What is a Slipped Disc?
A slipped disc is a common and general term used to describe displacement of an intervertebral disc. Intervertebral disks are found in between the vertebrae of the spinal column. They act as shock absorbers and allow for some degree of flexibility. A slipped disc is a somewhat nonspecific term, however the word “slipped” implies acute or sudden onset of symptoms and usually results from a disc herniation which occurs when the central core of the disc ruptures. The ruptured jelly-like inner core of the disc can put pressure on neighboring nerve roots and cause pain, numbness, tingling, or weakness in the affected arm or leg. A slipped or herniated disc often occurs as a result of degenerative disc disease when the integrity of the disc weakens and results in the rupturing of the disc wall.
Symptoms of Slipped Disc
Symptoms of a slipped disc vary based on the location of the disc in the spine and the extent of the rupturing. If the condition does not put pressure on a nerve, it may be unnoticeable. If the disc is in the neck or cervical spine, pain or numbness in the shoulders, arms or hands may result. A slipped disc in the lower back or lumbar spine may cause pain or numbness in the buttocks, legs or feet. In more severe cases, a slipped disc can result in weakness in the affected arm or leg. Sustained weakness, numbness, or intractable pain should alert the patient to seek immediate neurosurgical evaluation.
How is a slipped disc diagnosed?
Dr. Lipani will discuss your symptoms and the location of your pain. Is there tingling? Numbness? What movements or situations cause the most pain? Have you had a fall or an injury?
He’ll perform a physical exam to assess:
- Muscle strength — He’ll look for atrophy, wasting, or abnormal movement.
- Pain — He’ll check for pain both with motion and in response to touch, such as pressure applied to the lower back.
- Nerve function — He’ll test nerve function with a reflex hammer. Hot and cold stimuli may also be used to check nerve reactions.
He may order these diagnostic tests to confirm things:
- Imaging scans — CT scans and MRIs can show the spinal nerves, the discs, and how everything is aligned.
- Discogram — Dye is injected into the soft center of a disc or into several discs. The dye shows up on a CT scan or x-ray.
Who is a candidate for slipped disc surgery?
Surgery to address the pain and potential loss of function due to a slipped disc is always the last treatment option employed by Dr. Lipani. Conservative treatment options, such as physical therapy, weight loss, and even corticosteroid injections, are the first course of treatment. If these treatments aren’t reducing the patient’s now-chronic pain, surgery could be necessary. The goal in these procedures would be to decompress an inflamed nerve root or to also stabilize two or more vertebrae. That would be the difference between, say, a microdiscectomy and fusion surgery.
These procedures are not performed simply because the patient has chronic pain. The purpose is to correct an anatomical lesion in patients who don’t show improvement through conservative treatments. Surgery is not an option for patients when an anatomical lesion that’s behind the pain cannot be identified.
These surgeries are never exploratory. They are not done unless the nerve being compressed, the degenerating disc and impacted vertebrae, or another direct cause of the pain can be identified.
What happens if you don’t treat a slipped disc?
As mentioned above, the term “slipped disc” is simply a moniker that can describe a multitude of conditions that are causing compression of a nerve root or even the spinal cord. In most cases, these are bulging or herniated discs. They haven’t slipped, per se, but they have changed usually due to degenerative disc disease and the disc is now putting pressure on nearby nerves.
This doesn’t always require treatment, much less surgery. Many patients have issues with bulging or herniated discs, but they are lucky enough to not have any symptoms. There isn’t any pain and there isn’t any impact on their quality of life.
However, if the disc is compressing a nerve or is degraded to the degree that it is allowing bone spurs to form on the lamina or the foramen, not seeking treatment is only asking for a long painful road ahead. These conditions won’t improve unless Dr. Lipani can see what’s going on and recommend the treatment approach that works to alleviate the compression and the resulting pain.
Back pain has ruined the quality of life of many people. Whether it’s stubbornness or fear of treatment, they don’t seek help. And their quality of life degrades as they have to give up one activity after another that they formerly enjoyed. Something as simple as walking the dog around the block can become an exercise in serious pain.
There’s no reason for that to happen. Dr. Lipani is a board-certified neurological surgeon. He has pioneered many non-invasive approaches to neurosurgery that can be used to treat your problematic discs and resolve the pain they are causing.
Treatment and Surgery for Slipped Disc
The main causes of slipped disc are degenerative changes from the natural aging process or from injury such as improper lifting of heavy objects. Smoking and obesity also increases the risk of developing a slipped disc. Treatments for slipped disc include medication to relieve pain, exercises and physical therapy to relieve pressure on the spinal nerves.
In cases when conservative nonsurgical methods fail to relieve symptoms, surgical intervention may be required. Surgery is targeted at relieving the pressure from the nerve that is caused by the slipped disc. Surgery often involves minimally invasive microdiscectomy. The objective of this procedure is to remove the part of the disc that places pressure upon the affected nerve. The majority of the disc however is left behind.
What is recovery like after surgery to address a slipped disc?
There isn’t a single surgery to address the problems created by a slipped disc. As such, there isn’t a stock recovery either. Surgical approaches used can be minimally invasive options such as microdiscectomies or laminectomies. These may or may not also involve fusion to add stability to the vertebrae in question. Dr. Lipani may even remove the damaged spinal disc and replace it with an artificial disc. This is the newest advance in these procedures.
So, what will recovery be like? Spinal fusion requires the longest recovery, as the bone graft needs to grow between the adjacent vertebrae. This takes from 3-6 months. The bone then fully immobilizes the spine between those vertebrae.
Patients with microdiscectomies or laminectomies can begin walking the same day of their surgery, amazingly enough. Most patients can return to work in a week or so, depending on their duties. Most activities can be resumed relatively quickly, with pain being the guide to what is OK.
What activities will become limited after having these surgeries?
Again, that’s impossible to say without knowing what the surgery you just had involved. Take Tiger Woods, the world’s most famous golfer, as an example. He’s had multiple microdiscectomies but continued to have pain. Finally, he had fusion surgery on the L5-S1 portion of his spine. A year or so later he was back on the PGA Tour again, swinging a golf club at around 120 miles per hour. Shortly thereafter he won The Masters again.
There isn’t any set of limitations after these procedures with Dr. Lipani. You may not have to change anything. It will take some work to strengthen your back and the rest of your body on your part, but we’re not ruling anything in your life out beforehand. That’s why Dr. Lipani performs these procedures — to help patients get their lives back!
What can I do to prevent another slipped disc in the future?
Degenerative disc disease usually affects discs in the neck and the lower back, as the thoracic spine (mid back) is protected and stabilized by other structures such as the ribs. You can’t prevent degenerative disc disease, but you can take some steps to keep it from worsening over time.
Exercise
You can’t reverse damage that has already occurred, but by strengthening the muscles that support your spine this adds stability, and this can minimize the pressure on the nerves around the worn spinal discs. Exercise also increases circulation to your spine to help with the delivery of essential nutrients to the tissues. Endorphins released during exercise also reduce stress and anxiety and can create a pain-relieving response.
These types of exercise will benefit your spinal discs:
- Core strength training to target all muscle groups supporting your spine
- Water-based exercises that work the same muscles without the impact
- Cardio-based exercises such as brisk walking, biking, and swimming
Physical therapy
A physical therapist can help you go beyond exercise on your own. A physical therapist can recommend techniques that specifically target areas where you’re feeling pain. These are some common PT methods that could help:
- Hot and cold therapy
- Deep tissue massage
- Spinal traction to release muscle tightness and corresponding nerve compression
Hydration
Our spinal discs become less gel-like as we age. They also naturally compress during the day’s activities, and this depletes more moisture from the discs. Aim for 8 glasses of water a day for sufficient hydration.
Epidural injections
A combination of anesthetic and corticosteroid medication is injected into the space outside of the membrane that protects your spinal cord. This can provide pain relief for months.
Nutrition
It’s hard to see how your diet can help your spinal discs, but it can. Sugary foods and fried foods contribute to tissue swelling, which can exacerbate disc pain. Being overweight from a poor diet loads more pressure on discs and nerve roots. Many foods also offer natural anti-inflammatory properties: green leafy vegetables, berries, tomatoes, unsalted nuts, lean meat and fish, low-fat dairy products, beans, eggs, and other sources of healthy protein.
When the discs degrade, you’re prone to herniation or bulging in the disc. While you can’t do much about aging and degeneration, you can be mindful of ways you create injuries to these discs. When you lift, be sure to use your legs. Bring the object in close and use your legs to elevate it. Never twist and lift at the same time. Better yet, get someone else to do the heavy lifting! As mentioned above, the best defense against these injuries is to stay active and strengthen your core muscles that support your spine and back in general.
Contact us today
At Princeton Neurological Surgery, Dr. Lipani is a board certified fellowship trained spine surgeon in New Jersey who performs minimally invasive spine surgery as well as complex spinal procedures. Dr. Lipani is a specialist in the treatment for slipped disc and many other spinal conditions such as spinal stenosis, herniated discs, degenerative disc disease, low back pain, neck pain, spinal tumors, spinal cancer and more. Dr. Lipani treats patients from around the world, New York, Pennsylvania, and New Jersey including locally from Princeton, New Brunswick, Hopewell, Pennington and communities throughout Somerset, Middlesex, Ocean, Burlington, Monmouth, Morris and Mercer Counties for slipped disc. Dr. Lipani offers image guided spine surgery approaches for slipped disc treatment, tailored to the needs of each patient. For state-of-the-art slipped disc treatment, call or email us to schedule a consultation at our offices in Hamilton, Bridgewater, or Morristown, New Jersey!
Dr. Lipani’s affiliation with several major New Jersey hospitals means that you will receive slipped disc surgery you need without having to travel to New York or Philadelphia. Dr. Lipani has over 15 years of experience performing brain and spine surgeries, so you can count on him to provide the best possible quality of care to all his patients.
