Slipped Discs and Back Pain

The spinal column is an engineering marvel. It’s strong and keeps the body upright, yet flexible allowing the torso to bend to a jackknife like configuration without any damage. Not only has that, but the spinal CORD, which is the main trunk-line of communication between the brain and the rest of the body traveled right through the spine.

These three things, Strength and Flexibility and Communication happen because of 3 different components in the spine. The strength comes from bones that are stacked on top of each other called vertebrae. The flexibility, from soft gelatinous pads that are inserted between each of the vertebrae. These gelatinous pads are wrapped in a touch fiber ring and are called “inter-vertebral discs”. When we bend, our vertebrae don’t grind against each other because these soft discs. Finally, the communication happens because tiny nerves arise from the cord and exit the spine between the vertebrae (near the discs). These nerves are caring sensations and instructions between the brain and the rest of the body.

Wear and Tear

Being an intervertebral disc is a tough job, lots of bending and lots of movement equals lots of friction. The heavier the person is, the more weight is hanging off of the vertebrae and squashing the discs. These forces can tear up the soft fibers that wrap around the disc. When a disc tears, the gelatin leaks out and presses against those very same nerves that are exiting the cord. They really don’t appreciate that and send pain impulses to the pain that you would interpret as a short electrical shock like pain along the path of that nerve.

This kind of tearing and leakage of the discs contents is more likely to happen in people who are:

• Older: with age, plain old wear and tear will gradually destroy the fibrous ring that surrounds discs. This natural age related breakdown is called “Degenerative Disc Disease”. That’s not a very accurate term, it’s not a disease, its age.
• Heavier: Another reason not to be obese.
• Smokers: Another reason to quit. Smoking decreases the blood flow to these discs making it tougher for them to heal from their daily wear and tear ordeal.
• People who lift heavy objects for a living: The normal wear is bad enough, when your job involves lifting heavy objects at work, like loaders and stockiest and ware house work. The problem becomes extreme. Make sure your workplace has assist devices to lift heavy objects and make sure you learn how to lift objects safely without straining your back too much.

Treatment

Surgery is the first thing we think about when it comes to the management of this problem. But before.

First things first is making sure the diagnosis is correct. An MRI has turned out to be the best and therefore the most commonly used test to confirm a disc prolapse. Sometimes though. The MRI can cloud things further.

Sometimes the disc that is prolapsed doesn't match the nerve that is causing the pain. At that point tests like Electro-Neuro MyoGraphy (ENMG) can be used to find out which nerves are really suffering. In these situations your doctors will have to work slowly and methodically to confirm the diagnosis. The last thing you want is them rushing in and operating on a prolapsed disc that isn’t the cause of your problem.

Pain medications like Ibuprofen, Naproxen, etc. are great for short term pain relief but have side effects of their own.

The ultimate treatment for a prolapsed disc is surgery. A good Neurosurgeon or Orthopedic Spine surgeon can go in and lip of the leaky part of the disc. That relives the pressure on the nerve and solves the issue more or less permanently.