Strain on Spine- It Could be Slipped Disc!

Our spine consists of multiple bones called vertebrae that are stacked on top of each other. In between the vertebrae there are protective circular pads called discs, which contain a softer gel-like substance. These discs are responsible for maintaining the body’s flexibility and wide range of movement.

What is Slipped Disc?

It is also known as prolapsed or herniated disc- which occurs when one of the discs is damaged, thereby causing pressure on the nerves. Further, it can also cause back pain, neck pain and symptoms like numbness, tingling sensation or weakness. Slipped disc usually occurs in people aged between 30-50 years and more prominently in the lower back. The condition affects twice as many men and women.   

What Causes it?

As you get older, your spinal discs start to lose their water content, making them less flexible and more likely to rupture. A slipped disc occurs when the outer case of the disc splits, resulting in the gel inside to bulge out of the disc. The damaged disc can put pressure on the whole spinal cord or on a single nerve. 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. Smoking also plays a role as it causes the discs to lose their natural flexibility.

There are a number of factors that can put increased pressure and strain on your spine. These include:

• Bending awkwardly
• Jobs that involve heavy or awkward lifting
• Jobs that involve lots of sitting, particularly driving
• Being overweight or obese
• Weightbearing sports, such as weightlifting
• A traumatic injury to your back, such as a fall or accident

Situations such as these can weaken the disc tissue and can sometimes lead to a slipped disc.

Symptoms of a slipped disc

Most people with a slipped disc experience pain in the back that starts slowly and gets worse over time.

A slipped disc in the neck can cause:

•  Neck pain
•  Numbness or a tingling sensation in the neck, shoulder, arm or hand
•  Weakness in hand muscles

A slipped disc in the lower back can cause:

•  Back pain
•  Numbness or a tingling sensation in the back, buttocks, genitals, legs or feet
•  Weakness in leg or foot muscles
• Sciatica- The sciatic nerve runs from the back of the pelvis, through the buttocks and down the legs to the feet. If a slipped disc is putting pressure on the sciatic nerve, it can lead to pain in the leg, hip or buttocks. This is known as sciatica.

Caudaequina Syndrome

Caudaequina syndrome is a serious condition where the nerves at the very bottom of the spinal cord become compressed. Symptoms can include:

• Lower back pain
• Numbness in groin
• Paralysis of one or both legs
• Loss of bowel control (bowel incontinence)/loss of bladder control (urinary incontinence)

You should seek medical assistance immediately if you develop these symptoms. If caudaequina syndrome is not promptly treated, the nerves to bladder and bowel can become permanently damaged.

Diagnosing a Slipped Disc

Magnetic resonance imaging (MRI) scans are effective at showing the position and size of a slipped disc. They can also pinpoint the affected nerves. A CT scan can also pinpoint a slipped disc, although it is often not as effective. X-rays are not generally used as a test to look for slipped discs as they only show the bones and do not give a view of the nerves and spinal cord.

Treatment of Slipped Disc

An initial treatment will usually involve a combination of physiotherapy and medication to relieve the pain. Though in some cases like continuous pain for more than 6 weeks, surgery may be recommended to release the compressed nerve and remove a part of slipped disc. Below are few points you should consider:

• Keep active: to avoid back pain and help prevent a slipped disc, you should keep mobile, exercise regularly, maintain good posture while sitting and standing, use safe technique when lifting heavy objects, and quit smoking.

• Rest completely for the first couple of days and then start to move around as soon you can as it will keep your back mobile and speed up the recovery.

•  Any exercise that you do is gentle and does not put strain on your back. Swimming is an ideal form of exercise because the water supports your weight and puts less strain on other joints. However, a physiotherapist will be the ideal person to draw a tailored plan for you.

• Avoid any activity that can aggravate your condition like bending forward, lifting objects, and sitting for prolonged period of time.

• You may be prescribed medicines to help ease pain that may include painkillers and muscle relaxants. Corticosteroids injections can also be given in your lower spine to help reduce pain and inflammation.

Surgery may be considered if:

•  There is evidence of severe nerve compression
•  Symptoms have not improved with other treatment modalities
•  There is progressive weakness in muscles

The aim of surgery is to cut away the piece of the disc that bulges out. This is known as a 'Discectomy' and it can be done in several ways e.g., microdiscectomy, endoscopic discectomy or artificial disc replacement.