Article: Slipped disc

A slipped disc is a popular expression which is used interchangeably to describe a number of intervertebral disc problems. Other terms often used include: slipped disc, protruding disc, prolapsed disc, herniated disc, pinched nerve, sciatica and degenerative disc disease (spondylosis). Confusion tends to surround the topic, as laypersons and health professionals alike use a mixture of terms to describe a variety of pathologies. Therefore, rather than worry about the proper term, it is more important to understand the pathology — the anatomical or functional cause of pain. A medical diagnosis will determine whether the disc is affecting a spinal nerve root or if the disc itself is painful.

Slipped disc is most often used to describe a herniated intervertebral disc. A herniated intervertebral disc is a condition in which a tear in the outer fibrous ring (annulus) of the disc allows the central soft part (nucleus pulposus) to extrude, often into the spinal canal.

The term slipped disc is somewhat misleading, as an intervertebral disc, being tightly sandwiched between two vertebrae, cannot actually ‘slip,’ ‘slide’ or even get ‘out of place.’ It is actually grown together with the adjacent vertebrae and can be squeezed, stretched, and twisted, all in small degrees. A disc can also become degenerated, torn, ripped, and herniated, but not "slipped."

There are two forms of herniated disc, the lumbar disc herniation and the cervical disc herniation. Slipped disc generally refers to the more frequent of the two — the lumbar disc herniation. This condition causes lower back pain and often leg pain as well, in which case it is commonly referred to as sciatica.

As its name suggests, a lumbar disc herniation occurs in the lumbar region of the spine (lower back), most often between the fourth and fifth lumbar vertebral bodies or between the fifth and the sacrum. The herniation will usually extrude on one side of the spinal canal, at the point where a nerve root leaves the canal. Pressure on the nerve causes pain, numbness and/or weakness in the part of the skin and muscle tissue which the nerve serves. In addition, chemical substances will at times leak from disc and cause inflammation and pain at the nerve root. What's a slipped disc, herniated disc, pinched nerve...?.

Causes

Causes of a lumbar disc herniation can include general wear and tear on the disc over time, repetitive movements, stress on the disc that occurs while twisting and lifting, or other injuries.

Symptoms

Symptoms can include lower back pain, pain that runs along the back of the thigh and buttocks, and pain that may radiate into the foot and/or toe. Other symptoms may include leg weakness or numbness or tingling. Unlike a pulsating pain or pain that comes and goes, which can be causes by muscle spasm, pain from a herniated disc is usually continuous.

Treatment

The majority of herniated discs will heal themselves in about six weeks and do not require surgery. Your doctor may prescribe bed rest (usually for no more than two days), or advise you to maintain a low, painless activity level for a short period. If your doctor recommends physical therapy, this may include pelvic traction, gentle massage, ice and heat therapy, ultrasound, electrical muscle stimulation, and stretching exercises.[1] Pain medications are often prescribed to alleviate the acute pain and allow the patient to begin exercising and stretching.

See also

• Low back pain
• Sciatica
• Lumbar disc herniation