Slipped Disc (Disc prolapse)

A common, painful disorder of the spine, in which an intvertebral disc ruptures and part of its pulpy core protrudes, causing painful and at times disabling pressure on a nerve. About 95% of disc prolapses occur in the lower back, but they can affect any part of the back or the neck.

 

Causes and Incidence

Although a prolapsed disc may sometimes be caused by a sudden strenuous action (such as lifting a heavy weight or twisting violently), it usually develops gradually as a result of degeneration of the discs with age.

People between the ages of 30 and 40 are the most likely to suffer from a disc prolapse. Over the age of 30 discs start to dehydrate and become less resilient but, after 40, extra fibrous tissue forms around them, increasing their stability.

 

Diagnosis

Many other disorders may cause back and leg pain or neck and arm pain, and various tests may be needed to arrive at a firm diagnosis. After the doctor has examined the spine and tested movement and reflexes in the affected arm or leg, he or she may arrange for tests, which can include the following: X-rays, CT scanning, MRI, and EMG (tests of electrical activity in the muscles).

 

Symptoms and Treatment of Disc Prolapse

A prolapsed disc in the lower back causes low back pain and, if the sciatic nerve root is compressed, sciatica (pain running down the back of the leg from the buttock to the ankle), sometimes accompanied by numbness and tingling. Low back pain and sciatica are usually aggravated by coughing, sneezing, bending, and sitting for long periods. Prolonged pressure on the sciatic nerve can lead to weakness in the muscles of the leg.

A prolapsed disc in the neck causes neck pain, stiffness, and, if the root of a nerve that is in the arm is compressed, tingling and weakness in that arm and hand.

In rare cases, pressure is exerted on the spinal cord itself, sometimes leading to paralysis of the leg and loss of bladder or bowel control.

 

Treatment

Disc Prolapse often responds to bed rest (lying flat on the back on a firm mattress for a few weeks) and analgesics; later, a supportive collar or corset and special exercises are helpful. If these measures fail and the nerve root compression is producing muscle weakness, an operation may relieve the pressure.

In most cases, symptoms are relieved by bed rest and a variety of other measures. However, if the pain is persistent, if muscle, bladder, or bowel function are impaired, surgical techniques, such as decompression of the spinal canal or chemonucleolysis may be necessary.