Due to a weakness of the posterior part of the disc, damages of the cartilage ring (anulus fibrosus) can occur. That is, the posterior protective ring tears or protrudes. Through the tear, the softly inner part of the disc protrudes and, thereby, compresses and irritates a nerve (see images A and B). Physicians then talk about slipped disc, herniated disc, disc herniation or disc prolapse. Most herniated discs are to be found in lumbar spine or cervical spine.
A slipped disc can cause pain in the back but also radiating pain into buttocks, legs and feet. At the worst, a slipped disc results in paralysis and sensation loss. Even during protrusion, the nerve is irritated, so that severe pain can arise. The symptoms of a slipped disc in lumbar spine in short:
Which kind of complaints occur depends on height and direction of slipped disc. It is differed between those that are in the middle and cause back pain, and those that are more lateral and cause leg pain.
Not only heavy lifting and accidents but wrong body twisting and certain movements can cause a slipped disc if there is a genetic disposition. Risk factors comprise hereditary factors (‘weakness of the connective tissue’), overweight and a lack of movement, permanent sitting, some occupational strains (trucker) and smoking. Furthermore, a bad muscle condition can enlarge the risk of a slipped disc.
Anatomical and biomechanical factors play a certain role in the prevalence of a slipped disc, especially in the lower third of the cervical and lumbar spine. Mainly the spinal segments L 4/5 and L5/S1 are affected. The causes of slipped disc in lumbar spine in an overview:
To differentiate a slipped disc from other spinal diseases causing similar complaints, patients first get a neurological-orthopedic examination including a comprehensive talk about the history and treatment of illness. Often imaging examinations like MRI follow. Magnet resonance imaging enables us to examine and visualize a slipped disc and other spinal diseases very thoroughly. At Beta Klinik we use an open MRI system which allows us to comfortly examine patients suffering from claustrophobia or patients up to 250 kg (500 lbs).
The upper MR image shows a large herniated disc in the lowest lumbar segment with compression of the nerve roots. At the right MR image, the same herniated disc is depicted transversally.