What is a slipped disc?
- ‘Slipped disc’ is a misnomer as the disc does not slip out but rather protrudes (herniates) out of its place in different grades of severity.
- The spine consists of a stack of bones (vertebrae), with intervening shock- absorbing discs. The discs are made up of a strong outer fibrous coat containing a soft gel-like material inside. A herniated disc occurs when this gel-like material pushes out from between the bones of the spine (vertebrae) following the rupture of the outer coat.
- Pain is caused when the herniated disc presses the adjacent nerves or spinal cord.
- A slipped disc is most common in the lower back, but it can also occur in the neck and upper back.
What causes slipped disc?
- A disc may herniate because of sudden injury or repeated injuries through poor posture. Improper lifting technique over the years can also contribute to this.
- It is not uncommon for the disc to herniate from simply bending down to pick up a book or following a sneeze.
- Conventionally, it was thought that ageing and repeated injuries lead to weak discs, making them prone to herniation. Increasing occurrence of this problem in younger individuals suggests the possibility of genetically determined weakness in discs, which leads to their herniation.
What are the symptoms?
Symptoms may occur suddenly or build up gradually over a number of weeks:
- Aching back with difficulty in stooping forward, prolonged sitting and lifting weight.
- If the disc presses on a nerve, weakness, severe pain, numbness or tingling may occur in the leg or arm, depending on where in the spine the ‘slipped disc’ has occurred.
- Impaired bowel or bladder function can indicate severe pressure on nerves.
- If these symptoms arise, urgent medical advice is needed.
When to see a doctor?
Most back pain disappears within days or weeks and does not need medical intervention. There are, however, a few occasions where you need to consult a doctor:
- Along with back pain, if you have ‘red flag signs’ like trouble in passing or holding urine and stools, or have weight loss, fever, pain at night or weakness in your extremities.
- Your pain is persistently increasing, along with the discomfort.
- You have had a recent trauma or injury to your back.
What can be done for the pain of a herniated disc?
- Treatment may include avoiding further stress on the back by modifying physical activities, painkillers and physiotherapy. In most cases, this is enough to let the condition settle.
- Sometimes, traction, anesthetic injections or surgery is recommended if the symptoms persist or worsen.
- Staying active, regular back exercises, avoiding being overweight and adopting good posture is the key to prevention of back pain.
What about my posture?
- Good posture (standing up straight, sitting straight, lifting things with your back straight) can help your back.
- Bend your knees and hips when you lift something.
- Hold the object close to your body when you carry it.
- If you stand for a long time, put one foot on a small stool or a box for a while.
- If you sit for a long time, put your feet on a small stool so your knees are higher than your hips.
- Don’t wear high-heeled shoes and don’t sleep on your stomach as these things can put more pressure on your discs.
Importance of a clinical diagnosis for a herniated disc
Because of the complexities of understanding pain from a herniated disc, patients should not attempt to make their own diagnosis. An inaccurate self-diagnosis can be harmful; it may lead to further damage to spinal structures or to more severe episodes of back pain or leg pain if the condition is left untreated or treated incorrectly. They should work with a spine specialist to ensure that the correct location of a herniated disc, extent of the problem and source of pain are identified early on.