Your spine stretches from your neck all the way down to your lower back. It is made up of multiple bones or vertebrae stacked on top of each other. Between each vertebrae are soft, gel-like discs that help to cushion and absorb the impact of daily activities such as walking, lifting objects, and twisting/turning, thereby protecting the vertebrae from any pressure or strain.
Each disc consists of two layers, the inner layer and the outer layer. A slipped disc, also known as a prolapsed or herniated disc, occurs when the inner layer of the disc pushes through a crack or tear in the outer layer. If the slipped disc pushes against a spinal nerve, numbness or pain may be felt along that nerve. Slipped discs can occur in various parts of your spine but are most common in your lower back and neck, also known as a cervical herniated disc.
What causes slipped disc?
A slipped disc is typically caused by:
Wear and tear: wear and tear on your spinal discs due to ageing and/or repetitive strain are the most common causes of a slipped or herniated disc. This wear and tear can cause discs to weaken, which can lead to the outer layer of the disc bulging or breaking open, resulting in the inner gel-like substance leaking out and putting pressure on nearby nerves, causing pain and discomfort.
Trauma/injury: in rare cases, sudden trauma or injury can cause slipped discs.
What are the symptoms of slipped disc?
Symptoms of a slipped or herniated disc include:
Pain in the affected area that can affect other parts of your body over time
Numbness or tingling in the affected area or other parts of your body
Muscle weakness or spasms
Difficulty moving or standing straight
Loss of bladder or bowel control (severe cases)
If you notice any of the symptoms, make an appointment with an orthopaedic specialist to get an accurate diagnosis and treatment.
Dr Puah KL is our Senior Consultant Orthopaedic Surgeon at Artisan Sports & Orthopaedic Surgery. He used to serve the sports service of Singapore General Hospital - the highest volume trauma centre for orthopaedics in Singapore.
A slipped disc can cause pain. The severity of the pain depends on the location of the slipped disc and the amount of pressure it puts on the surrounding nerves.
The pain can be in your neck, back, arms, or legs and range from mild to severe. Other symptoms may include numbness, tingling or weakness in the affected area(s).
Who is at risk of slipped disc in Singapore?
Anyone can have a slipped disc, but some factors may increase your risk, such as:
Age: as we age, our discs become less flexible and more prone to wear and tear, leading to rupture of the outer layer. This allows the inner layer of the disc to leak out through the cracked outer layer, resulting in slipped disc.
Weight: being overweight or obese increases your risk of a slipped disc. The excess weight puts pressure and strain on the disc, causing the outer layer to rupture, resulting in a herniated disc.
Sedentary lifestyle: prolonged sitting can increase the pressure on the disc, causing the outer layer to rupture, and the inner layer to seep out. Regular exercise that strengthens your back muscles will reduce the pressure on the discs and thus helps to prevent slipped discs.
Smoking:research has shown that smoking reduces the oxygen supply to the discs, allowing them to disintegrate more easily.
Occupation/hobbies: activities that involve heavy lifting, pulling, pushing, or twisting can increase the risk of a slipped disc.
How is slipped discs diagnosed?
A slipped disc is diagnosed in the following ways:
Physical examination: during the physical examination, your orthopaedist will ask you to move your legs in various positions while lying flat. This is to check on your range of motion and muscle strength.
Neurological examination: in addition to the physical examination, your orthopaedist may also conduct a neurological examination to check on your reflexes and your ability to feel vibrations, light touches, and pin pricks.
Imaging tests:x-rays, computed tomography scans (CT-scan), and magnetic resonance imaging (MRI) will be performed to determine the severity and location of the slipped disc and help identify any other underlying conditions that may be causing your symptoms.
Nerve conduction test: conducted to investigate the receptivity of nerve signals and to identify if any alteration of sensation has occurred.
Electromyography (EMG): an EMG is often prescribed and would be necessary if an incidence of compressed nerves is suspected.
A proper diagnosis will help determine the most appropriate treatment option for your needs and increase the chances of the treatment being successful.
What are the treatment options for slipped discs in Singapore?
Depending on the severity of your symptoms, treatment options can vary from person to person. In most cases, a slipped disc can be treated conservatively without surgery.
Treatment options for a slipped disc include:
Rest: you may require 1 to 2 days of rest to help relieve symptoms.