relief for their patients suffering from a slipped disc. Often, avoiding painful positions and movements as well as an exercise regimen and pain medication relieves symptoms within a few weeks.

Non-Surgical Treatment

Non-surgical treatments for a slipped disc include:

Over-the-counter pain medication such as ibuprofen, naproxen, or acetaminophen

Muscle relaxers for patients who have had muscle spasms

Non-steroidal anti-inflammatory drugs (NSAIDs) to reduce inflammation and provide pain relief

Cortisone injections into the area around the spinal nerves

Oral steroids to reduce swelling and inflammation

Physical therapy

Alternative methods such a chiropractic care or acupuncture

Surgical Treatment

If your symptoms have not subsided and your pain has worsened to the point that it is chronic and impacting your quality of life, surgery may be necessary. The Bonati Spine Institute offers an array of procedures to treat a slipped disc, which may include:

Surgeries for a slipped disc include:

Foraminotomy/Foraminectomy to increase the space in the foramen and decompress the nerve root

Laminectomy/Laminotomy to relieve pressure on the spinal cord by removing a section of the lamina

Discectomy to remove a portion of the disc that is compressing the nerve roots

Prevention & Self-Care

Although the natural aging that causes degeneration of the spine cannot be avoided, there are some steps you can take prevent or delay the degeneration, including:

Maintain good posture

Stay active and exercise regularly

Incorporate strengthening and flexibility exercises into your exercise program

Use safe techniques when lifting or performing repetitive activities

Maintain a healthy weight and nutritious, anti-inflammatory diet

Don’t smoke

Staying healthy can help prevent or mitigate the symptoms of a slipped disc.