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Treating Slipped Disc Complications in New Jersey

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A slipped disc is a spine condition that often affects patients at any age but typically begins during the ages of the 30s or 40s. An intervertebral disc can herniate because of an acute injury or simply from normal wear and tear on the spine. If left untreated, a slipped disc could lead to nerve damage or other health issues. Learn more about diagnosing and treating slipped discs from Centers for Neurosurgery, Spine & Orthopedics, the most comprehensive spine care center in northern New Jersey.

What Is a Slipped Disc?

A slipped disc is also known as a herniated or ruptured disc, and it occurs when part or all of a disc shifts out of alignment with the vertebral bones. Spinal discs are located between each of the vertebrae and help the spine flex and bend while also serving as shock absorbers. Each spinal disc has an outer portion made of tough cartilage, in addition to an inner portion made of a jelly-like substance called nucleus pulposus.

Discs begin to degenerate naturally over time, losing their elasticity and water content. This can lead to a tear in parts of the disc nucleus that results in the outer portion protruding from the outer and inner contents of the disc, thereby compressing the surrounding spinal nerves. A slipped disc is different from a bulging disc, in which the disc loses its shape but there is no tear. Consequently, the nucleus pulposus does not leak out.

What Are Common Complications of a Slipped Disc?

Some herniated discs heal on their own. But for others, the pain gets worse over time and affects the patient’s mobility and quality of life. If left untreated, a slipped disc could lead to serious health complications, including permanent nerve damage that leads to muscle weakness, loss of sensation, or loss of use of an arm or leg. Slipped disc complications, a.k.a. symptoms can vary depending on the severity and location of the disc herniation.

In rare cases, a slipped disc can lead to cauda equina syndrome, in which the nerve roots in the lower back are compressed and damaged. This can impact bowel and bladder function, as well as sensation and movement in the legs. When bowel, bladder, or weakness of limbs occurs, it is considered a medical emergency, as it could result in permanent bilateral paralysis. Surgery is the only cure at this point.

How Common Are Slipped Discs?

About one to five percent of the U.S. population will experience a slipped disc at some point, according to the National Institutes of Health (NIH). Fortunately, most slipped discs can be treated non-surgically. The American Association of Neurological Surgeons reports that 90% of patients see symptom improvement without surgery.

Who Is at Risk for a Slipped Disc?

Certain patients are more likely to experience a slipped disc than others. Risk factors include:
  • Age: Slipped discs usually happen between the ages of 30 and 50.
  • Weight: Being overweight puts more strain on a person’s spine and may increase the likelihood of disc problems.
  • Gender: A slipped disc can affect anyone but is more common in male patients.
  • Occupation: Physically demanding jobs that require repetitive lifting, bending, or twisting can strain the spine and increase the chance of disc herniation.
  • Genetics: If a patient has one or more family members who have experienced disc herniation, they may be at higher risk themselves.

What Are the Signs and Symptoms of a Slipped Disc?

Sometimes a slipped disc does not cause any problems, so a patient does not even know they have it until it shows up on a routine scan. In other cases, however, a ruptured disc can cause severe, shooting pain. Slipped discs usually occur in the neck (cervical spine) or lower back (lumbar spine). A slipped disc in the neck area can cause pain that radiates down into the patient’s arms. In contrast, a slipped lumbar disc can cause sciatica, which is a pain in the lower back and buttocks that radiates down one leg. In both instances, the radiating pain is typically one-sided and referred to as radiculopathy. If the disc protrudes into the spinal cord, the patient displays symptoms of myelopathy and radiculopathy bilaterally. A slipped disc causes radiculopathy symptoms which are:
  • Pain
  • Tingling
  • Numbness
  • Paresthesias
  • Muscle weakness
  • Loss of function in the muscles, bladder, or bowels
  • Loss of function of extremities
Neck or back pain can be treated with home remedies such as rest, alternating ice and heat, and taking oral pain medications. These may help reduce symptoms. However, if a person suspects they have a slipped disc, they should see their medical provider for an accurate diagnosis.

How Is a Slipped Disc Diagnosed?

A slipped disc may be suspected by a patient’s primary care physician, neurosurgeon, pain management doctor, or orthopedic specialist based on the patient’s symptoms and medical history. They will conduct a physical examination that may include testing reflexes, muscle strength, and balance.

To confirm the diagnosis, one must use diagnostic tests such as an X-ray first, then an MRI, CT scan, or an electromyography and nerve conduction study (EMG/NCS). These tests monitor electrical activity in the muscles to detect any disorder in the muscle itself or whether there is a disorder within the nerves and if so, which nerve is affected.

Can a Slipped Disc Be Treated without Surgery?

Often, a slipped disc can be treated effectively without surgical intervention. Initial conservative treatment options include rest, stretching, and the use of over-the-counter medications. For further control of the pain, other prescription medications and localized steroid injections to reduce swelling and prevent the progression of disease and continuation of pain would be provided by a pain management doctor.

These complementary therapies may not cure a slipped disc, but they can help manage swelling and pain. A chiropractic adjustment aligns the vertebrae properly, whereas acupuncture stimulates the release of pain-relieving chemicals.

Will Medications Help a Slipped Disc?

Specific classes of medications can be utilized for conservative management of a slipped disc depending on the symptoms and severity. These medications include:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs): Available over the counter, NSAIDs reduce the inflammatory cascade which results in minor decreases in swelling. This will help relieve neck or back pain caused by a slipped disc.
  • Muscle relaxants: These medications ease muscle spasms that a slipped disc can trigger in the back or neck.
  • Oral Corticosteroids: Steroid medications reduce inflammation, which can relieve nerve irritation caused by the disc.

What Minimally Invasive Treatments Might Be Considered?

Interventional pain treatments are the next step in herniated disc treatment and are performed by a doctor specialized in pain management. A patient may need:

  • Transforaminal injections: This procedure uses fluoroscopy (X-ray guidance) to deliver a mix of local anesthetic and steroid medication into the foramina where a slipped disc is causing pressure on the exiting nerve root. The foramina are located on each side of every vertebrae and have a corresponding nerve root exiting through them.
  • Epidural steroid injections: This quick treatment injects anti-inflammatory medication into the epidural space around the spinal cord and bilateral spinal nerve roots.
  • Caudal steroid injection: A pain management doctor will place localized steroids at the end of the sacral bone to help with pelvic and lower back pain.

What Kind of Surgery Is Used to Treat Slipped Discs?

Note that CNSO takes a conservative approach to pain management and treatment, so back or neck surgery is recommended only if symptoms are severe or do not resolve through non-surgical intervention. Surgical procedures that are used to treat a slipped disc include:

Discectomy, Partial Discectomy or Microdiscectomy

 A discectomy of any type is used to remove the herniated portion of the disc or the entire disc, relieving pressure off the nerve root or spinal cord. This will reduce the irritation and inflammation of the offended neural structures. Performed by a CNSO surgeon, a partial and a microdiscectomy are less invasive, with a surgical incision site of 2-3 cm centimeters compared to a discectomy that may have an incision site of 3-4 cm.

Laminectomy

The lamina is the vertebral bone that forms a roof over the spinal canal. For a slipped disc, depending on the direction and extent of the ruptured disc, a laminectomy may be necessary for access and full resolution of the herniated disc. A laminectomy can be performed through a 2-4 cm incision and may be a minimally invasive procedure that removes a portion of the lamina to decompress the nerves or spinal cord and remove portions of the herniated disc.

Total Disc Replacement

If the slipped disc(s) were in the cervical spine, extensive and beyond a partial discectomy, a total cervical disc replacement may be offered for one up to two levels of the cervical spine. Also called a disc arthroplasty, this surgical procedure provides a full range of motion of the neck postoperatively.

Fusion Surgery

If the patient were to need a total disc replacement and is not a candidate for a disc replacement, a spine fusion would be offered. For example, disc replacements have not been proven successful for the thoracic or lumbar spine. Consequently, if complete disc removal is necessary, a spine fusion surgery would be necessary.

A fusion is used to stabilize the adjacent vertebrae once the diseased disc is removed. A spine surgeon reconstructs the connection between the vertebrae using bone grafts and hardware for long-term stability.

While all surgeries carry a level of risk, CNSO is noted for its advanced surgical care and is led by an elite team of board-certified neurosurgeons and orthopedic spine surgeons with expertise in every type of spine surgery. Wherever possible, CNSO uses minimally invasive techniques to minimize surgical trauma, blood loss, and other complications.

Recovering from Spine Surgery

After surgery, a patient’s recovery timeline will depend on the type of procedure, their overall health, and their occupation. Patients who work in an office setting may be able to return to work within a few days, which is sooner than those who perform more physically demanding labor. Complete recovery where heavy weightlifting can occur after a discectomy can take six to eight weeks and may include physical therapy, massage, or other rehabilitation care.

As part of a patient’s rehabilitation plan, their neurosurgeon or spine surgeon may recommend lifestyle changes to prevent future disc problems. These include:

  • Weight control: Being overweight puts additional stress on the spine. Staying active, maintaining an ideal body weight, and eating a balanced diet can help a patient avoid painful neck and back conditions.
  • Smoking cessation: Quitting smoking reduces the risk of degenerative disc disease and related health problems.
  • Stress management: Minimizing stress is important, as well. Patients can practice strategies such as increasing their quantity of sleep, breathing techniques, or meditation.
  • Alcohol moderation: Excessive alcohol causes dehydration and can increase pain caused by slipped discs, degenerative disc disease, and other spine issues.

Will Rehabilitation Involve Therapy?

After spine surgery, a patient will have a personalized rehabilitation plan to guide their recovery. For a simple herniated disc surgery in a healthy person, patients can resume physical activity shortly thereafter and prescribed physical therapy may not be necessary. Home physical therapy may be sufficient.

But for poorly-conditioned individuals or those who undergo more involved surgery, physical therapy, which helps maximize the benefits of a surgical procedure, will be prescribed. Physical therapy can:

  • Improve a patient’s range of motion and flexibility
  • Reduce pain and inflammation
  • Strengthen back or neck muscles to help stabilize the spine
  • Minimize joint stiffness

During physical therapy appointments, the patient’s therapist will create a treatment plan that may include exercises, stretches, or passive strategies such as massage or ultrasound. The physical therapist also will give the patient exercises to complete at home.

What Kind of Follow-up Care Is Common After Slipped Disc Treatment?

Whether a patient needs conservative care or surgery, CNSO schedules follow-up appointments to track their progress and ensure that symptoms are improving. Once resolved, no further appointments are necessary. If symptoms continue to remain prevalent, follow-up appointments may include further testing, such as imaging, and pain management procedures, as well as additional diagnostic tests such as EMG/NCS.

If the patient has stitches, they will be removed within two weeks after surgery. After surgery, the patient will receive instructions and activity limitations. Their surgical team will provide a rehabilitation plan that will be modified as needed and by the patient’s symptoms and stage of treatment.

Can Future Disc Problems Be Prevented?

While it may not be possible to prevent disc problems, certain lifestyle changes may help reduce the risk of a slipped disc. These include:

  • Maintaining an active lifestyle and exercising regularly
  • Maintain an ideal body weight
  • Practice good posture to strengthen muscles and properly support the spine
  • Avoid repetitive stress injuries
  • Use proper form when lifting heavy weights
  • Wear a back brace or other protective gear when lifting heavy objects
  • Switching to an ergonomic workspace designed to help keep the spine in a neutral position

Why Choose CNSO for Slipped Disc Care?

Patients know they can count on CNSO for expert back and spine care. The medical staff at CNSO takes a collaborative approach, working together to ensure each patient gets the best care possible. In addition to board-certified orthopedic spine surgeons and neurosurgeons, CNSO’s comprehensive team includes physiatrists, interventional pain management physicians, rehabilitation specialists, and certified physical therapists.

Patients can get all the care they need to treat a slipped disc from one convenient group. Plus, CNSO has multiple locations throughout northern New Jersey, with sites in Bergen, Essex, Hudson, Morris, and Passaic counties.

Trust the Comprehensive Spine Care at CNSO

A slipped disc can be painful, but there is a wide range of treatment options available. Serving patients throughout northern New Jersey, CNSO offers surgical and non-surgical care for herniated discs, degenerative disc disease, and many other related spine issues. For more information or to request an appointment, contact CNSO today.

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