Slipped disc is the common name for what
happens when one of the intervertebral discs that act as a cushion between
the vertebrae (bones of the backbone) slips out of position. It occurs most commonly in the
i.e. the lower part of the back, mainly as a result of strain
caused by lifting loads. A slipped disc can occur from adolescence onwards. In a
young person, the cause is usually a direct injury or strain. In old age,
However, backache, is more likely due to general degeneration as the discs dry
up and shrink.
Bending and straightening normally affect the cervical and lumbar vertebrae ,
rotation normally affect the thoracic vertebrae. The discs between the cervical
vertebrae may begin to bulge through long term faulty posture. Disc between the
thoracic vertebrae are normally spared any "slipping" because the two ribs
attached to each of them provides support. The discs between
the lumbar vertebrae are affected by the kind of strain caused by incorrect
lifting or lifting of heavy loads. Each disc has a jelly like core called the
nucleus pulposus. Under severe strain this part will bulge into the weakest back
part of the tough shell (Annulus Fibrosus).
The backbone consists of a curved, flexible
column of twenty four separate bones, seven in the neck (cervical), twelve in
the back (thoracic) and five in the lower back (lumbar) plus the sacrum and
coccyx or tail bone at the bottom. Between each of the movable bones or
vertebrae, is a cushion of cartilage, called an intervertebral disc. This allows
for a small amount of movement in each direction; it also acts as a natural
If a lumbar disc slips out of place, the usual
result from local backache is sciatica. Pain is felt in the back, back or side
of the buttocks and the back or side of the thigh and calf. Either the heel or
the top of your foot may be painful. If a new disc is involved it is likely to
give severe pain, with tingling and numbness usually affecting either the inner
or outer aspect of the arm and hand.
DIAGNOSIS AND TREATMENT
During the period of severe pain, rest is
essential, combined with generous doses of analgesics. A cervical collar or a
corset may be useful during the recovery period, while gradual exercises will
strengthen your back and neck muscles and provide a natural, flexible splint.
Avoid lifting anything heavy for the foreseeable future.
Diseases such as Herpez and diabetes mellitus
sometimes show symptoms similar to those produced by a slipped disc. These will
have to be rules out by appropriate tests.
If the pain is acute, it may be necessary to
lie on your back for a matter of weeks. If the vertebrae at the neck are
affected, then a splint in the form of a surgical collar may make this
unnecessary. In less severe cases, the disorder may respond to physiotherapy in
the form of teaching how to improve your posture. Physical manipulation will be
administered by a physiotherapist. It is quite feasible, if the disorder
persists, to cutout the protruding part of the disc surgically.