Slipped disc

What happens?

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The backbone is made up of smaller hollow bones stacked up on one another such that the hollows are continuous forming a tunnel where the spinal cord lies. In between one bone and another is a disc which has an outer shell and an inner fleshy part. This disc cushions the bones and allows a space in between them through which nerves can leave the spinal cord.

When a disc is said to have slipped, it means that it has been damaged and part of it is bulging out. It may be pressing on a nerve, and this is what causes the pain.

Slipped discs are often caused by strain on the lower back, and the chances of it occurring are increased with age, heavy lifting, sitting for a long time, obesity, smoking and playing strenuous contact sports like rugby. Slipped discs are more common in men than in women.

What are the symptoms?

The episode often starts dramatically during lifting, twisting or bending and produces a typical combination of low back pain and muscle spasm, and severe, lancinating pains, ‘pins and needles’ sensation, numbness and neurological signs in one leg usually (rarely both). The back pain is general, usually on one side and spreads to involve the buttock.

What treatments work?

Most people with a slipped disc get better in time, and very few go on to need surgery. The doctor may advise a short period (2–3 days) of bed rest, either lying flat or semi-reclining depending on the position of the slipped disc, and prescribe painkillers and drugs to relax the tense muscles.

Once the pain is tolerable, one is encouraged to move around, and may be refered to a physiotherapist for exercise and preventative advice.

Referral to a surgeon for possible surgery is necessary if there is severe neurological impairment or if the pain persists and is severe for more than 6–10 weeks.

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What will happen to me?

Pain from a slipped disc gets better without treatment for 9 out of 10 people. Most people feel better within six weeks, but it can take longer.

Back pain from a slipped disc may come back, whether or not you have treatment.