Slipped Disc Explained
A slipped disc is a common condition that can occur in the cervical (neck), thoracic (upper back) or lumbar (lower back) regions of the spine. The term “slipped disc” can also be referred to as a ruptured, bulging or herniated disc. These latter terms provide more accurate depictions of what actually happens inside the body, since discs do not actually “slip” out of place.
Depending on which disc is damaged or deteriorating, patients may experience a range of uncomfortable systems. For instance, a slipped disc that occurs in the lumbar region of the spine can cause pain, muscle weakness, tingling and numbness that radiates from the back to the buttocks, hips, legs and feet. The lumbar region bears more weight than any other part of the spine, and, as such, is the area where intervertebral disc damage most frequently occurs. On the other hand, a person with a slipped disc in the cervical spine, or neck region, may feel slipped disc symptoms in the neck, shoulders, arms and hands.
Slipped disc — no actual slippage occurs
As mentioned previously, the term “slipped disc” does not intend to imply that the disc has shifted or fallen out of place in any way. Rather, it refers to a disc that has split or ruptured, or whose layered, cartilaginous outer wall has been forced out of its normal boundary. That’s why the more proper terms for slipped discs are bulging discs, herniated discs, ruptured discs, or torn discs.
Slipped discs can occur as a consequence of intervertebral discs naturally deteriorating with age, or they can be the result of an injury from improper lifting techniques or poor body mechanics. The aging process is by far the most prominent factor in the development of a ruptured disc. Disc degeneration often begins with a gradual reduction in water content within the gel-like nucleus of the disc. Concurrently, the disc’s outer wall becomes brittle and weak over time. Even though the disc is losing elasticity, it still must endure everyday pressures from the vertebrae above and below it, but a weakened disc is unable to maintain its shape. This stress can reduce the height of the disc, or force the outer wall past its normal boundary (this is often called a bulging disc). The stress also can create small fissures within the wall, which may develop into ruptures and permit the extrusion of nucleus material (this is commonly called a ruptured or herniated disc).
Rarely does a sudden trauma, such as a fall or automobile accident, cause a slipped disc. However, people who experience traumatic spine injuries as children or teenagers are more likely to develop disc problems later in life.
Slipped disc risk factors
Certain activities put you at greater risk of developing a slipped disc. Smoking or carrying excess body weight can increase your chances of disc weakening. Also, people with physically demanding jobs that require repetitive lifting, bending and twisting or prolonged sitting and standing in the same position may be at greater risk. There also is a hereditary element to the development of a slipped disc. If your parents or grandparents had a spine degeneration that led to bulging or herniated discs, there is a better chance that you could develop those conditions as well.
Slipped disc treatments
If you have been diagnosed with a slipped disc, your physician will likely prescribe conservative treatments such as rest, pain medication or activity modification to begin with. These non-surgical treatments can be highly effective at controlling pain and discomfort, and can even help most patients avoid the need for a slipped disc surgery. In most cases, physicians will recommend a combination of conservative options for the first few weeks of treatment, using a process of trial and error to identify a regimen that works for each individual patient. Some of the most common conservative treatment options include:
- Over-the-counter pain relievers, such as acetaminophen. These drugs either increase the body’s pain threshold (so that a person must experience more pain than usual for the body to register the sensation) or block the enzymes that produce pain-sensing chemicals in the body.
- Anti-inflammatory medications, including over-the-counter options or prescription steroids. Both options can help reduce swelling around the disc, in turn alleviating the pressure on a compressed nerve or nerve root. While over-the-counter options like ibuprofen can be taken for a longer period of time, oral steroids are usually only prescribed for one or two week cycles.
- Physical therapy and exercise. An experienced physical therapist can create an individualized regimen of stretches and exercises to help you minimize the symptoms of a slipped disc. For instance, a physical therapist may recommend core strengthening and stability exercises along with stretches to increase flexibility and range of motion.
- Activity modification. While the activities recommended by a physical therapist can be helpful, certain everyday activities may make the pain of a slipped disc worse. For example, lifting heavy objects, bending or twisting, participating in high-impact sports or sitting for prolonged periods of time can all exacerbate neck and back pain. Limiting or avoiding these activities can help minimize discomfort.
- Heat therapy, cold therapy or both. Many patients find that applying heat or ice to the area where the slipped disc is located can lead to short-term relief. This can be repeated as needed.
- Epidural steroid injections. This minimally invasive procedure is often suggested after other conservative therapies but before surgery. During an epidural steroid injection, a longer-lasting corticosteroid and a short-term analgesic numbing agent are injected directly into the epidural space of the spine. One injection may provide adequate relief for slipped disc symptoms, or patients may receive a series of injections over a period of a few weeks or months. However, physicians typically limit the number of injections a patient can receive over the course of a year, as repeated injections can cause complications.
Physicians might also recommend certain lifestyle modifications when they diagnose a person with a slipped disc. For instance, most patients are advised to maintain a healthy weight, as carrying excess weight can increase the amount of strain placed on the spine. Exercising regularly — either to assist with weight loss or improve general fitness — is also recommended, although patients should choose activities that do not cause vibration or heavy impact on the spine. Additionally, patients who smoke or drink alcohol are often advised to quit.
Surgery for a slipped disc
Most people start to experience improved symptoms in just a few months of slipped disc treatment. However, for those patients with severe, limiting pain that persists even after non-surgical treatment, slipped disc surgery may be advised. Laser Spine Institute provides outpatient, minimally invasive procedures that address the symptoms of a slipped disc without the need for traditional open back surgery. For more information, contact us today.