|A slipped disc is a term used to describe the condition in which an intervertebral disc “slips” from between the bones of the spine and presses into the spinal canal which contains the spinal cord and its nerve branches.|
An intervertebral disc is a tough piece of cartilage around a soft spongy centre. The disc acts as a shock absorber.
During movement which involves the spine, particularly lifting, it is the disc and the soft centre which bears the brunt of the strain.
Disc degeneration normally begins in our 40’s and 50’s but it can start much earlier, especially in males, particularly if stress and strain has been placed on the lower back by competitive sport during adolescence.
Acute injury to the disc can occur at any age, more so if degenerative disease of the spine is present. When added strain is placed on the lower back, particularly by the lifting of heavy objects such as heavy weights in the gym, then rupture or slipping of the disc can occur. The disc bulgs into the spinal canal and irritation of the spinal cord and its nerve branches may be produced.
Pain may be localised to the disc or may radiate down the leg via the sciatic nerve producing the condition called sciatica.
Sciatica is a pain which radiates down the back and side of the leg to the sole and side of the foot and on to the big toe.
Typically it will occur whilst in the bending position when the strain on the lower disc is more pronounced. There is a sudden onset of intense lower back pain. The person involved cannot straighten up and the pain radiates down the leg. It may be associated with a tingling or numbness in the leg and there may be accompanying muscle weakness.
Immediate treatment consists of bed rest on a firm bed, even to the extent of using bed boards. Pain killing and muscle relaxant drugs taken under medical supervision will be necessary. Gradually the patient will be able to straighten out and hopefully over the next days to weeks, the bulging of the discs will retract and pain will subside.
Bed rest for 2 to 6 weeks may be necessary and if the condition is not relieved, surgery to relieve pressure on the spinal cord or nerve roots will have to be considered.
In suitable cases an enzyme injection into the centre of the disc which will cause partial absorption of prolapsed material may succeed in relieving symptoms of pain in the leg. However, back pain may still persist for several weeks.
In the recovery period physiotherapy to strengthen the spinal muscles will be necessary. Back exercises should not include sit ups and twisting of the spine, but should include strong extension of the spine and floor exercises where the back is supported.
Your doctor, in association with the physiotherapist, will advise on exercise and activity. Flexion of the spine should be avoided. Objects should be picked up with knees bent and the spine straight. If you are planning active sport it might be wise to wear a firm elastic support in the early stages of activity.
Slipped discs can occur in the neck and very occasionally in the mid spine area. In the neck the bulging of the disc can produce pain which radiates down the arm. In the resting phase a neck brace might be necessary but should be left off as pain gradually subsides and neck exercises strengthen the muscles
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