Slipped disc or disc prolapse

When an intervertebral disc presses against nerves in the spine (generally the lumbar and cervical spine) or the spinal cord, this is known as a slipped disc or disc prolapse. It causes pain and muscle tension affecting the back. If the slipped disc causes major damage to the nerve (nerve root), this can cause a loss of feeling in the legs and signs of paralysis.

Depending on the severity, slipped discs are either treated conservatively or with medical intervention involving surgery. 

Causes of a slipped disc

The intervertebral discs are located between the vertebrae of the spine and act like shock absorbers. They facilitate the spine’s movement and protect it from vibrations, bumps and jolts. As we age and if our backs are exposed to incorrect or excessive strain, the discs can become damaged. They gradually become less elastic and often a gelatinous substance starts to leak from one or more of the discs. This leakage is referred to as a slipped disc or herniated disc. A slipped disc usually involves the lumbar spine. However, any area of the spine can be affected.

The following factors can facilitate the development of a slipped disc:

  • Incorrect back posture
  • Chronic excessive strain 
  • Excessive weight
  • Age (usually affecting people aged between 30 and 50 years)
  • Gender (men are twice as likely as women to be affected)

What are the symptoms?

Common symptoms include back pain that radiates down into the buttocks and the leg. Pain in the neck or radiating down the arm may be felt as well. Depending on the severity, patients may also experience sensory disorders such as a tingling sensation or numbness. 

If there are signs of paralysis or problems with the functioning of the bladder or bowels, then it is crucial to act quickly to prevent irreversible nerve damage. 

Diagnosis of a slipped disc 

To diagnose a disc prolapse, doctors evaluate the symptoms and perform neurological tests and spinal examinations. Magnetic resonance imaging (MRI) and computed tomography (CT) examinations make it possible to determine the exact location and extent of the slipped disc.

Conservative and surgical treatment

The treatment depends on the severity of the patient’s disease. The main focus is on conservative treatment, which involves painkillers, anti-inflammatory medication and targeted physiotherapy exercises. The majority of all slipped discs can be effectively treated with these measures and a bit of patience. If conservative therapy is unsuccessful, or in severe cases involving a risk of paralysis, surgical treatment is then advisable. Emergency surgery is required if the patient is suffering from Cauda equina syndrome, which impairs the functioning of the bladder and bowels. Find out more about the surgical treatment options in the Disc surgerysection.

Prevention

Regular exercises to strengthen the muscles of the stomach and back help to protect the vertebrae and intervertebral discs. Another important way of preventing slipped discs is to avoid placing strain on the back (e.g. always keep it straight when lifting heavy objects).