A slipped disc is a very common orthopedic condition that can lead to back pain. Between each vertebra in the back, there are discs, which act as shock absorbers. Each disc is comprised of a jelly-like substance surrounded by a tough ring. A slipped disc occurs when the jelly-like substance inside the disc starts to push out towards the outer ring.
Causes
In most cases, a slipped disc develops due to age-related changes in the spine. There are also some risk factors that increase your chances of developing a slipped disc. For example, being overweight and improper lifting techniques place extra stress on the spine and can lead to a slipped disc.
Symptoms and Natural History
In the majority of cases, a slipped disc starts with back pain. Pain may come and go initially. When symptoms return, symptoms of sciatica including numbness and weakness in the legs may follow. Pain can extend from the back, past the knee and into the foot.
Some people only experience mild symptoms with a slipped disc. But in other instances, pain and numbness can interfere with work activities. For example, if you have a job that involves lifting, a slipped disc can make work difficult or impossible. But everyday activities, such as sitting and walking can be difficult as well.
Although it is rare, loss of bladder or bowel control can occur and indicates a serious complication. Cauda equina syndrome is a condition that is caused by compression of the spinal nerve root. If this condition is present, it requires immediate treatment.
Diagnosis
A diagnosis is made based on a physical exam and imaging tests. During an exam, your doctor will check for sensory loss or weakness in the legs and feet. A straight leg test will also likely be performed. During the test, you’ll be asked to raise one leg at a time while lying on your back to check for pain.
In addition to an exam and medical history, imaging tests may be ordered to make a definitive diagnosis. An x-ray is less costly than other imaging studies and may be ordered, but it does not create images of soft tissue. In many cases, an MRI will be recommended, since it shows soft tissue.
Self-help treatments for a Slipped Disc
Self-help treatments for a slipped disc may include a day or two of bed rest. In most cases, doctors don’t recommend long periods of inactivity. A few days of rest may be enough to ease symptoms. Avoiding activities that cause pain, such as bending or twisting, is also helpful until symptoms have subsided.
Standard Clinical treatments for a Slipped Disc
Non-surgical care is the first line of treatment unless symptoms are severe or cauda equina develops. Physical therapy may be prescribed in order to strengthen the back and adnominal muscles. Standard treatment may also include an epidural steroid injection. The injection helps decrease inflammation and pain.
Only a small percentage of people require surgery for a slipped disc. But if all other treatments fail and symptoms are severe, a surgical procedure called a microdiscectomy may be performed. The procedure involves removing parts of the slipped disc that are compressing the nerve.
Sources
U.S. National Library of Medicine. Slipped Disk: An Overview. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072656/
American Academy of Orthopaedic Surgeons. Herniated Disk in the Lower Back. http://orthoinfo.aaos.org/topic.cfm?topic=a00534
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