Slipped disc

The small, stacked bones of the spine are called vertebrae. Discs are small soft rubbery-like cushions that separate the vertebrae and act as shock absorbers. A slipped or herniated disc is very painful. It occurs when a disc in the back bulges into the spinal canal. Despite the common term, discs do not slip out or fall out. They rupture or bulge.

Each disc has a spongy center and a tough outer ring. Discs have water in them. As people age, the discs lose some of the water, shrink, and become less flexible. The ligaments that hold the discs in place become weak. With smaller discs and weaker ligaments, a minor strain or twist can cause the disc to bulge into the spinal canal. When a disc bulges into the spinal canal, it can put pressure on the nerves that travel through the spinal canal. Pressure on the nerves can cause pain.

Symptoms usually start with sudden pain in the back. Most slipped discs are in the lower back. A slipped disc can occur in the upper back or neck. If this happens, the pain will often be in the neck, shoulders, and arms. Other symptoms may include pain down the back of the leg and sometimes into the foot. There may be weakness or a "pins and needles" feeling. Sometimes, the pain starts slowly and gets worse and bowel or bladder problems may develop.

Anyone with back pain needs to see a healthcare provider. The provider will order x-rays, an MRI, or a CT scan of the back to find the cause of the pain.

Most of the time, treatment with limited rest and exercise are all that is needed for the pain to get better. Non-steroidal anti- inflammatory drugs (NSAIDs) like aspirin or ibuprofen may be used. Aspirin or medicines that have aspirin in them should not be given to anyone younger than 18 years of age. Taking aspirin is a risk for a serious illness called Reye's syndrome. NSAIDs should be taken with food or milk to prevent stomach upset. NSAIDs should not be taken by anyone who has been diagnosed with asthma, ulcer disease, or a bleeding disorder. Taking NSAIDs increases the risk of bleeding with trauma, dental work, surgery, or if taking blood thinners (anticoagulants).

Other medication that the provider may recommend includes muscle relaxants and, rarely, steroid injections. Heat or ice (whichever feels better) may be used to help relieve the pain. A cloth-covered ice pack should be put on the back for no more than 20 minutes at a time, 4 to 8 times a day. If heat is used, a heating pad on low for 10 to 20 minutes, 4 to 8 times a day can be put on the back. Acute back pain often goes away on its own in a few days or weeks. Two to 3 days in bed is the most that is needed. A longer time in bed may cause the muscles to weaken.

If the pain does not get better in a few days, the provider should be called, especially when:

• pain is severe or comes back after going away
• pain extends from the back to the leg or
• bowel or bladder problems develop

In a very few severe cases, surgery may be needed to remove the disc. This usually means a rapid relief from the pain.

There are some things that can be done to help prevent a slipped disc or back pain caused by a slipped disc. Regular exercise helps to keep the back and abdominal muscles strong. Keep good posture. Warm-up and cool down with stretching exercises before and after a workout or recreational or sports activity keeps the muscles flexible. Avoid smoking since it aggravates back pain.

Being overweight can put stress on the lower back, so losing weight may help prevent a slipped disc. Comfortable supportive seats when sitting or driving for a long time and breaks to stretch and walk around take pressure off the back. When sleeping on your side, keep your knees bent and when sleeping on your back, keep proper body mechanics when lifting.

Last Reviewed 2005

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

HIL File BACK4205.RF2 VRS# 4205 Data Version 7.0 Copyright 1999-2000, 2003 McKesson Health Solutions LLC. All rights reserved.