Slipped disk
A slipped disk, also known as a herniated or bulging disk, occurs when the outer layer of an intervertebral disk weakens, allowing the inner gel-like center to protrude or leak out. This condition is often linked to aging, as disks lose water content and elasticity over time. It can also result from improper lifting, excessive weight, twisting movements, or trauma. Slipped disks most frequently affect the lumbar region of the spine, leading to low back pain that may radiate to the buttocks, legs, and feet, often accompanied by symptoms like weakness or tingling.
In the cervical region, symptoms may include neck pain that radiates to the arm or hand, with possible numbness or weakness. Treatment typically begins with conservative measures such as bed rest, pain relievers, and physical therapy, with more severe cases potentially requiring injections or surgery, including diskectomy or spinal fusion. Emerging treatments, such as disk replacement and novel regenerative techniques, are being explored as alternatives to traditional surgery. Overall, understanding a slipped disk and its management options can provide valuable insights for those experiencing related symptoms.
Slipped disk
Also known as: Herniated disk, ruptured disk, prolapsed disk, intervertebral disk displacement
Anatomy or system affected: Arms, back, legs, musculoskeletal system, neck, nerves, nervous system, spine
Definition: A condition in which the soft, gelatinous center part of an intervertebral disk pushes out through a weakened portion of the disk, often placing pressure on a spinal nerve
Causes and Symptoms
The spinal column has small bones called vertebrae that connect the skull to the pelvis. It is divided into regions: cervical (neck), thoracic (chest), and lumbar (lower back). Separating the vertebrae are intervertebral disks that provide cushioning and shock absorption during movement. The spinal column also has a hollow center portion called the spinal canal, which contains the spinal cord and nerves.
A slipped disk occurs when the outer portion of the intervertebral disk, called the annulus fibrosus, becomes weakened and allows the center portion, called the nucleus pulposus, to push out or leak through. There are various reasons that such bulging may occur. The process of aging is associated with degeneration and loss of water content in the disk material, which causes it to weaken over time, becoming less elastic. Improper lifting, excessive weight or vertical pressure on the spine, twisting, or forceful trauma can also cause a disk to rupture. Slipped disks are most common in the lumbar region, occur less frequently in the cervical region, and occur rarely in the thoracic region.
Symptoms vary with the degree of disk protrusion and nerve compression. In the lumbar region, the main symptom is low back pain, which may be a dull ache or a sharp and burning sensation radiating to the buttocks, legs, and feet (sciatica). Other symptoms include weakness or tingling in one leg and loss of bladder or bowel control. In the cervical region, symptoms include neck pain, often radiating to the shoulder, arm, or hand, and numbness, tingling, or weakness in any of these areas. All cases may include muscle spasms, and pain may be worsened upon movement, coughing, or straining.
Treatment and Therapy
Conservative treatment with initial bed rest, over-the-counter pain relievers, and anti-inflammatory medications is standard for a slipped disk. Muscle relaxants may be prescribed for muscle spasms. After forty-eight hours, activity and physical therapy are recommended. Most patients recover with this regimen. In cases of acute pain, steroid injections in the back may be used to reduce inflammation. Various surgical approaches involving diskectomy, microdiskectomy, and spinal fusion, exist for patients who do not improve with conservative treatment.
An often effective alternative to surgery is chemonucleolysis, wherein the orthopedist injects an enzyme that dissolves the ruptured portion of the disk. In 2007, the Food and Drug Administration approved lumbar disk replacement as a treatment option for some types of low back pain. Some clinical researchers believe that as new materials and placement techniques are developed, spinal disk-replacement surgery may become a standard treatment for some types of low back pain. In the 2020s, a new treatment involving the injection of hyaluronic acid into the disk and the use of collagen to seal the hole was developed. This treatment has been compared to healing a disk as one would reinflate a flat tire.
Bibliography
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Nutt, David. “Like Patching a Flat Tire: New Fix Heals Herniated Discs.” ScienceDaily, 11 Mar. 2020, www.sciencedaily.com/releases/2020/03/200311161810.htm. Accessed 21 July 2023.
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