PAIN in the neck and lower back is a growing predicament in Singapore. Ageing population, sedentary lifestyles, work environment all have an active role to play in the issue. In most instances, back pain is usually the consequence of over exertion, fatigue or a twist or sharp movement of the back. But when there is an injury to the spine or, the pain stems from a slipped disc, medical attention is required. 

What is a slipped disc?

The human spinal cord is a soft network of nerve fibres, running down from the brain. It is protected by a spinal column which is made of blocks of bone (vertebrae). Each block is separated from another by a soft, flexible, gel-like cushion called a “disc”. The disc acts as a shock absorber. Any sort of activity, stress or mechanical problem in the spine can cause a disc to bulge and, add pressure on the nerve root. This condition is called “Slipped Disc” or Herniated Disc. This added pressure in the nerve roots can lead to pain in the arms, in the case of the neck (cervical) discs or in the legs, in the case of the back (lumbar) discs.

In more severe cases, the disc bulge may cause disc rupture or herniation, placing even greater pressure on the nerve root. The nerve roots of the lower back cause not only back pain, but also pain that radiates down one or both legs. There may also be muscle weakness, numbness and changes in reflexes in the legs.

Causes of a slipped disc

Our spine ages just like the rest of our body. As a result of the ageing process, our bodies dehydrate causing the discs that cushion and separate our vertebrae to simultaneously dry out; rendering them less effective as shock absorbers, and more prone to tearing or rupturing with even a minor strain or twist. Other causes include improper habits of bending, lifting, turning and twisting that might have caused direct or indirect pressure on the spinal cords. Obesity, long hours of sitting and sedentary lifestyle habits can add further strain to the delicate spine.

Symptoms of a slipped disc

The symptoms may vary, depending on where the slipped disc is located along the spine and the size of the herniation. Most of the time, slipped disc occurs in the lower back (lumbar spine), although it can also occur in your neck (cervical spine). If the herniated disc is nor pressing on a nerve, there may be an ache in the low back or no symptoms at all.

The most common signs and symptoms of a slipped disc that presses on a nerve are:

  • Arm or leg pain. If the slipped disc is in the lower back, intense pain can be felt in the thighs and leg below the knee. It may also involve part of the foot. If the slipped disc is in your neck, the pain will typically be most profound in the shoulder and arm.
  • Numbness or tingling. People who suffer from a slipped disc often experience numbness or tingling in the body part served by the affected nerves.
  • Weakness. Muscles served by the affected nerves tend to weaken. This may cause you to stumble, or impair your ability to life or hold items.

Diagnosis of a slipped disc

Modern diagnostic tests include the MRI scan (Magnetic Resonance Imaging) of the spine give the clearest picture of the spinal cord, nerve roots and the possible causes of nerve pressure.

Treatment for slipped disc

When the problem is not deemed to be severe, a course of pain killers and muscle relaxants can be prescribed.  Ultrasound and neck traction can also be helpful. Wearing a neck collar or a lumbar corset is a preventive measure to limit excessive movement and provide support.

For severe problems of disc rupture or actual narrowing of the spinal canal, surgery may be required, especially if nerve function is affected. These are carried out with less invasive surgical options that include the use of new generation miscroscopes. These allow excellent visualisation of fine nerve roots and the discs compressing them, via small openings. These procedures are called cervical or lumbar discectomies.

Conclusion for slipped disc

Spine related problems are no longer confined to the aged. There has been an upward trend in the number of young people who suffer from spine problems. With some simple tips, these issues can be easily prevented.

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