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Other Names:
Lumbar Radiculopathy, Cervical Radiculopathy, Herniated Intervertebral Disk, Prolapsed Intervertebral Disk, Ruptured Disk
Slipped Disk

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Definition

Slipped disk is a condition characterized by protrusion (bulging) or tearing of all or part of the soft, gelatinous central portion of an intervertebral disk through a weakened part of the disk. This results in irritation of the nerve root and manifests itself clinically by back pain and leg pain (lumbar herniation) or neck pain and arm pain (cervical herniation) depending on the part of the spinal column that may be involved. Lumbar disk herniation occurs more frequently than cervical herniation.

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Causes

  • Herniated (move out of place) or ruptured disk from trauma e.g. a car accident
  • Physical strain on the back e.g. picking up a heavy object
  • Gradual, degenerative changes due to aging
  • Strenuous physical activity.
  • Obesity

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Symptoms

  • Lumbar Herniation.
    • Sharp, shooting low back pain.
    • Pain starts from the low back, radiates to the buttocks, thighs, legs and feet
    • Pain worsens with sneezing, coughing, straining or laughing
    • Tingling sensation or numbness in legs or feet
    • Muscle spasm, weakness or atrophy of the affected side.
  • Cervical Herniation
    • Pain in the neck, especially in the back and sides
    • Pain on deep pressure near or over the shoulder blades on the affected side
    • Pain radiates to the shoulder, upper arm, forearm and rarely the hand, fingers or chest, worsens with coughing, straining or laughing, increases when bending the neck or turning head to the side.
    • Spasm of the neck and arm muscles

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Implications

Pain caused by slipped disk can affect nearly every aspect of your life i.e. sitting, standing, working, playing etc. All these activities may become less enjoyable and sometimes intolerable because they trigger sharp, shooting pain. Ordinary movements like sitting or bending over can trigger a sharp pain that radiates to your back or down one of your legs. Severe pain may require you to lie down for several days and give up all physical activities. The pain may progress to chronic back pain and may result in loss of movement or sensation in the legs or feet. If the damage to the spinal nerves is severe, there may be loss of bowel and bladder function.

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What You Can Do

  • Medications
    • Pain relievers like nonsteroidal anti-inflammatory medications (NSAIDs) such as aspirin, tylenol and ibuprofen may be prescribed.
    • Muscle relaxants and narcotics
    • Corticosteroids - either orally, as an intravenous infusion or intra-articularly directly in the intervertebral joints (back area).
  • Surgery
    • Surgery is a good option for people who do not respond to medications and physical therapy. A surgical procedure called diskectomy is performed to remove the protruding disk. Other surgical options include micro diskectomy which is a procedure for removing fragments of torn or protruding disk through a very small incision under X-ray guidance. Chemonucleolysis involves the injection of an enzyme (called chymopapain) into the herniated disk to dissolve the protruding gelatinous substance. This procedure may be an alternative to diskectomy in certain situations.
  • Physical Therapy
    • Physical therapy is crucial treatment for complete treatment of lumbar disk disease. Your physical therapist will instruct you how to properly lift, dress, walk, and perform other daily activities without straining your back. They will also work on strengthening the muscles of the abdomen and lower back to help support the spine and flexibility of the spine and legs.
  • Lifestyle Changes
    • Loose weight by doing regular exercises and eating low carb, low fat diet.
    • Back braces to support the spine
    • Use weight belts if your work requires lifting heavy objects
    • Soft cervical or neck collar to limit neck movements and control pain and muscle spasms.
    • To prevent recurrent back injury, modify your work environment if your job requires you to lift heavy objects.
    • To prevent back injuries, learn safe work and play practices, proper lifting techniques and weight control

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Slipped Disk