Slipped (herniated) disc

It is one of the most common causes of lower back pain, leg pain, or sciatica.

A disk begins to herniate when its jelly-like nucleus pushes against its outer ring due to wear and tear or a sudden injury. This pressure against the outer ring may cause lower back pain.

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What causes a herniated disc

  • Age-related wear and tear

  • A traumatic event such as a fall

Risk factor of herniating disc 

  • Gender: male is more at risk than female

  • Overweight

  • Repetitive activities that strain your spine

  • Frequent driving

  • Sedentary lifestyle

  • Smoking-- lessens the oxygen supply to the disk and causes more rapid degeneration.

Symptoms 

 Low back pain is the first symptom of a herniated disk.

Other symptoms include

  • Sciatica. Sharp shooting pain that extends from the buttock down the back of one leg.

  • Numbness or a tingling sensation in the leg and/or foot

  • Weakness in the leg and/or foot

  • Loss of bladder or bowel control.

When should I seek medical help?

There are circumstances when back pain might be caused or accompanied by serious issues. If such symptoms are present it is best to seek immediate medical attention to avoid further complications.

Although these are rare to encounter, it is always good to make sure you have no worrying symptoms. You should seek help if you have any of the following:

  • Severe back pain which disturbs your sleep

  • Pain does not improve after 6 weeks or worsens

  • Neurological symptoms

    • Lower limb weakness or paralysis

    • Tingling and numbness of lower limbs

    • Loss of bladder control

 

Diagnosis 

To diagnose slipped disc in your lower back your doctor will perform a physical examination and special tests, taking your case history and past medical history. They will also palpate (gently examine by touch) the area to establish the source. Special tests include

  • Neurological examination. Determine if you have any muscle weakness or loss of sensation.

  • Straight leg raise (SLR) test. A specialized test to predict if a disk herniation in present

Further imaging including an MRI will be done. MRI scans provide clear imagines of the body’s soft tissues, including intervertebral disks. 

Treatment 

Non-surgical treatment

  • Rest

  • NSAIDs (non-steroidal inflammatory drugs)

  • Physiotherapy; strengthen your lower back and abdominal muscles.

  • Epidural steroid injection; provide short-term pain relief by reducing inflammation.

Surgical treatment

Only a small percentage of patients with lumbar disk herniation require surgery. Spine surgery is typically recommended only after a period of nonsurgical treatment has not relieved painful symptoms, or for patients who are experiencing the following symptoms:

  • Muscle weakness

  • Difficulty walking

  • Loss of bladder or bowel control

Recovery 

Up to 90% of people, herniated disk pain improves on its own or with simple medical care. You’ll probably feel better within a month. If you don’t, you should see your healthcare provider.

Prevention 

  • Using proper lifting techniques. Don’t bend at the waist. Bend your knees while keeping your back straight. Use your strong leg muscles to help support the load.

  • Maintaining a healthy weight. Excess weight puts pressure on the lower back.

  • Practicing good posture. Good posture reduces strain on your spine.

  • Stretching. It’s especially important to take stretching breaks if you often sit for long periods.

  • Avoid wearing high-heeled shoes. This type of shoe throws your spine out of alignment.

  • Exercising regularly. Focus on workouts that strengthen your back and abdomen muscles to support your spine.

  • Stop smoking.