Herniated Disc: Symptoms and Treatment

A slipped disc often causes sudden back pain. Here you can find out what other symptoms there are and how the treatment works.

What is a Herniated (Slipped) Disc?

A herniated disc (disc prolapse) often causes complaints such as back pain, numbness or even paralysis, but it can also be completely symptom-free. The herniated disc often occurs in people between 30 and 50 years of age due to age- and stress-related wear and tear and can in many cases be treated with conservative therapy, e.g. by sufficient exercise.

Causes and Risk Factors: How Does a Slipped Disc Occur?

In order to understand how a herniated disc develops, one must first know what a disc actually is and what function it fulfils. The intervertebral disc consists of two parts: The outer fibrous ring (Anulus fibrosus), which fixes its position, and the so-called liquid gelatinous core (Nucleus pilposus). In general, intervertebral discs act as elastic shock absorbers between two vertebrae and keep the spine flexible. If they did not exist, the vertebrae would rub directly against each other and get caught more easily – which can lead to severe pain.

In the event of a herniated disc, the outer fibrous ring tears and the liquid gelatinous core emerges. This does not always cause direct discomfort – in fact, a herniated disc is sometimes only discovered during a routine examination because it has not become further noticeable. However, if the gelatinous core presses on a nerve root or on the spinal cord, pain occurs. In some cases, parts of the nucleus also loosen and slip into the spinal canal – here doctors speak of a “sequestered disc herniation”.

Slipped Disc: Wear and Tear as A Risk

But why does a crack in the fibre ring occur at all? Mostly it is caused by age and stress. In the course of time, the intervertebral disc loses its elasticity and is more likely to tear, especially under heavy load. The risk is highest between the ages of 30 and 50 – after that the probability decreases again, because the gelatinous core then loses more and more fluid and leaks less frequently. The following risk factors also favour a slipped disc:

• Overweight
• Lack of exercise
• Weak trunk muscles, especially on the back and stomach
• Sports that can put a strain on the spine, e.g. riding
• Lifting and / or carrying heavy loads
• Bad posture
• In rare cases, a congenital weakness of the connective tissue or an injury (e.g. from a fall) can also trigger a slipped disc.

What Are The Symptoms of a Slipped Disc?

If a herniated disc causes symptoms because there is pressure on a nerve root, the respective complaints often depend on where exactly this nerve is located. In general, the following complaints can occur due to a herniated disc:

• Pain that may radiate to other parts of the body
• Tingling
• Deafness
• Symptoms of paralysis
• Dysfunctions during bladder or bowel emptying

The spinal column can be divided into different sections. The cervical, thoracic and lumbar spine are the areas that are affected by a herniated disc and can trigger various symptoms.

• Herniated disc in the cervical spine: There are seven cervical vertebrae in total. A herniated disc is most likely to occur between the fifth and sixth and the sixth and seventh vertebrae. This causes mainly neck pain, the complaints radiate more often into the arm, and muscle paralysis around the affected nerve roots is also possible.
• Herniated disc in the thoracic spine: This case is very rare, but theoretically the herniated disc can occur between each of the twelve thoracic vertebrae and then causes back pain in this area. It can also happen that the pain radiates into areas that are supplied by the affected nerve.
• Slipped disc in the lumbar spine: In the area of the total of five lumbar vertebrae, a slipped disc is most likely to occur because one’s own body weight exerts strong pressure on the discs and vertebrae. The intervertebral discs between the fourth and fifth lumbar vertebrae or between the first lumbar vertebra and the first coccyx are usually affected. There can be severe pain in the lower back, which radiates into the leg. Often there is also tingling or numbness, less frequently paralysis. If the sciatic nerve is affected, patients often experience the discomfort as being even more severe, as it can extend over the buttocks, the back of the thigh and down to the foot.

Herniated Disc: How is The Diagnosis Made?

Based on a physical examination by the family doctor, it is usually possible to make an initial diagnosis, which is then referred to a specialist – for example in neurology or orthopaedics. There, the suspicion of a slipped disc can be confirmed with an imaging procedure such as computer tomography (CT) or magnetic resonance imaging (MRI).

MRT and CT are not always Recommended

However, it should be noted that the imaging procedures may indicate a herniated disc – but this is not always the actual cause of the complaints. Moreover, studies show that a CT or MRI can even make the pain chronic. Experts suspect that looking at one’s own backbone has a negative influence on patients on a psychological level.

If the symptoms are “only” limited to back pain without any signs of numbness or paralysis, it is therefore not always advisable to use an imaging procedure directly. Patients should wait about six to eight weeks to see whether the back pain subsides on its own – which is what happens in most cases. Only in about one to five percent of all patients with low back pain can the cause actually be traced back to a herniated disc.

Therapy: Which Treatment Helps with a Slipped Disc?

In more than 90 percent of all patients a conservative treatment of the herniated disc is sufficient to become painless again. Surgery is now only rarely recommended, for example, if the symptoms are severe or if the symptoms do not improve even after more than three months despite conservative treatment. The following methods are usually recommended for a herniated disc:

• Light to moderate movement: Light movement is in most cases much more sensible in the case of a herniated disc than bed rest. For this purpose, one can train movement sequences in a physiotherapy session, for example, which reduce the pain. In addition, the intervertebral disc needs alternating loading and unloading in order to be sufficiently nourished. And: Targeted exercises for the abdomen and the back, which strengthen the muscles, are also useful. Spinal disc-friendly sports such as running, swimming or dancing are also suitable for treatment. In contrast, patients should refrain from sports that require fast and jerky movements, such as ball or weight training.
  Relaxation techniques: Some relaxation techniques aim to loosen and relax the muscles. In this way, pain can be reduced when a slipped disc occurs.
  Medication: If necessary, over-the-counter painkillers such as ibuprofen or diclofenac can be used, which not only relieve pain but also reduce swelling and reduce inflammation. However, they should only be taken in close consultation with the doctor.
  Heat treatment: Heat also relaxes cramped muscles and is therefore perceived as pleasant by many patients with herniated discs. Cherry pit pillows or hot water bottles are suitable, for example, which can be placed against the painful parts of the body.

Can a Slipped Disc be Prevented?

With some measures, the risk of a herniated disc can be significantly reduced. These include:

• A body weight in the normal range according to BMI (you can find our BMI calculator here!)
• Move at least two to three times a week for at least 30 minutes each time, preferably with a focus on strengthening the back muscles
• Regular performance of relaxation techniques
• If possible, an office desk at which one can work standing up
• Lifting heavy objects only from the legs: To do this, kneel down, keep the spine stretched and then lift the load
• Pay attention to straight posture: A good mattress as well as a suitable slatted frame, so that the spine is perfectly supported during sleep