Intervertebral discs are specialized joints that connect the bones (vertebrae) of your spinal column. Discs have a soft, spongy interior contained inside a tough, fibrous outer layer. Disks provide flexibility and shock absorption to your spine.
A slipped disc or disc herniation happens when the tough, outer layer of the disc weakens or tears, allowing soft material from the inside to slip out and place pressure on a nearby nerve or the spinal cord. A slipped disc can happen anywhere in the spine, but most commonly occurs in the neck or low back. A slipped disc is synonymous with a herniated disc or prolapsed disc.
Symptoms
Slipped discs can cause two types of symptoms:
- Local pain – Because intervertebral discs are specialized joints, a tear in the joint can cause discomfort where the joint is located. A slipped disc in the cervical spine can cause neck pain, and a slipped disc in the lumbar spine can cause low back pain.
- Nerve pain – If the portion that slips out puts pressure on a nearby nerve, symptoms can be felt wherever the nerve travels, such as into the arms or legs (pinched nerve, radiculopathy, sciatica).
Symptoms of a slipped disc can range from mild aches and spasms to excruciating pain that may include numbness, tingling, cramping, or a burning sensation. Symptoms can vary with your activity level and/or movement. Typically, symptoms are limited to one arm or leg, depending on the location of the slipped disc, but can affect both sides if the slipped disc fragment is large.
Symptoms of a slipped disc can vary greatly from person to person. A trained medical practitioner can help determine the cause of your symptoms and how to best treat them. If you experience any of the following symptoms, schedule an appointment with a trained spine specialist.
- Shooting pain in neck and/or into the arm.
- Shooting pain in the back and/or down the leg.
- Numbness, tingling, or loss of feeling in arm, hands or fingers, legs or feet.
- Muscle weakness of arms, hands, legs or feet.
- Numbness around the buttocks or genitals.
- Problems with bowel or bladder control.
Causes
Slipped discs can occur at any age, but most commonly affect people 30 or older. Slipped discs can happen as a result of the natural aging process, repetitive heavy lifting, lifting with bad technique, poor posture, and trauma to the back or neck.
Risk Factors
Risk factors include obesity, sedentary lifestyle, weakened back muscles, smoking, heavy lifting, bad posture, collision sports, or trauma.
Complications
Complications of a slipped disc can vary, depending on the severity and placement of the slipped disc. Not all slipped discs will cause symptoms; and in most that do, those symptoms typically improve with time. However, large slipped discs can cause complications. If these are left untreated, permanent nerve damage can occur, leading to muscle weakness or loss of sensation. A very large slipped disc in the lower back can cut off nerve signals to your bowel or bladder which leads to urinary or bowel incontinence. This is considered a medical emergency and requires urgent evaluation by a medical professional.
Diagnosis
Your trained medical practitioner will review your symptoms with you and perform an examination to help identify a slipped disc.
X-rays can show early degenerative changes in the bones of your spine, and help identify possible areas of concern.
MRI scans of the spine show anatomical details of the spine, such as the discs and nerves. MRIs are obtained if the patient displays worrisome findings on exam, or does not get better after initial conservative care such as rest or physical therapy.
EMG studies help characterize the location and degree of nerve damage if a slipped disc compresses a nerve.
Treatment
The majority of patients with symptoms from a slipped disc get better within 6-8 weeks. Therefore, initial treatments are conservative. These include:
- Activity restriction and temporary rest to prevent further damage and reduce inflammation.
- Medications to control pain, relieve spasm, and calm down irritated nerves.
- Physical therapy for muscle and joint mobility, stretching, skeletal stabilization, and postural training.
- Epidural injections to deliver inflammation-reducing steroids to the area of concern.
For the few patients who do not get better with conservative treatments, or who present with worrisome neurological findings initially, surgery can be an effective way to get back quickly to normal functioning.
Surgical options include minimally invasive microdiscectomy, decompressive laminectomy with discectomy, and sometimes decompressive laminectomy with fusion. Following a thorough review of your symptoms, examination, and imaging, your trained medical professional will decide what is right for you.
Summary
Slipped discs are common, and can cause a great deal of pain and activity limitation. Fortunately, most cases of slipped disc get better with time and conservative therapy. Surgery is a rarely needed but highly effective option for a small subset of patients with slipped discs. Smoking cessation, weight loss, proper posture, and core strengthening are your best defenses against developing a slipped disc, or developing a second slipped disc after you have healed from the first one.
If you or someone you know is experiencing any of the symptoms that may indicate disc herniation, consider making an appointment with the doctors and physiatrists at Centers for Neurosurgery, Spine & Orthopedics of Northern New Jersey today.
