Slipped disc: Treatment, symptoms, advice and help

About slipped disc

Slipped disc refers to a condition whereby portions of shock-absorbing pads between the bones of the spine (called disc) have protruded, causing pressure on the spinal cord or nerve tissues.

Slipped disc: Incidence, age and sex

A symptomatic lumbar disc herniation occurs during the lifetime of approximately, 2% of the population. The incidence is more in the male gender in the age group of 30 – 50 years.

Signs & symptoms of slipped disc: Diagnosis

Signs and symptoms range from no pain if only the disc is injured, to severe and unrelenting pain that will radiate into the regions served by nerve roots that are irritated by the herniated disc .The pain may be followed by paraesthesia, motor weakness, loss of reflexes and a reduction in straight leg raise. A large midline disc herniation may compress the cauda equina leading to a syndrome defined by bowel and / or bladder difficulties, saddle anaesthesia and lower limb sensory and motor deficits. Diagnosis is made by a practitioner based on the history, symptoms, and physical examination. A Spine x-ray may be done to rule out other causes of back or neck pain. However, it is not possible to diagnose a herniated disk by spinal x-ray alone. Spine MRI or spine CT will show spinal canal compression by the herniated disk.EMG may be done to determine the exact nerve root that is involved. Nerve conduction velocity test may also be done. Myelogram may be done to determine the size and location of disk herniation.

Causes and prevention of slipped disc

Disc herniations result from wear and tear. The herniation most often occurs when lifting while bent at the waist, rather than lifting with the legs while the back is straight. Safe work and play practices, proper lifting techniques, and weight control may help prevent back injury in some people.

Slipped disc: Complications

These may range from long-term back pain, loss of movement or sensation in the legs or feet, loss of bowel and bladder function, or permanent spinal cord injury (very rarely).

Slipped disc: Treatment

Surgery for cauda equine syndrome should be performed within 24 hours of the onset of symptoms to allow for the optimum recovery of the neural elements. For a simple slipped disc, a period of 6–12 weeks of conservative treatment is advised. Up to 70% of patients will settle within this period. Epidural steroid injection may be helpful. Microdiscectomy is the standard surgical intervention for those in whom conservative treatment has failed. Surgical excision removes both the source of the pressure and the initiator of the inflammatory response.