Slip Disc: Types, Risk Factors and Treatment

What is a Slip Disc?

A herniated disk or slip disc is a spinal injury involving a series of bones (vertebrae) in the spine, extending from the base of the skull to the tailbone. Between the vertebrae are circular cushions known as disks, serving as buffers between the bones and facilitating flexible movement. When a disk tears or leaks, it is referred to as a herniated disk. Neurosurgeons often diagnose and treat this condition due to their expertise in musculoskeletal disorders.

Types of Slip Disc

A slipped disc can occur in different forms, depending on the nature and location of the disc damage. Here are the common types:

Protrusion

This is the most common type of slipped disc. It occurs when the disc bulges out without rupturing the outer fibrous ring (annulus fibrosus). The bulge typically affects a large part of the disc, causing it to protrude into the spinal canal without breaking through the outer layer.

Extrusion

In this type, the nucleus material of the disc breaks through the annulus fibrosus but remains within the disc. The distinction between protrusion and extrusion is based on the shape and position of the herniated material.

Sequestration

This is a more severe form where the nucleus material breaks through the annulus fibrosus and then separates from the disc, floating into the spinal canal. This can lead to significant nerve compression and pain.

Bulging Disc

While often considered synonymous with a herniated disc, a bulging disc is slightly different. It involves the disc bulging out around its entire circumference. It's more of a generalised disc expansion than a localised herniation.

Symptoms of Slip Disc

Herniated disk symptoms vary based on the spinal location of the issue, with aggravation upon movement and alleviation during periods of rest.

For a herniated lumbar disk in the lower back, it is typical for individuals to experience sciatic nerve pain, characterised by a sharp sensation radiating down one side of the buttocks into the leg and occasionally reaching the foot. Additional indicators of a herniated disk in the lower back encompass:

• Back Pain: Presence of pain in the lower back.
• Tingling or Numbness: Sensations of tingling or numbness in the legs and/or feet.
• Muscle Weakness: Weakness observed in the muscles.

In the case of a herniated cervical disk in the neck, manifestations include:

• Shoulder Blade Pain: Discomfort located near or between the shoulder blades.
• Radiating Pain: Pain extending to the shoulder, arm, and, at times, the hand and fingers.
• Neck Pain: Discomfort, particularly at the back and sides of the neck.
• Increased Pain with Movement: Exacerbation of pain during neck bending or turning.

Read more - https://www.maxhealthcare.in/blogs/know-symptoms-slip-disc-and-sciatica

Causes of Slip Disc

Disk herniation commonly arises from the gradual wear and tear associated with ageing, known as disk degeneration. As individuals age, their spinal disks lose flexibility and become susceptible to tearing or rupturing, even with minor strains or twists.

Identifying the precise cause of a herniated disk is often challenging for most people. In some cases, improper lifting techniques, such as using back muscles instead of leg and thigh muscles when handling heavy objects, can contribute to disk herniation. Additionally, twisting and turning during lifting may also be a factor. While uncommon, traumatic events like falls or blows to the back can also result in a herniated disk.

Risk Factors of Slip Disc

Several factors can heighten the likelihood of a herniated disk, including:

• Weight: Excess body weight imposes additional stress on the lower back disks.
• Occupation: Individuals with physically demanding jobs face an increased risk of back issues, especially with repetitive activities like lifting, pulling, pushing, bending sideways, and twisting.
• Genetics: Some individuals may inherit a predisposition to developing a herniated disk.
• Smoking: Smoking is believed to reduce oxygen supply to disks, accelerating their breakdown.
• Frequent Driving: Prolonged periods of sitting, coupled with the vibrations from a motor vehicle engine, can exert pressure on the spine.
• Sedentary Lifestyle: Lack of regular exercise may contribute to an elevated risk of herniated disks.

Read more - https://www.maxhealthcare.in/blogs/strain-on-spine-it-could-be-slipped-disc

Diagnosis of Slip Disc

A diagnostic test consists of a combination of different tests, including physical examination and imaging tests. In many cases, neurology doctors may be involved in the diagnosis due to their specialised knowledge of the nervous system and its impact on spinal health.

Physical Examination

During a physical examination, the healthcare professional will assess the patient's back for tenderness. The patient may be instructed to lie flat and move their legs into different positions to help identify the source of pain.

A neurological examination may also be conducted to evaluate:

• Reflexes
• Muscle strength
• Walking ability
• Sensation to light touches, pinpricks, or vibration.

In many cases of herniated disks, a diagnosis can be established through a physical examination and medical history. If the healthcare professional suspects an alternative condition or needs further information about affected nerves, additional tests may be recommended.

Imaging Tests

• X-rays: While plain X-rays do not reveal herniated disks, they can exclude other causes of back pain, such as infection, tumours, spinal alignment issues, or fractures.
• CT Scan: This involves a series of X-rays taken from different angles to create cross-sectional images of the spinal column and surrounding structures.
• MRI: This test uses radio waves and a strong magnetic field to generate detailed images of the body's internal structures, confirming the herniated disk's location and identifying affected nerves.
• Myelogram: A dye is injected into the spinal fluid before a CT scan to reveal pressure on the spinal cord or nerves caused by multiple herniated disks or other conditions.

Nerve Tests

• Nerve Conduction Studies: This measures how well electrical impulses move along nerve tissue, aiding in pinpointing the location of nerve damage. Electrodes on the skin assess electrical nerve impulses.
• Electromyogram (EMG): During an EMG, a doctor inserts a needle electrode into various muscles to assess the electrical activity when muscles are contracted and at rest.

Treatment of Slip Disc

For individuals experiencing pain due to a herniated disk, conservative measures involve modifying activities to avoid pain-triggering movements and using pain medications. Physiotherapy is often recommended as part of the treatment plan. A physiotherapist can provide tailored exercises and therapy techniques to alleviate pain and improve mobility.

Medications

• Nonprescription Pain Medicines: Healthcare professionals may recommend over-the-counter pain relievers such as acetaminophen, ibuprofen, or naproxen sodium for mild to moderate pain.
• Neuropathic Drugs: Medications like gabapentin, pregabalin, duloxetine, and venlafaxine, which influence nerve impulses to reduce pain, may be prescribed.
• Muscle Relaxers: In cases of muscle spasms, muscle relaxers may be prescribed, with common side effects being sedation and dizziness.
• Opioids: Due to potential side effects and the risk of addiction, healthcare professionals are cautious about prescribing opioids for herniated disks. Short-term use, such as codeine or oxycodone-acetaminophen combinations, may be considered if other medications are ineffective.

Cortisone Injections

If oral medications fail to improve pain, healthcare professionals might recommend corticosteroid injections around the spinal nerves. Spinal imaging is used to guide the needle.

Therapy

Physical therapy may be suggested to manage herniated disk pain. Physical therapists can teach specific positions and exercises aimed at minimising pain associated with the condition.

Surgery

While surgery is rarely necessary for herniated disks, it becomes an option if conservative treatments prove ineffective after six weeks, especially if the patient continues to experience:

• Poorly controlled pain.
• Numbness or weakness.
• Difficulty standing or walking.
• Loss of bladder or bowel control.

Slip Disc Prevention

To minimise the risk of developing a herniated disk, consider the following preventive measures:

• Engage in Regular Exercise: Strengthening the muscles in your trunk provides stability and support for the spine.
• Ensure Good Posture: Reduce pressure on the spine and discs by maintaining proper posture. When sitting for extended periods, keep your back straight and aligned. When lifting heavy objects, rely on your legs rather than your back to do the majority of the work.
• Maintain a Healthy Weight: Keeping your weight within a healthy range is crucial, as excess weight adds more pressure to the spine and discs, increasing the vulnerability to herniation.

Conclusion

At Max Hospital, we are committed to providing individualised care and cutting-edge treatments for slip disc conditions. Our comprehensive diagnostic approach involves a thorough review of medical history and advanced imaging studies. Treatment options are tailored to each patient and may include conservative measures, physical therapy, and, when necessary, surgical interventions. In emergency situations, our prompt and efficient care is designed to be your solution. Additionally, we also offer guidance on lifestyle modifications and customised management for those dealing with slip disc concerns. At Max Hospital, your health and well-being are always our foremost priorities.