Overview: What is a slipped disc?
The intervertebral discs are cartilaginous intervertebral discs between two adjacent vertebral bodies. The medical term for an intervertebral disc is discus intervertebralis.
The intervertebral discs are flexible and thus allow the spine to move. At the same time, they serve as a kind of shock absorber that absorbs shocks to the spine.
Each intervertebral disc has an outer, firm fibrous ring and an inner, somewhat softer gelatinous core. This ensures that the intervertebral disc remains elastic.
If the gelatinous nucleus and thus the intervertebral disc bulges without tearing the protective fibrous ring, doctors refer to this as a protrusion. A bulging disc is a preliminary stage of a herniated disc. A herniated disc occurs when a part of this nucleus moves outwards through the fibrous ring into the nerve canal of the spinal column. Here it can press on the surrounding nerves or the spinal cord.
Other medical terms for a bulging or herniated disc are disc hernia (from the Latin “diskus” = “disc” and “hernia” = hernia) and disc prolapse (from the Latin “pro” = “in front of” and “lapsus” = “fall”).
Herniated disc – frequency and age
Most people show signs of wear and tear on their spine from the age of 30. This is part of the normal ageing process and is not yet a sign of illness.
The situation is different if a herniated disc occurs as a result of wear and tear or injury. A slipped disc with symptoms caused by irritation or compression of nerves affects around 150 out of 100,000 people every year. Most of the people affected are between 40 and 50 years old.
Herniated disc: causes and risk factors
The most common cause of a slipped disc is age-related wear and tear of the intervertebral disc. More rarely, it is triggered by an injury. Over the years, the intervertebral disc becomes increasingly less elastic. This increases the risk of the fibrous ring of the intervertebral disc rupturing and parts of the gelatinous nucleus bulging or prolapsing into the nerve canal, resulting in a herniated disc. This is why people in middle age are particularly affected by disc problems and herniated discs.
However, age is not the only reason for a slipped disc. There are numerous factors that put strain on the intervertebral disc. These include:
- Overweight,
- Lack of exercise,
- Posture errors,
- heavy physical work and
- Lifting heavy objects with a biomechanically unfavorable posture.
Symptoms: Herniated disc
A slipped disc does not necessarily have to cause symptoms. A small slipped disc often goes unnoticed for a long time or is discovered by chance.
Depending on its location and size, a herniated disc can cause various symptoms. A slipped disc can occur in any area of the spine. However, they most frequently affect the lumbar spine (LS) and less frequently the cervical spine (CS) or thoracic spine (CF). More than 90 percent of all herniated discs occur in the lumbar spine.
A slipped disc in the lumbar spine typically causes the following symptoms:
- Back pain with radiation into the leg and possibly the foot
- Sensory disorders in the area of the leg and possibly the foot
- Tingling in the buttocks, leg and/or foot
- Paralysis of the leg
In rare cases, problems with bowel movements and urination as well as numbness in the anal and genital area and on the inside of the thighs can also occur as part of a herniated disc. Such an emergency is also known as cauda equina syndrome. In this case, the surgeon must perform emergency surgery to remove the prolapsed disc tissue in order to prevent permanent nerve damage and symptoms.
Herniated disc: diagnosis
If a slipped disc is suspected, we will examine the affected person thoroughly. These include:
- Neurological examination: We check reflexes, sensitivity and mobility. Depending on whether and where the pain radiates to, this allows conclusions to be drawn as to whether and which nerves are irritated or compressed by the herniated disc
- Magnetic resonance imaging (MRI ): With the help of this imaging procedure, the spinal cord and nerves can be visualized and a herniated disc can be differentiated from other diseases of the spine.
- Computed tomography (CT): An imaging procedure based on X-rays. Changes in the spine can be made visible.
- X-ray examination: If the suspicion of a slipped disc is confirmed, an X-ray examination may be carried out for further clarification It is important that the X-ray images show the spine in various positions. This allows us to assess the mobility of the spine.
Herniated disc: prevention, early detection, prognosis
It is not possible to prevent a slipped disc directly. Nevertheless, you can take various measures to strengthen yourback muscles and thus reduce your risk of a slipped disc. It is also important. to organize everyday life in such a way that unnecessary, unhealthy strain on the spine is avoided:
What you should look out for:
- Do regular, targeted back and abdominal muscle training to support and relieve the strain on your spine.
- Avoid being overweight. It puts additional strain on the spine and intervertebral discs.
- Lifting in a bent-forward position can put eight to twelve times the weight on the intervertebral discs. If possible, lift heavy objects from a squatting position with a straight spine.
- Always carry out household and professional tasks in an upright, normal posture.
- If you are predominantly sedentary, you should stand up and walk around from time to time.
- Seating should be ergonomically designed and have a height-adjustable seat and backrest.
Progression and prognosis of herniated discs
Around 80 percent of all herniated discs heal without surgery. In these cases, the prognosis is good. In some cases, however, the symptoms can worsen or lead to chronic restrictions. In this case, surgery can help to remove the bulging or prolapsed disc tissue, relieve the nerve structures and alleviate the symptoms. In very rare cases, however, surgery can also lead to complications or the appearance of excess scar tissue.
For this reason, it makes sense to always weigh up the pros and cons of an operation carefully.
Herniated disc: treatment depending on the symptoms
Depending on the type, location and size of the herniated disc and the resulting nerve irritation and symptoms, several treatment options are available.