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Slipped Disc

How Do You Know it’s a Slipped Disc?

When people say they have a slipped disc, they are often using a general term for back problems. Indeed, many may be unaware that the term ‘slipped disc’ can refer to a range of medical problems; all of which relate to the ‘discs’ of soft tissue that separate the vertebrae in the spinal column. In fact such problems can occur along the length of the spinal column from the neck to the lower back.

What Does ‘Slipped Disc’ Actually Mean?

In medical terms, a ‘slipped disc’ could be either a disc bulge (protrusion) or a ruptured disc (disc extrusion or sequestrum). Slipped discs may arise in the neck (cervical spine), back of chest (thoracic spine) or lower back (lumbar spine). Medical professionals always use this terminology to ensure strict accuracy of both description and communication and in order to avoid misinterpretation.

How is a Slipped Disc Diagnosed?

One of the complications in diagnosing a slipped disc is that whilst the apparent pain or problem may manifest itself in one part of the body, the actual cause of the problem can lie in a different part of the spinal region. For this reason, medical professionals pay close attention to the symptoms as a first step in evaluating what the problem may be, before moving on to more focused diagnostic procedures.

Is the Pain in Your Lower Back?

Various combinations of pain in the lower back, buttock, groin or leg can arise either from irritation within the disc itself, or when the disc causes irritation of the adjacent nerves. The pain, which when it spreads below the knee, is termed Sciatica, occurs when the slipped disc presses on a nerve in the lumbar spine. This may cause numbness or pins and needles in the leg and be associated with weakness such as “foot drop” (difficulty lifting the toes and foot up) or weakness when pushing off with the foot.

Is the Pain in Your Neck?

Neck pain, headaches and pain in the face, shoulders, arms and hands may be created when the slipped disc presses on the nerves in the neck. This may cause numbness or ‘pins & needles’ in the face, shoulder, arm or hand and may also be associated with weakness of shoulder, elbow, wrist or hand movements. Any one of these symptoms, or a combination of them, can indicate disc problems.

How is The First Attack Treated?

The major symptoms arising from the first attack generally settle down over the first 6 weeks and half of the remainder will generally settle down over the following 6 weeks. Treatment during this period is focused upon reducing the irritation. This may include: anti-inflammatory drugs (Steroids or Non-Steroidal Anti-Inflammatory; therapy such as Ibuprofen, Diclofenac or Acemethacin); and Muscle Balance Physiotherapy to correct the posture and maintain mobility.

How are Repeated Attacks Treated?

Repeated attacks or enduring symptoms need more radical treatment and these may be grouped in to three treatment pathways; Conservative Therapy, Conventional Open Surgery and Endoscopic Minimally Invasive Spine Surgery.

  • Conservative therapy consists of Muscle Balance Physiotherapy, injection, Cognitive Behavioural Therapy and coping courses, plus a restricted lifestyle, and the hope that the symptoms will abate over time.
  • Conventional Open Surgery, whilst not without risk altogether, carries greater risk and cannot guarantee success. The surgical options are tabulated below.
  • Endoscopic Minimally Invasive Spine Surgery has shown encouraging results in over 80% of 3.800 procedures carried out. This includes patients treated for Slipped discs, Failed Back Surgery, Failed Fusion Surgery, Spine Instability, Chronic Lumbar Spondylosis and Back pain, Lateral Recess Stenosis and Axial Stenosis, Spondylolytic Spondylolisthesis and Disc infections. In addition, our current and yet incomplete survey of patients operated upon 10 years ago is proving surprisingly encouraging.
Procedure Complications Success at Year 2
Microdiscectomy 6% (Recurrent Protrusion 3 – 17%) Leg pain but not back pain 90%
Open Decompression 8% (Instability and scarring) Poor data @ 75%
Instrumented Fusion 11 – 18% (International Controlled Trials) 60%
Total Disc Replacement 16 – 45% 50%
Interspinous Spacers Spinous process fractures, settlement, infection Insufficient data
Endoscopic Minimally Invasive Spine Surgery (Transforaminal) 2.4% 80%
Thank you - From the Spinal Foundation