What is a slipped disc?
Many people are surprised to learn that discs do not really slip. Discs are basically spongy cushions sandwiched in between the spinal vertebrae. They have a tough, fibrous case - the annulus - that contains a softer gel-like substance - called the nucleus. The discs help maintain your spine's flexibility and range of movement. A slipped disc - more accurately known as a prolapsed disc - occurs when the outer annulus splits, allowing the nucleus inside to bulge out of the disc. The damaged disc can put pressure on the spinal cord or more commonly on a single nerve root. This means that a prolapsed disc can cause pain both in the area of the protruding disc and in the area of the body controlled by the nerve that the disc is pressing on. If the disc is in the neck this causes pain in the arm.
How do we treat slipped discs?
Treatment usually involves a combination of physical therapy, such as osteopathy, medication to relieve the back pain, and injections to relieve the nerve pain.
Surgery to release the compressed nerve and remove part of the disc may be considered in severe cases, or if the pain continues for too long. If surgical treatment is required, the Mansfield Clinic can arrange for this to be organised.
It is not always clear what causes a disc to prolapse, although age is one factor. As you get older, your discs start to lose their water content, making them less flexible and more likely to rupture. Smoking also plays a role as it causes the discs to lose their natural flexibility.
It's important to note that not all prolapsed discs cause symptoms. Many people will go their whole life and not know that they have a prolapsed disc, even though they have one.
There are a number of other factors that can put increased pressure and strain on your spine. These include:
Situations such as these can weaken the disc tissue and can sometimes lead to a prolapsed disc.
Most people with a disc prolapse have pain on one side of the body that starts slowly and gradually gets worse. The pain you experience when a disc presses on a nerve is often aggravated by coughing, sneezing or sitting down. A prolapsed disc in the neck can cause:
The Mansfield Clinic specialises in the diagnosis and the treatment of people with disc prolapses. Prolapsed discs are diagnosed from your symptoms and your medical history. Dr Allfree will carry out a physical examination to test your:
If your symptoms do not ease after four to six weeks, an MRI scan may be required to rule out other conditions and investigate the size and position of the prolapsed disc. Some of the tests you may have are described below.
An MRI scan uses a strong magnetic field to produce detailed images of the inside of your body. MRI scans allow us to take a very detailed cross-sectional pictures of the discs and the nerve roots inside your spine. They are very effective at showing the position and size of a prolapsed disc. They can also pinpoint the affected nerves. These can be arranged for you if necessary at the Mansfield Clinic. MRI scans can normally be arranged and completed within two weeks of referral.
X-rays are not generally used as a test to look for slipped discs as they only see the bones and do not give a view of the nerves and spinal cord.
In many cases, a prolapsed disc will eventually shrink back away from the nerve and the pain will ease as the disc stops pressing on the affected nerve.
If you have a prolapsed disc, it is very important to keep active. Initially moving may be difficult, but after resting for a few days you should start to move around, but try not to do things that aggravate the pain. This will help keep you mobile and stop the joints becoming stiff and the muscles that support the neck becoming weak. Keeping moving will help to speed up your recovery.
Any exercise you do should be gentle and not put too much strain on your neck. Sports that involve high impact, or unusual postures of the neck such as snooker, should be avoided at first as they may cause a flare-up of the pain. You may well need some specific exercises to aid your recovery, and Dr Allfree will advise you on an appropriate regime.
Taking a few sensible precautions, such as leading a healthy lifestyle, can help prevent back pain and lower your risk of getting a slipped disc. For example, you should: