I recently went to see our family doctor after suffering severe back pain for about two weeks. After observation, he asked me whether I had lifted any heavy objects. I still can’t recall doing so. He diagnosed my problem as a slipped disk. I’m undergoing treatment but the pain still persists. What is slipped disc and is it curable?
Nancy W. Kogi
Slipped disk is a back problem involving the disks of elastic cartilage tissue located between the vertebrae – the bones of the spine. The bones are loosely stung together by bands of tissue called ligaments that allow body movement and flexibility. The function of each disk is to cushion any friction between the bones as the body moves.
When this intricate spinal structure experiences strain and over-exertion, the rim of the disc weakens and tears, rather than ‘slips,’ causing part of the gelatinous centre of the disc to be forced out of position. In it’s new position, the protruding material presses against an adjacent spinal nerve and causes pain along the path of the affected nerve.
WHAT CAUSES SLIPPED DISC?
A slipped disk most often occurs when bending and straightening the back to lift heavy objects resulting in strain or injury. However, one can go for months before realising there is disc damage. People with the problem frequently have a history of damage to the same area. Discs also disintegrate with age losing some of their fluidity and becoming more compressed. This form of degeneration usually results in only mild pain with intermittent backache and stiffness.
WHAT ARE THE SYMPTOMS?
Symptoms of slipped disc may vary with the location of the disc. The most common slipped disc is the lowest movable disc in the small of the back. Injury to this disc causes pain along the sciatic nerve, a condition called sciatica. Mild or disabling pain and tenderness may result. Any straining, such as coughing or moving, can aggravate the discomfort. Weakness, tingling, or numbness in parts of the arms, legs, or feet may also result from damage to a particular disc.
To determine the source of back pain, a doctor will ask you about your current medical history, observe you sitting, walking and bending and explore for sensitive areas by maneouvering your legs in different positions, checking ankle and knee reflexes, and testing muscle strength. He may also do an X-ray that will reveal any structural changes in bones, joints or discs.
Special tests may be necessary to locate particularly problematic discs and surgery may be recommended. The special tests may include a myelogram, which is an X-ray taken after a dye is injected into the space surrounding the spinal cord and nerve roots. The protruding disc is detected at the point where the flow of dye is interrupted or distorted. Discography is another type of X-ray that gives much the same information, but before this X-ray, the dye is injected directly into the discs. Special scans such as MRI (magnetic resonance imaging) enable the doctor to see a picture of the disc directly.
WHAT’S THE TREATMENT?
The first line of slipped disc treatment involves complete bed rest on a firm mattress. Rest relieves pressure of the disc on the nerve and may shrink the protruding material. For severe pain, a doctor may prescribe a pain reliever. As pain subsides, an exercise programme may be recommended to gradually strengthen muscles. Non-surgical therapy provides most slip disc sufferers with partial or complete relief. However, in some cases, removing the disc surgically provides the only remedy.
A process called discolysis often provides the same results eliminating or reducing the disc without major surgery. With this method, a drug called chymopapain is injected into the damaged disc and acts by slowly dissolving the part of the disc that is pressing on a nerve. Treatment is fast and relatively painless, but pain reduction occurs slowly, probably in a period covering several weeks.