Disc Herniation/Slipped Disc

What is a Disc Herniation/Slipped Disc?

A disc herniation, often referred to as a slipped or ruptured disc, occurs when the soft, gel-like centre (nucleus pulposus) of a spinal disc pushes through a tear in the outer layer (annulus fibrosus). This displacement can irritate nearby nerves, resulting in pain, numbness, or weakness in the back, neck, or extremities. While herniated discs are more common in the lower back (lumbar spine), they can also occur in the neck (cervical spine) or, rarely, in the upper back (thoracic spine).

Types of Disc Herniation/Slipped Disc

Disc herniations are classified based on their location and the degree of displacement:

Lumbar Disc Herniation: This is the most common type, affecting the lower back. Common symptoms include:

• Localised back pain.

• Sciatica, characterised by pain radiating down the leg.

• Weakness or tingling in the legs or feet.

Cervical Disc Herniation: Occurs in the neck region and may cause:

• Pain radiating to the shoulders or arms.

• Numbness or weakness in the hands.

• Stiff neck or reduced range of motion.

Thoracic Disc Herniation: Rarely occurring, this type affects the upper back and may lead to:

• Mid-back pain.

• Symptoms radiating around the chest or abdomen.

• Difficulty standing straight or walking due to pain.

Stages of Disc HerniationDisc herniation develops in stages based on the severity of damage to the disc:

1. Bulging Disc: The disc protrudes outward but remains intact.

2. Herniated Disc: The inner gel leaks out and presses on nearby nerves.

3. Sequestered Disc: A fragment of the disc breaks off, potentially causing more severe nerve compression.

Symptoms of a Disc Herniation

The symptoms of a herniated disc depend on its location and the severity of nerve involvement. Common symptoms include:

• Localised pain in the back or neck.

• Radiating pain (sciatica) that travels down the leg or arm.

• Numbness, tingling, or a pins-and-needles sensation.

• Muscle weakness in the affected area, such as the legs or arms.

• Reduced range of motion or difficulty with movements like bending or twisting.

Warning Signs: Seek immediate medical attention if you experience:

• Loss of bladder or bowel control (cauda equina syndrome).

• Severe, sudden pain or weakness.

• Persistent pain that does not improve with rest or medication.

• Difficulty walking or maintaining balance.

Diagnosis and Treatment Options

Diagnosis: A comprehensive evaluation is essential to diagnose a herniated disc accurately. Diagnostic steps may include:

• Medical History and Physical Examination: To identify symptoms, assess reflexes, and test muscle strength.

• Imaging Studies: MRI or CT scans to visualise the disc and detect nerve compression.

• Nerve Function Tests: Electromyography (EMG) to evaluate nerve and muscle activity.

Treatment Options: Treatment for disc herniation aims to relieve symptoms, improve mobility, and prevent further damage. Approaches include:

Conservative Treatments:

• Rest and Activity Modification: Avoid strenuous activities that worsen symptoms while maintaining light physical activity.

• Medications:

  • Over-the-counter pain relievers such as ibuprofen or paracetamol.

  • Prescription medications like muscle relaxants or nerve pain medications (e.g., gabapentin).

• Physical Therapy:

  • Exercises to strengthen the back and core muscles.

  • Stretching routines to improve flexibility and reduce tension.

Advanced Interventions:

• Epidural Steroid Injections: To reduce inflammation and provide temporary relief.

• Minimally Invasive Procedures:

  • Microdiscectomy: Surgical removal of the herniated portion of the disc to relieve nerve pressure.

  • Laminectomy: Removal of part of the vertebra to create space and ease nerve compression.

Alternative Therapies:

• Chiropractic care, acupuncture, or massage for symptom relief.

• Yoga or Pilates to strengthen muscles and improve posture.

Surgical Treatments: Surgery is considered for severe cases where conservative measures fail, or if there are complications like nerve damage. Procedures include:

• Spinal fusion: To stabilise the spine.

• Artificial disc replacement: In suitable cases, the damaged disc is replaced with a synthetic one.

Conclusion

A herniated disc can significantly impact daily life, but with the right diagnosis and tailored treatment, most individuals experience relief and a return to normal activities. If you are experiencing back pain, sciatica, or other related symptoms, seek expert medical advice. At Singapore Brain Spine Nerves Centre, our experienced team provides thorough evaluations and personalised treatment plans to help you regain your mobility and comfort. Take the first step towards recovery by scheduling an appointment with us today.