Spinal discs are one of the most important structures in the spine – they sit in between the vertebrae, where they provide cushioning, support, and shock absorption to the bones of the spine. Strong, flexible discs enable the spine to move fluidly and flexibly when a person lifts, twists and bends. As an individual ages, natural wear and tear from weight-bearing and daily activities cause the spinal discs to become stiffer, less flexible, and less able to provide adequate support and cushioning. When disc degeneration occurs, the discs are more prone to injury or damage. A slipped disc (herniated disc) in the back or neck is a common spine injury.
A slipped disc goes by several other names, which are:
- Herniated disc
- Bulging disc
- Protruding disc (partial herniation)
- Ruptured disc
- Prolapsed disc (partial herniation)
- Disc extrusion (complete herniation)
- Sequestered disc (complete herniation)
Disc herniation occurs when degenerative changes cause the tough, fibrous outer shell of a disc to tear or break, which then releases the disc’s inner fluid into the spinal canal. While a slipped disc can occur anywhere along the spine, it most commonly develops in the lumbar or cervical spine.
Causes & Symptoms
Slipped discs may occur when too much force is exerted on an otherwise healthy intervertebral disc. Heavy forces on the neck or lower back may simply be too much for even a healthy disc to absorb. For instance, falling from a significant height causes a large amount of force through the spine, and if strong enough, a vertebra can break or the disc can rupture.
Bending can also place high forces on the discs between each vertebra. If you bend and try to lift a heavy object, the force may cause a disc to rupture partially (or in severe cases, completely). A disc can also rupture after repeated annular tears that weaken over a period of time. At some point, lifting or bending can cause overpressure across the disc.
This activity may have been only a small force and something that years earlier would never have been a problem. This is due to the effects of aging and degeneration on the spine. The natural process of aging causes discs to become weakened from degeneration. Not all patients with a slipped disc have degenerative problems, and not everyone with degeneration will suffer from a slipped disc.
Another common cause of a slipped disc is trauma. Trauma to the disc may occur due to lifting a heavy load using incorrect posture or from external forces, such as a whiplash injury.
Overall, you can have a slipped disc in any part of your spine, from your neck to your lower back. The lower back (lumbar) is one of the most common areas for slipped discs – a slipped disc can place extra pressure on the nerves and muscles around it.
Certain other symptoms of a slipped disc include the following:
- Numbness, most commonly on one side of the body.
- Pain that extends to your arms or legs.
- Pain that worsens at night (or with certain movements).
- Coughing or sneezing.
- Hunching forward.
- Pain when you walk short distances.
- Unexpected and unexplainable muscle weakness.
- Aching, burning, and tingling sensations in the affected area.
An additional symptom associated with a slipped disc in the back is sciatica. When the inner material from a damaged disc leaks out into the spinal canal, it may either irritate or compress nearby nerves.
When the disc fluid compresses the sciatic nerve, it causes one-sided pain, weakness, numbness, and tingling that travels from the lower back to the buttock, thigh, and calf. Sciatica may feel like a constant deep ache or a sharp and burning pain that occurs frequently.
Who gets a Slipped Disc?
Several risk factors have been identified to be associated with a slipped disc. Some of the following factors include:
- Age – All discs experience a normal amount of degeneration throughout a lifetime of use – the inner gel of a disc will lose a certain amount of water as it ages, making it less flexible and reducing the effectiveness of its cushioning abilities. The cartilage comprising the outer layer of a disc is also subject to regular wear and tear.
- Excess body weight – Patients carrying too much body weight will cause excessive stress on the discs of the lumbar area. Obesity is defined as having a BMI of 30 or higher.
- Sedentary lifestyle – Living a sedentary, or low-movement lifestyle can increase the chances of a slipped disc.
- Occupation – Working in a physically demanding occupation, particularly if you are unable to take sufficient rest and recuperative time.
- Repetitive motions – Lifting, pushing, pulling, bending sideways, and twisting all place unusual stresses on your back. Doing these types of motions repeatedly will increase the chances of a disc rupture.
- Genetics – Some patients inherit a predisposition to suffering a slipped disc.
- Gender – Men are statistically more likely to experience some form of disc disease rather than women.
How Does it Affect You? How Serious is it?
If a slipped disc is untreated, a severe slipped disc may lead to permanent nerve damage. In most rare cases, a slipped disc can cut off nerve impulses to cause equina nerves in your lower back and legs. If this happens, you may lose bowel or bladder control.
Another possible complication is known as saddle anesthesia. In these cases, the slipped disc compresses nerves and causes you to lose sensation in your inner thighs, the back of your legs, and around your rectum.
The total complications due to a slipped disc are the following:
- Loss of bladder or bowel control.
- Permanent disability.
- Permanent nerve damage.
- Longer-term pain, weakness, and loss of muscle function.
- Permanent loss of sensation in the inner thighs, back of legs, and rectal area.
- Chronic lower back pain (pain that is caused on a regular daily basis).
In some cases, if a patient suffers from severe lumbar pain due to a slipped disc, lumbar decompression surgery may be required. Often a micro-decompression, a type of lumbar decompression surgery is used to treat nerve compression from a slipped disc. During this type of surgery, the herniated portion of the disc under the nerve root is removed. By giving the nerve root enough space, the pressure is relieved, and the nerve root can start to recover.
Recommended Treatment & Rehabilitation
During the process of starting the recovery from a slipped disc, your doctor will begin by checking your back for tenderness. You might be asked to lie flat and move your legs into various positions to help determine the cause of your pain. Afterwards, your doctor will perform a neurological exam to check your reflexes, walking ability, muscle strength, and ability to feel light touches. In most cases, a physical exam and a medical history are what are needed for the diagnosis of this condition. In addition, the following tests are used to rule out other conditions associating with slipped discs:
- Magnetic Resonance Imaging (MRI) – Radio waves and a strong magnetic field are used to create images of your body’s internal structures. This test can be used to confirm the location of the slipped disc and to see which nerves are affected.
- Computed Tomography (CT) scan – A CT scanner takes a series of X-rays from different directions and then combines them to create cross-sectional images of your spinal column and the structures around it.
- X-rays – Unfortunately, X-rays cannot detect slipped discs. However, they can rule out other causes of back pain, such as an infection, tumor, spinal alignment problems, or a broken bone.
Once physiotherapy is in process, a physiotherapist will work with you to design a specific treatment program that will speed your recovery, including exercises and treatments that you can do at home. Here are a few treatment programs your physiotherapist will help to reduce further symptoms linked to slipped discs:
- Improve your posture – If your physiotherapist finds that poor posture has contributed to your slipped disc, he / she will teach you how to improve your posture so that pressure is reduced in the injured area, and healing can begin and progress as fast as possible.
- Improve your motion – Your physiotherapist will choose specific activities and treatments to help restore normal movement in any stiff joints. These might begin with “passive” motions that the physiotherapist performs for you to move your spine, and progress to “active” exercises and stretches that you can do yourself.
- Improve your flexibility – Your physiotherapist will determine if any of the involved muscles are tight, and then start helping you to stretch them as well as teaching you how to stretch them at home.
- Improve your strength – If your physiotherapist finds any weak or injured muscles, your physiotherapist will choose and teach you the correct exercises to steadily restore your strength and agility.
- Improve your endurance – Restoring your endurance is important after an injury. Your physiotherapist will develop a program of activities to help you regain the endurance you had before the injury.
- Reduce pain and other symptoms – Your physiotherapist will help you to know how to avoid and / or modify the activities that caused the injury so healing can begin to occur. Your physiotherapist may use different types of treatments and technologies to control and reduce pain and symptoms.
The following exercises can help ease your symptoms linked to slipped discs in the spine or neck area:
- Neck stretches – Sit upright in a chair and move the chin toward the chest, then back against the headrest, stretching the neck. Next, move the left ear toward the left shoulder, then the right ear toward the right shoulder. Repeat this exercise 2-3 times a day.
- Towel hamstring stretch – Lie flat on a yoga mat with one leg lifted into the air. Wrap a towel around the foot of the leg in the air. Then, holding the towel, pull the leg toward the body, holding for 15-30 seconds. Finally, switch legs and repeat 2-3 times a day.
- Back flexion stretch – Begin by lying on your back and hold both knees toward the chest. At the same time, move the head forward until there is a comfortable stretch across the mid and low back. Repeat this stretch 2-3 times a day.
- Piriformis muscle stretch – Lie on your back with the knees bent and both heels on the floor. Cross one leg over the other, resting the ankle on the bent knee. Gently pull the crossed knee toward the chest until there is a stretch in the buttock. Repeat this method on both sides, 2-3 times a day.
Alternative & Homeopathic Treatment
Homeopathic treatment for a slipped disc can help you reduce symptoms without the need for injections or any additional surgical treatments. Some of these include:
- Medications – These are often used to manage pain, inflammation, muscle spasm, and sleep disturbance. Some medications include non-steroidal anti-inflammatory drugs (NSAIDs), pain medications, and muscle relaxers to help control symptoms and reduce inflammation.
- Rest – Rest can relieve swelling and give your back time to heal. It is recommended to avoid exercising or doing physical activities in order to recover rapidly.
- Ice and heat application – One or both of these homeopathic treatments are great support when you are in pain. Begin with ice to relieve inflammation. Apply an ice pack to your lower back for the first couple of days after the pain begins. After three to four days, switch to heat to allow blood circulation to the affected area.