Protect your spine to avoid getting a slipped disc, which can be painful and debilitating. Find out more about the stages of severity and ways to treat slipped discs.
If you notice someone's bare back, especially when he leans forward, you can see his spine running down the centre of his body. You can also see that the spine is not one single long pole, but is divided into segments, or vertebrae.
Discs are located between each vertebra to keep the spine flexible and absorb the impact of daily activities, much like how shock absorbers in cars bear the brunt of every road hump and pothole, explains Dr Chen Haobin, Consultant, Department of Orthopaedic Surgery, Sengkang General Hospital.
"Each disc is like a spongy cushion which provides shock absorption. With age, the cushion starts to become prone to injury. A sudden increase in pressure such as that which can occur with heavy lifting or straining can result in a tear of the outer shell of the cushion, causing the internal contents to be pushed out," explains Dr Chen, adding that the resulting bulge may press on the spinal nerves, leading to severe pain, numbness or even weakness in parts of the leg.
Slipped disc is also known as a 'herniated', 'ruptured' or 'prolapsed' disc.
According to Dr Chen, risk factors for developing this condition include smoking, age, being male, and having a high Body Mass Index (BMI).
Male: Men are predisposed to heavier work and labour, resulting in more stress on the spine.
Smoking: Smoking has been shown to be strongly linked to accelerated degeneration of the discs and a higher incidence of slipped discs.
High BMI: This can cause increased loading stress on the spinal disc cushion, resulting in disc injury.
To mitigate these risks, Dr Chen advises one to stop smoking, exercise (including stretching) regularly to maintain healthy body weight, adopt good posture, and learn proper lifting techniques.
There are different stages of this condition. In increasing severity, they rank in the following order:
Disc compression
Disc bulge
Disc protrusion
Disc herniation
Dr Chen says that the severity can be determined through MRI scans and the most common symptoms are back pain, pain or numbness radiating down one or both legs.
"Symptoms may not always correlate with the severity of the MRI findings and I will advise patients who experience such symptoms to seek advice from a spine specialist," he advises. "In general, this condition is expected to have a good outlook, and an estimated two-thirds of patients will see an improvement of symptoms with some rest and conservative treatment that may include medications and physiotherapy.
Dr Chen adds that surgery is often only necessary for patients with very severe symptoms that affect their function and have neurological deficits or pain that does not resolve with conservative measures such as medication, physiotherapy, and rest.
Dr Chen says that SKH offers both conservative and surgical treatment options for disc issues, adopting a multidisciplinary approach for individualised care to ensure optimal treatment outcomes. Such options include:
Conservative treatments:
Physiotherapy
Acupuncture
Medication
Nerve root injections
Surgical treatments:
Endoscopic decompression
Minimally invasive tubular decompression
Open decompression
Early assessment by a spine specialist will allow for appropriate and timely treatment. More importantly, making lifestyle changes may significantly help to avoid aggravation of the existing condition.
For patients who require surgical treatment, the SKH Orthopaedic team offers a comprehensive suite of surgical solutions ranging from traditional open surgery to minimally invasive surgical optoins include endoscopic and tubular surgery.
Each surgical technique carries its own set of advantages, and the spine surgeon will be able to advise on the most suitable treatment for each patient. As a general guide, minimally invasive surgical options (including endoscopic and tubular decompression) demonstrate a good success rate in terms of pain relief while allowing the patient to mobilise early and be discharged either on the same day or the day after surgery.
While the above techniques are helpful in treating slipped discs, prevention is the best medicine. Maintaining a healthy weight, exercising regularly, and staying mobile should help you keep limber. Also, always practise safe lifting techniques and ensure proper support when sleeping.
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