What is a Slipped Disk?

Back pain and injury affect millions of people across the globe, and when the symptoms strike, we often try to diagnose the problem ourselves. You may have heard a friend or family member suggest their symptoms are likely coming from “a slipped disk,” or you might even use the phrase yourself.

However, when pressed, many of us could not answer what a slipped disk is or how and why it happens. The name conjures up images of a disc that has “slipped” away from the spine, but a better description (and one that may be used by many doctors) is that the disc is protruding.

Another common name for this injury is a herniated disk, and according to the Cleveland Clinic, this occurs in two percent of the population each year. There are many other causes of back pain, so a proper diagnosis is required to confirm a herniated disk and ensure it is treated properly. We will look at how and why this happens (as well as some other possible causes of your symptoms) below.

What is a Slipped Disk?

To understand slipped disks, you need to have a general understanding of what makes up your spinal cord or spinal column.

Most people know that the spinal column includes bones, or a series of vertebra, arranged in a sort of stack, and it is therefore easy to understand how a problem with one vertebra in the “stack” can create problems elsewhere. (Anyone who has played Jenga knows how this works!)

In the spinal column, there are specific divisions of vertebra including:

• The cervical spine, with seven bones
• The thoracic spine, with twelve bones
• The lumbar spine, with five bones
• The sacrum
• The coccyx

Disks do the important work of cushioning all of these bones. They absorb shock (like a car’s suspension), and this enables us to participate in the basic physical activities of daily life, like walking, bending, twisting, and lifting.

The disk itself consists of a tough outer portion (the annulus fibrosis or “ring”) and a softer inner portion (nucleus pulposus). When we refer to a disk as slipped, we mean that part of the soft inner portion has pushed through the outer ring. 

Slipped Disk Causes

Now that you have a general idea of how disks function in the spinal cord and what happens when they are damaged, we will look at some of the reasons you may suffer a herniated disk.

Unfortunately, slipped disks can be a reality of aging. Even without a serious trauma, a disk can simply protrude in this way due to age and wear and tear. A simple twist to pick something up or put something away could result in herniated disk disease if the outer ring is weak or torn. As we age, our disks lose some of the protective water content, making them more susceptible to injury.

People with physically demanding jobs may experience protruding disks and more so as they age. A lot of lifting heavy can cause this problem over time and put you at a greater risk to experience a herniated disk.

Another factor that plays a role in spinal health is weight. There is an increased risk for slipped disks among those who are overweight as the disks are supporting the body’s weight.

What Type of Pain Occurs with a Slipped Disk?

Since back pain can vary in frequency, location, and intensity, it helps to understand what type of symptoms are most often associated with slipped disks. This will help differentiate between a slipped disk and other common spine injuries or problems with the spinal cord.

One of the most surprising things to learn about slipped disks is that sometimes they cause no symptoms at all, at least not initially. It is possible to have a herniated disk without experiencing any severe indications that there is a problem. You could also luck out and have a slipped disk that resolves itself without medical intervention.

For those who suffer from disk herniation, symptoms may present themselves in the back, neck, or even in the form of arm and leg pain. When the disc protrudes near a spinal nerve root, you may end up with pain that originates from spinal nerve root that travels to your arms or legs. You could also experience localized pain at the site of the herniated disk, which is referred to as discogenic pain.

This herniated disk pain can result in decreased mobility as some motions, such as reaching or twisting, may cause such severe pain and a possible muscle spasm that they are avoided altogether.

How is a Slipped Disk Diagnosed?

Even if you feel certain the symptoms you are experiencing has been caused by a slipped disk, you will need a proper diagnosis to be sure. The diagnosis is key to determining the proper treatment and also ruling out other causes of pain.

There are several questions your doctor will ask to try to understand the source of the pain, and this will include discussing your medical history, any recent accidents or injuries, your exercise and sleeping habits, and more.

During the physical exam, your doctor will be looking at how certain movements may or may not cause pain and if certain areas of the body are sensitive to touch.

Imaging tests are often used by healthcare providers to look for spinal damage or injury, and yours may order a CT scan, MRI scan, x-ray, and discograms.  A combination of these tests may help a physician piece together the source and cause of the symptoms and pain as well as give her an idea of how it may have occurred, by considering your medical history and other information you have shared about recent activities.

What Else Could Be Causing My Back or Neck Pain?

In some cases, a physical exam and imaging tests may rule out the presence of a herniated disk. Then a patient is left to wonder “what is causing my pain?”

There are many other possible causes, ranging from mild strain to more serious issues like cauda equina syndrome. If you are experiencing back pain from a minor strain or poor posture, for example, you may be able to treat it at home by alternating ice and heat applications along with rest.

Some warning signs that point to the need for a medical evaluation, including:

• Symptoms that last for more than one week
• Pain that is accompanied by a fever
• Weakness or numbness in the legs
• Digestive issues and/or incontinence

Back pain can occur with everything from gallstones and pancreatitis to endometriosis. The discomfort you are feeling in your lower back, which you may have assumed was related to “overdoing it” on a mountain bike, could be from another area of your body and unrelated to your spine or neck.

In some rare cases, symptoms or discomfort in the back can also be associated with life-threatening conditions from stroke to meningitis. If your symptoms are severe, it is best to seek medical attention right away.

How to Prevent Slipped Disks

While we cannot prevent some of the deterioration that occurs with aging, there are many things we can do to be proactive about the health of our backs and spinal nerves and the prevention of disk herniation or slipped disks.

Reducing your risk of experiencing a herniated disk can be achieved by the following:

• Maintaining a healthy weight.
• Focusing on safety while lifting heavy objects and remember to lift with your legs.
• Avoiding long periods of sitting and take frequent movement breaks if you work in an office. Choose a chair with proper lumbar support for your desk.
• Participating in exercise routines that combat muscle weakness and strengthen your core.

Possible Treatment Options for Slipped Disks

Once your physician diagnoses a herniated disk, she will recommend a treatment plan that is related to both your pain level as well as the physical characteristics of the protruding disk.

Conservative measures to correct a slipped disk may include over-the-counter pain medication and physical therapy. More serious cases could require surgical treatment.

In all cases, your physician will recommend that you avoid heavy lifting, but they may suggest physical therapy or an exercise program that will help you strengthen your back and manage your pain in addition to other nonsurgical treatment options.

Crawling into bed and staying there is not a good option when it comes to slipped disks. If you are too sedentary, you could end up with joint stiffness and ultimately even more pain.

Light to moderate exercise and stretching will make a tremendous difference in your recovery. Just do not overexert yourself with anything Herculean: now is not the time to start training for a marathon or a CrossFit competition.

For those with pain that cannot be managed by over-the-counter medications, your physician may prescribe muscle relaxers, steroid injections, narcotics, and/or medications that can stabilize the nerve root pain. Be sure you discuss any concerns about prescription medications and addiction with your doctor. There are also other pain management tools to consider that do not involve prescription medication, such as the popular TENS unit therapy for back pain or disk herniation.

In cases where the pain does not subside after six weeks or more of nonsurgical treatment such as medicine and physical therapy, surgery may be required. 

A microdiscectomy is a surgical procedure where the damaged section of the disc is removed. In addition to a microdiscectomy, there are also surgical procedures where the disk could be replaced with an artificial one or removed altogether.

Whether surgical or nonsurgical treatment options are chosen, be sure you follow all of your doctor’s specific guidelines as you recover, which will reduce the risk of complications or additional injury.