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Prolapsed Disc (Slipped Disc)

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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 spinal cord, which contains the nerves that come from the brain, is protected by the spine. Nerves from the spinal cord come out from between the vertebrae to relay messages to and from various parts of the body.

What is a prolapsed disc?

Part of the inner softer part of the disc (the nucleus pulposus) bulges out (herniates) through a weakness in the outer part of the disc. A prolapsed disc is sometimes called a 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.

Who gets a prolapsed disc?

Bouts of back pain are very common. The most common age to develop a prolapsed disc is between 30 and 50 years. Twice as many men as women are affected.

What causes a prolapsed disc?

It is not clear why some people develop a prolapsed disc and not others. 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.

What are the symptoms of a prolapsed disc?
  • Back pain
  • Nerve root pain (usually sciatica)
  • Nerve root pain is pain that occurs because a nerve coming from the spinal cord is pressed on (trapped) by a prolapsed disc, or is irritated by the inflammation caused by the prolapsed disc. Although the problem is in the back, you feel pain along the course of the nerve in addition to back pain. Therefore, you may feel pain down a leg to the calf or foot. Nerve root pain can range from mild to severe.

  • Other nerve root symptoms
  • The irritation or pressure on the nerve next to the spine may also cause pins and needles, numbness or weakness in part of a buttock, leg or foot.

  • Cauda equina syndrome - rare, but an emergency
  • This is a rare disorder where the nerves at the very bottom of the spinal cord are pressed on. This syndrome can cause low back pain plus: problems with bowel and bladder function (usually unable to pass urine), numbness in the saddle area (around the anus), and weakness in one or both legs. This syndrome needs urgent treatment to preserve the nerves to the bladder and bowel from becoming permanently damaged.

How does a prolapsed disc progress?

In most cases, the symptoms tend to improve over a few weeks. Research studies of repeated MRI scans have shown that the bulging prolapsed portion of the disc tends to get smaller (regress) over time in most cases. The symptoms then tend to ease, and go in many cases.

Do I need any tests?

Your doctor will normally be able to diagnose a prolapsed disc from the symptoms and by examining you. In most cases, no tests are needed, as the symptoms often settle within a few weeks.

Tests such as X-rays or scans may be advised if symptoms persist. In particular, an MRI scan can show the site and size of a prolapsed disc.

What are the treatments for a prolapsed disc?
  1. Exercise and keep going
  2. Medication
  3. If you need painkillers, it is best to take them regularly. This is better than taking them now and again just when the pain is very bad. If you take them regularly the pain is more likely to be eased for much of the time and enable you to exercise and keep active.

    A muscle relaxant such as diazepam is sometimes prescribed for a few days if the back muscles become very tense and make the pain worse.

  4. Physical treatments
  5. It is debatable whether physical treatments would help all people with a prolapsed disc. However, physical treatments provide some short-term comfort and hasten recovery in some cases.

  6. Surgery
  7. Surgery may be an option in some cases. As a rule, surgery may be considered if the symptoms have not settled after about six weeks or so. The aim of surgery is to cut out the prolapsed part of the disc. This often eases symptoms.


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