Slipped Disk

The backbone, or spine, consists of 26 bones known as vertebrae. Soft disks, placed in between them are filled with a jelly-like substance. These disks give support to the vertebrae and keep them in proper location. A herniated disk, (slipped disk) is a disk that slips out of place or splits. If it exerts pressure on a nerve, it may result in back pain or sciatica.

The most commonly affected region is in the low back, but in fact any disk can rupture, including those in the neck.

Causes

A slipped is the result of various factors like aging with associated degeneration and loss of elasticity of the disks and supporting structures; injury from improper lifting, especially if accompanied by twisting or turning; and excessive strain forces associated with physical activities. Sudden forceful acute trauma is an unusual cause of a slipped disk.

Symptoms

A slipped disk can generate varying degrees of pain in the back or neck together with numbness or weakness in the corresponding organs, arms, or legs as follows:
For slipped disks in the neck: Numbness, tingling, weakness, or pain in the shoulder, neck, arm, or hand
For slipped disks in the lower back : Numbness, tingling, weakness, or pain in the buttocks, back, legs, or feet

Numbness and tingling around the anus or genitals :

1. Pain down the back of each leg from the buttocks to the knee (this is called sciatica)

2. Pain with movement, straining, coughing, or doing leg raises

3. Difficulty controlling bowel movements or bladder function

Lumbar spine (lower back): Sciatica often causes from a herniated disc in the lower back. Pressure on one or several nerves that contribute to the sciatic nerve can results in pain, burning, tingling, and numbness that spread out from the buttock into the leg and at times into the foot. Generally one side (left or right) is affected. This pain often is expressed as sharp and electric shock-like. It may be more rigorous with standing, walking or sitting. In company with leg pain, you may suffer from low back pain.

Cervical spine (neck): Symptoms may take account of dull or sharp pain in the neck or between the shoulder blades, pain that diversifies down the arm to the hand or fingers, or numbness or tingling in the shoulder or arm. With certain positions or movements of the neck the pain may be severe.

Diagnosis

A neurosurgeon will diagnose based on your history, symptoms, a physical examination, and results of tests, including the following:

This history will incorporate questions about other illnesses, previous spine problems, any injuries, duration and type of symptoms, and response to treatments. The test includes a spine examination, testing of basic nerve functions, an abdominal examination, and a general screening.

X-ray: Application of radiation to create a film or picture of a part of the body can demonstrate the construction of the vertebrae and the outline of the joints. X-rays of the spine are obtained to investigate for other possible reasons of pain, i.e. tumors, infections, fractures, etc.

Computed tomography scan (CT or CAT scan): A diagnostic image created on a computer reads x-rays which can explain the shape and size of the spinal canal, its contents, and the structures surrounded it.

Magnetic resonance imaging (MRI): A diagnostic examination that fabricates three-dimensional images of body structures utilizing powerful magnets and computer technology; can demonstrate the spinal cord, nerve roots, and surrounding parts, in addition to enlargement, degeneration, and tumors.

Myleogram: An x-ray of the spinal canal following injection of a contrast material into the surrounding cerebrospinal fluid spaces; can show pressure on the spinal cord or nerves due to herniated discs, bone spurs or tumors.

Electromyogram and Nerve Conduction Studies (EMG/NCS): These tests assess the electrical impulse along nerve roots, peripheral nerves, and muscle tissue. This will point out whether there is constant nerve damage, if the nerves are in a state of healing from a past injury, or whether there is one more location of nerve compression.

In certain circumstances, laboratory tests of blood and urine can produce some additional information necessary to establish a diagnosis. If required at all, they may not be essential right away.

Treatment

Self-Care at Home

Minor cases can be taken care of at home in consultation with your doctor. Application of hot or cold packs, limited activity (although strict bed rest is not generally advised), and basic pain relievers such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) are the basic treatments. As your condition gets better, specific back stretching or strengthening exercises may be proposed.

Exercises can be useful. Start with stretching. Bend over forward and bend to the sides. Warm up with these exercises after your back is a bit stronger and doesn\’t promote pain as much. Through exercise you cane make your back and stomach muscles much stronger. This will relieve the pressure on your disk and make you pain less. Consult your doctor about essential exercises for your back. Your doctor may suggest you to make an appointment with a physical therapist to learn about safe back exercises.

Medical Treatment

The early treatment for a herniated disc is generally traditional and non-surgical. Your doctor may advise bed rest, or advise you to maintain a low, painless activity level for a few days to several weeks. This slows down the spinal nerve inflammation.

A herniated disc is often treated with non-steroidal anti-inflammatory medication if the pain is merely mild to moderate. An epidural steroid injection may be pushed using a spinal needle under x-ray guidance to direct the medication to the exact level of the disc herniation.

Your physician may suggest physical therapy. The therapist will carry out an in-depth review; which mingled with the doctor’s diagnosis, will focus on a treatment distinctively considered for patients with herniated discs. Therapy may contain pelvic traction, gentle massage, ice and heat therapy, ultrasound, electrical muscle stimulation, and stretching exercises. Pain medication and muscle relaxants may also be beneficial in combination with the physical therapy.

Surgery

Your doctor may suggest surgery if conservative treatment options, for example physical therapy and medications fail ease or end the pain altogether. The doctor will discuss with you about the types of spinal surgery accessible, and depending on your particular case, will help to decide the suitable option for you. Like any other surgeries, a patient’s age, overall health, and other issues are the depending factors when surgery is considered.

The benefits of surgery should always be considered carefully against its risks. Although a huge number of patients with herniated discs report significant pain relief after surgery, there is no guarantee that surgery will be beneficial to every individual.

The surgery will take place if:

Back and leg pain restricts regular activity or impairs your quality of life
You build up progressive neurological discrepancies, for instance leg weakness and/or numbness
You experience loss of regular bowel and bladder functions
You have trouble in standing or walking
Medication and physical therapy are unproductive
You have convincingly good healt

Lumbar Spine Surgery

Lumbar laminotomy is a method frequently used to reduce leg pain and sciatica caused by a herniated disc. It is executed through an incision down the center of the back over the location of the herniated disc. In this procedure, a portion of the lamina may be eradicated. Once the incision is done through the skin, the muscles are moved to the side so that the surgeon can observe the back of the vertebrae. A minute opening is made between the two vertebrae to achieve access to the herniated disc. After the disc is removed through a discectomy, the spine must be stabilized. Spinal fusion is frequently carried out in combination with a laminotomy. In more involved cases, a laminectomy may be performed.

In artificial disc surgery, an incision is made through the abdomen and the affected disc is eliminated and replaced. Only a small percentage of patients are in favor of artificial disc surgery. You must have disc degeneration in only one disc, between L4 and L5, or L5 and S1 (the first sacral vertebra). You have to carry on at least six months of treatment, such as physical therapy, pain medication, or wearing a back brace, without showing progress. But your overall health must be in good condition with no symptoms of infection, osteoporosis or arthritis. If you have suffered from degeneration more than one disc, or severe leg pain, you should not opt for this surgery.

Cervical Spine Surgery
The medical conclusion to perform the operation from the front of the neck (anterior) or the back of the neck (posterior) is controlled by the accurate location of the herniated disc, as well as the experience and inclination of the surgeon. A segment of the lamina may be operated through a laminotomy, followed by a discectomy. After the removal of the disk, the spine usually needs to be stabilized. This is accomplished using a cervical plate and screws (instrumentation) and often, spinal fusion.

After surgery
Post–surgery instructions should be followed as your doctor suggested. He/she usually prescribe pain medication. Your doctor will decide when you can recommence regular activities such as returning to work, driving and exercising. Some patients may benefit from supervised rehabilitation or physical therapy after surgery. Discomfort is predictable while you slowly come back to normal activity, but pain is an alarming indication that you might need to hold back.

Prevention

Regular exercise can diminish hardening and early breakdown of the disks, as well as develop the overall potency and tone of the supporting muscles and structures. Perform crunches and other abdominal-muscle strengthening exercises to give more spine steadiness. Swimming, stationary bicycling and brisk walking are good aerobic exercises that generally do not put extra stress on your back.

Exploit appropriate techniques while doing laborious exercise and strenuous work, including lifting. Lifting should be carried out with the legs performing the work, not the back. The worst potential blend of activities for your spine is heavy lifting while bending and twisting simultaneously.

Utilization of a spine brace during heavy lifting may be recommended. Its correct use is to maintain your back straight and support proper lifting technique. It should not be used as an alternate for proper technique or to encourage you to exceed safe lifting limit

Smoking is harmful for artherosclerosis (hardening of the arteries), which can bring about lower back pain and degenerative disc disorders.

Avoid tense situations if possible, as this can cause muscle tension.

Maintain a healthy weight. Extra weight, especially around the midsection, can put strain on your lower back.

How can yoga help a slipped disc?
Yoga is one of the best exercises for slipped disc. There have been authenticated cases where this ancient therapeutic technique has completely relieved all the pain and other signs connected with a slipped disk. Yoga has a huge success rate in treating a slipped disc due to its innate nature. Yoga exercises, or Asanas, are designed to resolve any disparities in the body and return it to a balanced status.

There are numerous yoga slipped disc exercises that can give lots of benefits and provide quick relief from pain. These include the Pawan Mukta Asana (Wind releasing posture), Salabha Asana (Locust pose), Makara Asana (Crocodile pose), and Bhujanga Asana (Cobra pose).

Yoga breath control exercises, or Pranayama, also provide positive effect on the spine. These breathing exercises are some of the best exercises for slipped disc. This is because these exercises stimulate the rib cage and help to reinforce the core muscles. When these muscles become stronger, the pressure that is exerted on the spine is unfailingly slowed down.