Surgery Is The Only Treatment Option For Slipped Disc - This And Other Myths Busted

Slipped Disc: There are several possible reasons behind back pain

Lockdown has set a new normal with an increasing number of individuals being exposed to unaccustomed activities and timeout from their routine schedule. Whether that be sitting for long hours in the non-ergonomically designed work from home chair or the household chores due to absence of help or time away from your walks or gyms, unaccustomed activity can be a seed for pain flares. The prevalence of back pain worldwide is high with up to 80% of individuals experiencing back pain at some point in their life. A major shift to sedentary lifestyles with reducing physical work is possibly contributing to the increasing incidence of back pain. A higher proportion of the younger population is also complaining for the same.

Fortunately, most episodes are a result of minor problems such as a strained muscle or a ligament that usually resolve within a few weeks. Less than 5% of cases of sudden onset back pain are due to a slip disc and these can become a source of long term trouble if not managed appropriately.

What is slipped disc?

The human spine is made up of a number of bones called vertebrae, stacked one above the other with discs present in between. There are a total of 23 discs in the human spine, each having a tough outer layer that surrounds a jelly-like material in the centre. These discs act like cushions or shock absorbers helping to absorb the forces on the spine during movement and high intensity activities. When this disc loses its shape and/or consistency it is referred to as a slipped disc. This is one of the common causes of lower back pain, but can also affect the neck and middle of the spine.

Not every slipped disc case lasts for lifetime. Spontaneous regression of disc injury can occur with surgery being required only for a few severe or non-resolving cases.

Top 7 myths about slipped disc, busted!

1. Discs slip out of place

The name slipped disc is a misnomer as the disc does not slip out of place. It is firmly supported in its place surrounded by tissues and strong ligaments. Slipped disc is used to refer to a condition where the disc loses its shape and/or consistency and either the central jelly-like material of the disc leaks or bulges out. This can lead to irritation or pressure on the nerves in the spine and the pain travelling down to the legs or arms.

2. Slipped discs are always a result of injury

Slipped disc results from a magnitude of factors causing weakening of the disc such as genetic factors, age related wear and tear, lifestyle including physical activity, body weight, smoking, repeated stress with improper lifting technique etc. They may however come to light after a sudden movement/injury but the predisposition is already present and sometimes even trivial activities can trigger the symptoms.

Not all slipped disc cases are a result of injury
Photo Credit: iStock

3. Slipped discs always cause excruciating pain

Whilst slipped discs can be quite painful, this is not the case always as the severity of pain can vary. It is possible for a person to have a slipped disc and feel no pain or show no symptoms. For most people, a slipped disc will cause some pain and discomfort, and this generally reduces with time.

The pain from a slipped disc may be felt in the back and/or the arms/legs. Pressure on the nerves in and around the spine causes a shooting pain traveling to the arms or legs. There may be an increased pain on coughing or sneezing in some cases. Pain is often accompanied by other symptoms such as numbness, tingling, muscle weakness, cramping or spasms. In case of a slip disc in the back bending forwards or being in one position for a long time may be difficult and painful. Urgent medical help should be sought in cases where there is loss of urine or stool control, numbness in between the legs or severe weakness with balance issues and inability to walk.

Also read: Effective exercises to relive back pain

4. My x-ray is fine so I cannot have a slipped disc

X-rays of the spine are used more for evaluation of the bones and are not good for looking at discs although they may show problems such as reduced disc height. Technological advancements have enabled us to identify minute changes in disc structure using investigations such as the MRI scans which are better at looking at the spine anatomy. Discs normally wear down as you age and a significant number of healthy individuals with no symptoms, when scanned show disc abnormalities. So, just because the MRI showed a disc problem doesn't mean that it is the cause of your pain. This emphasises the point that not every slipped disc causes pain and the findings need to be interpreted in relation to your history and examination findings.

Also read: 5 Common Orthopaedic Problems You Might Experience While Working From Home

5. Slipped discs require surgery sooner or later

In an overwhelming majority of cases the problem will not require surgery and can be managed conservatively. Surgery is required only for severe or non resolving cases. Medical professionals always try less invasive treatments first. Non-surgical interventions, such as medications, physical therapy and injections, can help in reducing the symptoms.

Spinal injections such as nerve root block and epidurals can sometimes play a key role in controlling symptoms and speeding up recovery. They are different from the muscle injections which one may have had before and are performed under x-ray guidance to ensure accuracy. These injections deliver the medicines right next to where the problem lies, thereby reducing the inflammation and the resulting pain.

Not all slipped disc cases require surgery
Photo Credit: iStock

6. Movement will make disc problem worse

Whilst extreme pain episodes may require rest, continued activity is generally advised for patients with slipped disc. Simple activities (such as walking, mild stretches) as recommended by your specialist, can reduce the loss of muscle strength and endurance. It can reduce deconditioning of muscles which in itself can be a source of pain. It may be sensible to avoid certain types of activities such as heavy lifting, impact sports, etc. whilst the body attempts to repair itself. Movement can play an essential role in the healing process. In the long run physical therapy can help improve posture, flexibility and muscle strength.

Also read: Working From Home During The Pandemic? Here Are Some Tips That Can Help You Work Efficiently

7: Slipped disc is a permanently disabling condition

Many believe that once they get a slipped disc it's a lifetime problem and they will never be able to return to normal activity. Such strongly embedded negative beliefs are disabling and dealing with them can be challenging. With patience, correct knowledge and timely treatment, the majority of individuals can return to the prior level of functioning.

(Dr. Amod Manocha, Senior Consultant and Head Pain Management Services, Max Super Speciality Hospital, Saket)

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