Slip disc: Rupturing of the tissue that separates the vertebral bones of the spinal column.
The center of the disc, which is called the nucleus, is soft, springy and receives the shock of standing, walking, running, etc. The outer ring of the disc, which is called the annulus (Latin for ring), provides structure and strength to the disc. The annulus consists of a complex series of interwoven layers of fibrous tissue that hold the nucleus in place.
A slipped disc is also known as a herniated disc. The term "slipped disc" comes from the action of the nuclear tissue when it is forced from the center of the disc. The nuclear tissue located in the center of the disc can be placed under so much pressure that it can cause the annulus to rupture. When a disc herniates or ruptures, it may create pressure against one or more of the spinal nerves which can cause pain, weakness or numbness in the area of the body served by those nerves. Other names for slipped (herniated) discs are prolapsed and ruptured discs.
What Is Slipped Disc (Herniated Disc)?
The discs are protective shock-absorbing pads between the bones of the spine (vertebrae). The discs of the spine are also referred to as intervertebral discs. Although they do not actually "slip," a disc may bulge, split, or rupture. This can cause the disc cartilage and nearby tissue to fail (herniate), allowing the inner gel portion of the disc to escape into the surrounding tissue. This protruding, jelly-like substance can place pressure on the spinal cord or on an adjacent nerve to cause symptoms of pain, numbness, or weakness either around the damaged disc or anywhere along the area supplied by that nerve.
Many people experience no symptoms from a herniated disc, and the majority of people who have herniated discs do not need surgery.
The layman's term "slipped disc" is, therefore, a misnomer and actually refers to a condition whereby portions of an abnormal, injured, or degenerated disc have protruded against adjacent nerve tissues. This condition is also known as a slipped disk, herniated disc, ruptured disc, or prolapsed disc. The most frequently affected area is in the low back, but any disc can rupture, including those in the neck.
Slipped Disc - Symptoms, Causes, and Treatment
Understanding the spine
The spine is made up of many bones called vertebrae. These are roughly circular and between each vertebra is a 'disc'. The discs are made of strong 'rubber-like' tissue, which allows the spine to be fairly flexible. A disc has a stronger fibrous outer part, and a softer jelly-like middle part called the nucleus pulposus.
The spine protects the spinal cord, which contains the nerves that come from the brain. Nerves from the spinal cord come out from between the vertebrae to take and receive messages to various parts of the body. Strong ligaments attach to the vertebrae. These give extra support and strength to the spine. Various muscles also surround and are attached to various parts of the spine.
What is a prolapsed disc?
When you have a prolapsed disc (commonly called a 'slipped disc'). A disc does not actually 'slip'. What happens is that part of the inner softer part of the disc (the nucleus purposes) bulges out through a weakness in the outer part of the disc. A prolapsed disc is sometimes called herniated disc. The bulging disc may press on nearby structures such as a nerve coming from the spinal cord. Some inflammation also develops around the prolapsed part of the disc.
Any disc in the spine can prolapse. However, most prolapsed discs occur in the lumbar part of the spine (lower back). The size of the prolapse can vary. As a rule, the larger the prolapse, the more severe the symptoms are likely to be.
Who gets a prolapsed disc?
It is not clear why some people develop a prolapsed disc and not others, even when they do the same job or lift the same sort of objects. It seems that some people may have a weakness in the outer part of the affected disc. Various things may trigger the inner softer part of the disc to prolapse out through the weakened outer part of the disc. For example, sneezing, awkward bending, or heavy lifting in an awkward position may cause some extra pressure on the disc. In people with a weakness in a disc this may be sufficient to cause a prolapse. Factors that may increase the risk of developing a prolapsed disc include: a job involving lots of liftin, a job involving lots of sitting (especially driving), weight-bearing sports (weight lifting etc), smoking, obesity and increasing age (a disc is more likely to develop a weakness with increasing age).
What is sciatica?
Sciatica is a symptom. It consists of leg pain, which might feel like a bad leg cramp, or it can be excruciating, shooting pain that makes standing or sitting nearly impossible.
The pain might be worse when you sit, sneeze, or cough. Sciatica can occur suddenly or it can develop gradually. You might also feel weakness, numbness, or a burning or tingling ("pins and needles") sensation down your leg, possibly even in your toes. Less common symptoms might include the inability to bend your knee or move your foot and toes.
What causes sciatica?
Sciatica might be a symptom of a "pinched nerve" affecting one or more of the lower spinal nerves. The nerve might be pinched inside or outside of the spinal canal as it passes into the leg.
Conditions that cause sciatica:
A herniated or slipped disc that causes pressure on a nerve root. This is the most common cause of sciatica.
Piriformis syndrome. This develops when the piriformis muscle, a small muscle that lies deep in the buttocks, becomes tight or spasms, which can put pressure on and irritate the sciatic nerve.
Spinal stenosis. This condition results from narrowing of the spinal canal with pressure on the nerves.
Spondylolisthesis. This is a slippage of one vertebra so that it is out of line with the one above it, narrowing the opening through which the nerve exits
The condition usually heals itself, given sufficient time and rest. Approximately 80% to 90% of patients with sciatica get better over time without surgery, typically within several weeks.
Nonsurgical treatment is aimed at helping you manage your pain without long-term use of medications. Nonsteroidal anti-inflammatory drugs such as ibuprofen, aspirin, or muscle relaxants may also help. In addition, you may find it soothing to put gentle heat or cold on your painful muscles. It is important that you continue to move. Do not remain in bed, as too much rest may cause other parts of the body to feel discomfort.
Find positions that are comfortable, but be as active as possible. Motion helps to reduce inflammation. Most of the time, your condition will get better within a few weeks.
Sometimes, your doctor may inject your spinal area with a cortisone-like drug.
As soon as possible, start stretching exercises so you can resume your physical activities without sciatica pain. Your doctor may want you to take short walks and may prescribe physical therapy.
You might need surgery if you still have disabling leg pain after 3 months or more of nonsurgical treatment. A part of your surgery, your herniated disk may be removed to stop it from pressing on your nerve.
The surgery (laminotomy with discectomy) may be done under local, spinal, or general anesthesia. This surgery is usually very successful at relieving pain, particularly if most of the pain is in your leg.
Back pain in pregnancy
It is very common to get backache or back pain during pregnancy, especially in the early stages.
During pregnancy, the ligaments in your body naturally become softer and stretch to prepare you for labour. This can put a strain on the joints of your lower back and pelvis, which can cause back pain.
Avoiding and easing back pain in pregnancy
Try these tips:
bend your knees and keep your back straight when you lift or pick something up from the floor
avoid lifting heavy objects
move your feet when you turn to avoid twisting your spine
wear flat shoes to evenly distribute your weight
try to balance the weight between 2 bags when carrying shopping
keep your back straight and well supported when sitting at work and at home – look for maternity support pillows
get enough rest, particularly later in pregnancy
a massage or warm bath may help
use a mattress that supports you properly – you can put a piece of hardboard under a soft mattress to make it firmer, if necessary
go to a group or individual back care class
You can take paracetamol to ease back pain while you are pregnant, unless your GP or midwife says not to. Always follow the instructions on the packet.
Exercises to ease back pain in pregnancy
This gentle exercise helps to strengthen stomach (abdominal) muscles, which can ease back pain in pregnancy:
start on all fours (a box position) with knees under hips, hands under shoulders, fingers facing forwards and stomach muscles lifted to keep your back straight
pull in your stomach muscles and raise your back up towards the ceiling, letting your head and bum relax downwards gently – don't let your elbows lock
hold for a few seconds then slowly return to the box position
take care not to hollow your back – it should always return to a straight, neutral position
do this slowly and rhythmically 10 times, making your muscles work hard and moving your back carefully
only move your back as far as you comfortably can
Doing prenatal yoga or aquanatal classes (gentle exercise classes in water) with a qualified instructor can also help build your muscles to better support your back. Ask at your local leisure centre.
When to get help for back pain in pregnancy
If your backache is very painful, talk to your GP or midwife. They may be able to refer you to an obstetric physiotherapist at your hospital, who can give you advice and may suggest some helpful exercises.
Contact your GP or midwife as soon as possible if you have back pain and you:
are in your second or third trimester – this could be a sign of early labor
also have a fever, bleeding from your vagina or pain when you pee
lose feeling in one or both of your legs, your bum, or your genitals
have pain in one or more of your sides (under your ribs)
Back pain is a common complaint. Most people will experience lower back pain at least once during their lives. Back pain is also one of the most common reasons people go to the doctor or miss work. Most back pain gradually improves with home treatment and self-care. Although the pain may take several weeks to disappear completely, you should notice some improvement within the first 72 hours of self-care. If not, see your doctor.
Back pain usually originates from the muscles, nerves, bones, joints or other structures in the spine. The onset of back pain may be acute or chronic. It can be constant or intermittent, stay in one place or radiate to other areas. It may be characterized by a dull ache, or a sharp or piercing or burning sensation. Back pain may be classified by various methods to aid its diagnosis and management. The anatomic classification of back pain follows the segments of the spine: cervical, thoracic, lumbar or sacral.
Symptoms of Back Pain
Many people have experienced some form of back pain at some point in their lives. There are many causes of back pain, from self-inflicted causes due to bad habits, to back pain caused by muscle strains, accidents, or sports injuries. Despite the causes of the back pain a person experiences, the symptoms may be the same.
Symptoms people with back pain experience might include:
• A persistent stiffness or aching along their spine, from the base of their neck to their hips.
• Sharp, localized pains in their lower back, upper back, or neck, - particularly after lifting heavy objects or after other strenuous activity.
• Chronic aches in their lower or middle back, particularly after sitting or standing for lengthy periods of time.
• Back pains which radiate from their lower back to their buttocks, down their back of their thighs, and into their calves and toes.
• An inability to stand up straight without experiencing oftentimes severe muscle spasms in their low back.
If you experience back pain, it is important to contact a doctor if you:
• Experience numbness, tingling, or loss of control in your arms or legs. These may be signs of signal damage to your spinal cord.
• Experience pain in your back that extends downward along the back of the leg. You may be suffering from sciatica.
• Experience pain that increases whenever you bend forward at the waist, or cough. The reason this needs to be looked at by a doctor is because it could be a sign of a herniated disc.
• Experience pain that is accompanied by burning urination, strong-smelling urine, or fever. You could have a bacterial urinary tract infection.
• Experience urinary or fecal incontinence.
• Experience dull pain in one particular area of your spine whenever you lie down or get out of bed. People who are over the age of fifty may have osteoarthritis.
Diagnosing Back Pain
A doctor will test your range of motion in relation to the back pain you are experiencing, unless you are completely immobilized by a back injury, and test for both areas of discomfort and nerve function. The doctor will most likely do some tests such as urine and blood testing in order to determine whether the back pain is due to either an infection or a systemic problem. X-rays may be taken to determine if you have any broken bones or skeletal issues that are the cause of your back pain; they can also help to locate issues with connective tissues. Soft-tissue damages that may be the cause of back pain can be analyzed using Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) scans. Nerve and muscle damage can be determined through Electromygram (EMG) tests.
Australian researchers are working with an international team to understand the relationship between sitting for long periods and bone health. Sitting for long periods may be bad for your bones, with Australian researchers contributing to a global study to explore links to osteoporosis.
"In everyday life, long periods of immobility such as this are rare however, sedentary lifestyles are commonplace in modern society, through transport, work and leisure.
"If the proof of concept study identifies a significant effect of sedentary behaviour on bone metabolism, promoting frequent breaks from sitting could be a possible, and simple, preventative intervention for osteoporosis in later life."
The study will use data and blood samples already collected - but yet to be analysed - in previous sedentary behaviour studies by the research group.
About 1.2 million Australians are estimated to have osteoporosis while 6.3 million fellow residents have low bone density, the institute states.
The institute's Professor David Dunstan also added the study would shed light on the mechanisms behind osteoporosis and give a greater understanding of the relationship between lifestyle and bone health.
Experts at the Baker Heart and Diabetes Institute in Melbourne have teamed up with researchers in the United Kingdom to find out if breaking up sedentary behaviour could reverse or slow down any potential damage of the disease."We know that in extreme environments, such as total bed rest, bone loss is very high," the institute's Professor Neville Owen said in a statement on Thursday.
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