A slipped disc, though common, is somewhat misleading term for a herniated disc.
The disc does not actually slip, but its inner softer part (the nucleus pulposus) bulges out (herniates) through its weaker outer part.
The rupture allows fluid from within the disc to leak into the spinal canal where it interferes with the functioning of nerves.
The “slipped disc” is not a shift in the actual position of the disc. It is the last stage in a degenerative disc disease process that begins with a bulging disc.
It progresses to become a protruding disc as the disc wall becomes more distended, culminating with the rupturing of the disc wall.
Symptoms of a slipped disc depends on the location of the disc in the spine and the extent of rupturing.
If there is no pressure being put on the nerves, it may be unnoticeable.
In case of a slipped cervical disc (disc in the neck), pain or numbness in the shoulders, arms or chest may result.
Most common in the lumbar spine (lower back), slip disc can also occur in the cervical spine (neck). Symptoms include pain in the lower back, leg pain (sciatica), muscle spasm, tingling and numbness in legs and feet, etc.
One of the most common causes of disc herniation are effects of ageing, pressure on the spine, heavy manual labour, repetitive lifting and twisting.
Other factors that may lead to disc herniation are sedentary lifestyle, working in poor postures, smoking, being overweight, sitting for long hours, etc.
The first step to recovery includes non-surgical treatment, such as mild pain medication, adequate rest, physiotherapy, hydrotherapy and pain management.
Physiotherapy focuses on pain management using various therapeutic maneuvers like manual therapy, cupping, dry needling, and therapeutic modalities. It also helps in training muscles and improving postures with therapeutic exercises.
Practicing herniated disc exercises like mckenzie, under the guidance of a trained physiotherapist can strengthen the lower back, leg and stomach muscles and increase flexibility of the spine. Before planning the treatment, it’s imperative to find out the functional position that will reduce the symptoms. If the symptoms reduce on bending back (Extension) and are provoked with bending forward, the Patient has Extension Bias and should be put on Back extension exercise. Extension Bias is most commonly seen in PIVD (Prolapsed Intervertebral Disc).
Backward Bending Exercise- Prone-on-Elbows
Backward Bending Exercise – Prone-on hands
Backward Bending Exercise – Back Extension in standing
The patient is said to have Flexion Bias when forward bending (Flexion) reduces symptoms and back bending proves symptoms. Patients with Spinal Stenosis and Spondylolisthesis generally have Flexion Bias. Such patients need to be put on forward flexion exercises.
Forward Bending Exercise – Flexion in lying
Forward Bending Execises – Flexion in Sitting followed by Standing.
Spinal Extension exercises shouldn’t be done when neither forward bending nor back bending reduces symptoms, and patient has urinary and/or bowel control issues, loss of sensations around the genitals (saddle anesthesia), and extreme pain.
Spinal Flexion exercises should not be done when extension reduces symptoms and/or forward bending increases symptoms.
Ergonomics is the mainstay of improving function of patients with herniated discs as it focuses on practicing and working in the correct forms to eliminate excessive stress on spine.
Severe cases require to undergo spinal surgeries such as discectomies, laminectomies, spinal fusion surgeries, etc.
Key lies in prevention. Take care of certain things on a daily basis. Ensure good posture while sitting, sleeping and walking.
Use the right technique during heavy-weight lifting and always maintain a healthy body.