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What is Slipped Disc (or Herniated Disc)

With adult having some 80% chance of getting back pain at some point in their lives, who hasn’t complained of an aching back? How many people have experienced the sudden pain of “throwing one’s back out?”

In most instances, back pain is simply the result of unusual exertion, fatigue or a twist or sharp movement, but occasionally, there has been an injury to the spine and medical attention is required. A slipped disc is one such common injury to the spine. It can be extremely painful, and may damage surrounding muscle and nerve systems. If pain is very severe, if it persists or worsens when you lie down, if it travels down your leg or if numbness sets in, then a doctor should be consulted.

Despite the common name – “slipped disc”, it doesn’t really “slips” out, rather the gel-like material in the centre of the disc bulges into the spinal canal. A slipped disc is also known as a pro-lapsed intervertebral disc (PID), herniated or ruptured disc.

A disc is a small mass of elastic, gristle-like tissue. Located between each vertebra in the spinal column, discs act as shock absorbers for the spinal bones. Thick ligaments attached to the vertebrae hold the pulpy disc material in place.

Why do disks herniate?

Occasionally, a single excessive strain may cause a slipped disc. However, disc material degenerates naturally as we age, and the ligaments that hold it in place begin to weaken. As this degeneration progresses, a relatively minor strain or twisting movement can cause a disc to pop out of place.

Certain individuals may be more vulnerable to disc problems, and as a consequence may suffer herniations at several places along the spine.

What are the symptoms of a slipped disc?

Extreme, sudden pain is usually the first symptom. Since most herniations involve the bottom two discs in the spinal column, the pain usually begins in the lower back. The bulging disc in this location exerts pressure on the sciatic nerve, and sharp pain may follow that nerve all the way down the leg and into the foot. Pressure on this nerve may eventually cause numbness or a “pins and needles” sensation. Over time, the surrounding muscles can weaken and shrink in size.

Discs can also rupture at higher levels in the spine causing pain and weakness in the neck, shoulders and arms.

Even if the initial pain subsides, it is important that the condition be diagnosed and treated in order to prevent further damage.

>>What treatment options are available?

References

1. Stabilizing training compared with manual treatment in sub-acuteand chronic low-back pain, Rasmussen-Barr et al, Manual Therapy (2003) 8(4), 233?41
2. Achieving Spine Stability: Blending Engineering and Clinical Approaches, S. McGill, 4th Interdisciplinary World Congree on Low Back & Pelvic Pain, November 2001
3. Morphology of the Transversus Abdominis, Obliquus Internus, and Obliquus Externus Muscles, Urquhart, Hodges et al, 4th Interdisciplinary World Congree on Low Back & Pelvic Pain, November 2001
4. The stabilising system of the spine. Part I.Function, dysfunction, adaptation and enhancement., Panjabi MM,  Journal of Spinal Disorder 4: 383?89,
5. The stabilising system of the spine. Part II.Neutral zone and instability Hypothesis. , Panjabi MM  Journal of Spinal Disorder 4: 390?97
6. What exercise would you prescribe? Manual Therapy 1: 2?0 Muscle control ?pain control. What exercise would you
7. prescribe?, Richardson CA, Jull GA 1995, Manual Therapy 1: 2?0
8. Therapeutic Exercise for Spinal Segmental Stabilisation in Low Back Pain., Richardson CA, Jull GA, Hodges PW, Hides J 1999  Scientific Basis and Clinical Approach. 1st edn. Churchill Livingstone, London