Slipped (Herniated) Disc

What is Slipped (Herniated) Disc?

Slipped disc occurs when the discs which are like a soft cushion between the vertebraes bulges out from the spinal bone. The discs are the gel or rubber like material, placed between each bone of spine. This can comes out from any injury or aging and can cause pain. If it gives pressure to the nerve, it will be more painful.

The term Slipped disc is also known as Herniated disc, ruptured disc or prolapsed disc. Most of the times it gets better with rest or with some gentle exercise or from painkillers. Usually, the slipped disc occurs in the lower back or the lumber part of the spine.

What are the signs or symptoms of Slipped Disc?

Many people don’t recognize that they have herniated disc. The larger the size of the bulged out discs, the more will be the symptoms.

The prolapsed disc symptoms may include following:

  • Back pain
  • Neck pain
  • Muscles weakness or pain
  • Numbness or tingling in leg, feet, hand or shoulder
  • Pain in lower back like hip if it presses the nerve
  • Facing problem in some activity like bending or straightening your back

What are the causes of Slipped Disc?

The reasons for herniated disc are:

  • Ageing
  • Being Inactive or overweight
  • Injury or falls
  • Strain on the back.
  • Lifting heavy object with wrong postures
  • Bad sitting, standing or activity posture
  • Strained or tensioned muscles or ligaments.
  • Long sitting, standing or driving hours without break.
  • Twisting or stretching

How can you ease the pain of Slipped Disc yourself?

Usually prolapsed disc gets better with the following:

  • Take rest
  • Walking
  • Mild or gentle exercise
  • Painkiller
  • Avoid the activity that causes pain
  • Give up smoking
If these don’t work or the symptoms get worse then you should consult your orthopaedic doctor.

When to seek for the medical Attention for Slipped Disc?

  • If pain resists for long than 30 days.
  • If your painkillers are not affecting.
  • If pain is worse than earlier or at night.
  • If you feel hot and also shivering.
  • Swelling in your neck
If you feel any of the above, you should contact the spine specialist or surgeon near you.

How to Diagnose the Slipped Disc?

During the physical examination, your orthopaedic doctor will ask you to lie flat on your back. He might move your legs or arms in different direction to check the tenderness and the pain of the area. The doctor may also ask:

  • How old is your pain?
  • If you have walking inability?
  • If you feel any tingling or numbness in any area of body?
  • If you have any muscles pain?
  • If you feel vibration while touching the pain area?
  • Will ask about your any other medical history?

The doctor may also ask you to go for some medical test. The result can show the affected nerve or other conditions that need to be scrutinised.

For more information, other lab tests or imaging scan are:

  • X rays: To see herniated disc. Simple X-rays may not able to detect the prolapsed disc. But it will be able to check for alignments of the bone and any damage in bone, muscles, cord or pressed nerves.
  • MRI: During MRI scan, the body’s internal structure is shown in 3D form. It can give you the confirmed location of the herniated disc.
  • CT Scan: CT scan takes several images of the spine structure from different directions. It shows problem with any tissue, nerves or disk.
  • Myography: With this procedure, doctor can detect the pressure on the spinal cord and nerve. The pressure could be due to the herniated disk or spinal stenosis.

What are the treatment options for Slipped Disc?

The treatment options of a herniated disc or slipped disc are as following:

Home treatment:

  • Lose your body weight
  • Keep exercising- walking, stretching
  • Yoga
  • Drink plenty of water
  • Be active during the day
  • Avoid excess bed rest
  • Quit smoking

Physical Therapy:

A physical therapist can teach you some exercises to strengthen muscles and bone. It also can improve the symptoms of a herniated disc. Physical therapy can include:

  • Icing and heating pad
  • Oil Massage or relaxant massage
  • Aerobic exercises such as walking or riding a cycle
  • Ultrasound therapy
  • Stretching exercises
  • Electrical muscle stimulation

Medications:

  • Your orthopaedic doctor may prescribe painkiller and relaxant medicines. These over the counter medicines reduce swelling and pain.
  • Doctor prescribes some narcotics for short term. If pain reliever doesn’t work such as codeine or oxycodone-acetaminophen. The side effects of these medicines are sedation, nausea, confusion and constipation.
  • Anti-inflammatory and pain-relief injections give immediate relief from the pain. Steroid injections may also be prescribed to reduce swelling and inflammation.

Surgery:

Even after trying out various therapies and medications, if the pain still doesn’t subside, then does the Orthopaedic surgeon recommend a surgical procedure to remove the herniated disc.

Doctor may give you the brief about the surgery options available. He will only recommend the surgery which will be suitable for you. All aspects need to be considered like your age and overall health conditions before the surgeon recommends a surgery.

Although, surgery reduces the pain for a large percentage of the number of patients, however the result of the surgery varies from individual to individual. Doctor will also tell you about the risk related to the surgery.

Your spine surgeon will recommend surgery only in the condition if:

  • You have numbness or weakness
  • You have difficulty in standing or walking
  • Your pain is radiating to legs, back, buttocks or chest.
  • All other treatment options don’t reduce pain

Different Types of Surgery

Laminectomy/ Laminotomy

The rear part of the vertebrae is called lamina. During laminectomy, surgeon creates the space by removing lamina to reduce the pressure on the nerves and canal.

The pressure could be caused by overgrowth bone or bone spur. Bone spur can occur because of the spine arthritis or aging process.

Doctor consider Laminectomy only if other treatments are not reducing the pain and worsen the symptoms.

Discectomy Surgery or Microdiscectomy

Discectomy is the surgical procedure wherein the protruding disc between the vertabraes touching the nerve or spinal cord is removed to relieve one from the excruciating pain.

In this disc surgery the surgeon makes a small incision to conduct the same procedure of removal of the disc. The incision is a very tiny one with the newer methods and instruments in place. Its also called microdiscectomy.

In some cases the entire disc need to be removed and replaced with the synthetic bone substitute. Vertebrae are joined together with some metal hardware.

Artificial Disc Surgery:

Doctor will suggest going for an artificial disc surgery if there is any need of removing the disc completely. During the surgery, he implants the artificial disc to imitate function of spine disc. This is a replacement disc made of either plastic or metal.

Spinal Fusion

Spinal fusion joints two vertebrae into single with the help of screw and rods. This artificial joint supports spinal structure. Once they get joined together, the mobility however of that joint gets restricted.

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