UAE: The spine consists of multiple bones called vertebrae that are stacked on top of each other. In between each vertebra there are protective circular pads called discs that contains a softer gel-like substance. The discs help maintain the back's flexibility and wide range of movement. A slipped disc – known as a prolapsed or herniated disc – occurs when one of the discs is damaged and presses on the nerves. This can cause back pain and neck pain.
When asked to address the causes of a slipped disc, Dr. Sumit Batra, Specialist Orthopedic Surgeon at Medeor 24x7 Hospital, Al Ain said, “There are a number of factors that can put increased pressure and strain on the spine such as bending awkwardly, jobs that involve heavy or awkward lifting, jobs that involve lots of sitting, particularly driving, being overweight or obese, weight bearing sports, such as weightlifting, a traumatic injury to the back, such as a fall or accident. Smoking also plays a role as it causes the discs to lose their natural flexibility. Situations such as these can weaken the disc tissue and can sometimes lead to a slipped disc.” He further said, “As we get older, our spinal discs start to lose their water content, making them less flexible and more likely to rupture. A slipped disc occurs when the outer case of the disc splits, resulting in the gel inside bulging out of the disc. The damaged disc can put pressure on the whole spinal cord or on a single nerve. A slipped disc can cause pain both in the area of the protruding disc and in the area of the body controlled by the nerve that the disc is pressing on.”
Dr. Sumit pointed out that most people with a slipped disc experience symptoms such as pain in the back that starts slowly and gets worse over time. A slipped disc in the neck can cause neck pain, numbness or a tingling sensation in the neck, shoulder, arm or hand and weakness in hand muscles. While a slipped disc in the lower back can cause back pain, numbness or a tingling sensation in the back, buttocks, genitals, legs or feet and weakness in the leg or foot muscles.
The sciatic nerve runs from the back of the pelvis, through the buttocks and down the legs to the feet. If a slipped disc is putting pressure on the sciatic nerve, it can lead to pain in the leg, hip or buttocks. This is known as Sciatica.
Caudaequina syndrome is a serious condition where the nerves at the very bottom of the spinal cord become compressed. Symptoms can include lower back pain, numbness in groin, paralysis of one or both legs, and loss of bowel or bladder control. One should seek immediate medical assistance since the nerves to bladder and bowel can become permanently damaged if not promptly treated.
Magnetic resonance imaging (MRI) scans are effective at diagnosing the position and size of a slipped disc. They can also pinpoint the affected nerves. A CT scan can also pinpoint a slipped disc, although it is often not as effective. X-rays are not generally used as a test to look for slipped discs as they only show the bones and do not give a view of the nerves and spinal cord. Treatment of a slipped disc usually involves a combination of physiotherapy and medication such as painkillers and muscle relaxants to relieve the pain. Corticosteroids injections can also be given to the lower spine to help reduce pain and inflammation. Surgery to release the compressed nerve and remove part of the slipped disc may be considered in severe cases, or if the pain continues for longer than six weeks and there is progressive weakness in the muscles. The aim of surgery is to cut away the piece of the disc that bulges out. This is known as a discectomy and it can be done in several ways e.g., microdiscectomy, endoscopic discectomy or artificial disc replacement. Post surgery, the patient may need to rest completely for the first couple of days to speed up the recovery and ensure exercise that is gentle and does not put a strain on the back. Swimming is an ideal form of exercise because the water supports the weight and puts very little strain on other joints.
Dr. Batra concluded, “To avoid back pain and help prevent a slipped disc, one should keep mobile, exercise regularly, maintain good posture while sitting and standing, use safe techniques when lifting heavy objects, avoid sitting for a prolonged period of time and quit smoking.”