Slipped disc
From Free net encyclopedia
Template:DiseaseDisorder infobox |
ICDO = | OMIM = | DiseasesDB = 6861 | MedlinePlus = | eMedicineSubj = | eMedicineTopic = |
}} A slipped disc is a misleading layman's expression for a prolapsed or herniated intervertebral disc. It is a condition in which, due to a tear in the outer fibrous ring (annulus), the central part (nucleus pulposus) of the intervertebral disc gets extruded, often into the spinal canal.
The expression is imprecise and misleading because intervertebral discs can neither "slip," slide, or get "out of place." They are firmly grown together with the adjacent vertebrae and can be squeezed, stretched, and twisted, all in small degrees. They can also become degenerated, torn, ripped, and herniated, but not "slipped."
Disc herniations occur most commonly in the lowermost part of the spine, especially between the fourth and fifth lumbar vertebral bodies and between the fifth lumbar vetrebral body and the sacrum. This protrusion usually occurs to one side of the spinal canal, at the point where a nerve root leaves the canal. Impingement on the nerve causes pain, numbness and/or weakness in the part of the skin (dermatome) and muscle that are taken care of by the particular nerve root. The pressure on the nerve is not the only cause of the pain. The leaking of chemical substances from the disc lead to an inflammation of the root, also causing pain.
Contents |
Types
- Spondylolisthesis is a condition in which one vertebra moves forward in relation to the one below it.
- Retrolisthesis is when one vertebra moves backwards in relation to the one below it.
These conditions do not necessarily involve disc herniation, but can predispose a disc to herniation. Therefore they do not qualify as "slipped discs," since that expression only applies as a misleading layman's term for a herniated disc.
Causes
This most often occurs because the facet joints in the posterior part of the spine have degenerated (worn away) and fail to prevent excessive vertebral movement. In adults, the most common cause is a degenerative disc disease which leads to excessive stress on the facet joints and causes degeneration (such as arthritis) and the movement usually occurs between the fourth and fifth lumbar vertebrae (L4 and L5) or the one below that level.
Other causes of spondylolisthesis include stress fractures (caused by repetitive hyper-extension of the back, commonly seen in gymnasts) and traumatic fractures.
Genetics may also play a role, since the frequency of spondylolisthesis in Eskimos is 30-50%.
Symptoms
Symptoms can include lower back pain, pain in the thighs and buttocks or tenderness in the local area where the excessive movement occurs. Leg weakness or numbness can result from pressure on nerve roots and can cause pain to radiate down the legs.
Treatment
The majority of herniated discs will heal themselves in about six weeks and do not require surgery. Your doctor may prescribe bed rest (usually for no more than two days), or advise you to maintain a low, painless activity level. If your doctor recommends physical therapy, this may include pelvic traction, gentle massage, ice and heat therapy, ultrasound, electrical muscle stimulation, and stretching exercises.[1]