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Slipped Disc

A slipped disc, also known as a herniated disc, happens when the disc that sits between your vertebrae ruptures or tears, leading to the centre of the disc, the nucleus to herniate or protrude. Slipped discs are a common cause of back pain, and can be treated with the right pain management plan.

What is a slipped disc?

Our spine is made up of vertebrae bones, which house the spinal cord that runs down from the brain along the spinal canal. Each of these vertebrae are cushioned by fibrocartilaginous intervertebral discs, consisting of a gel-like nucleus pulposus, surrounded by the tough annulus pulposus.

Herniated discs are a result of the leaking or displacement of the nucleus pulposus from the centre of the disc, which compresses on the spinal cord or spinal nerves, this causes the painful sensation associated with the condition. Slipped discs are most common in the bones of the lumbar spine (lower back), followed by the cervical spine (neck).

Slipped disc treatment in Singapore.
Lower back pain is a common symptom of lumbar disc herniation.

What are the symptoms of a slipped disc?

Slipped discs are caused by the tearing or rupture of the annulus of the disc.
A herniated disc is described as the rupture of the intervertebral disc, leading to the compression of the spinal nerve by the leaking nucleus pulposus.

While it typically causes a sharp, shooting pain, slipped discs can be asymptomatic in some patients, and it can also cause other symptoms due to the nerve compression. Common symptoms of a slipped disc include:

  • Back pain – Lower back pain is a common symptom as herniated discs commonly happen in the lumbar spine. Pain can also be felt in the buttocks, thigh and calves as well. If the slipped disc occurs on the cervical spine, the pain can be felt on the shoulders and arms. Sometimes, the pain can worsen with movements, such as twisting or bending.
  • Numbness or tingling – Numbness, tingling, or any sensory changes are also commonly felt in patients with herniated discs.
  • Weakness – Weakness due to the compressed nerves can appear as instability of the limbs while holding or lifting items, or as gait abnormalities while walking. In some cases, weakness may also lead to paralysis.

What causes slipped discs?

Herniated discs are commonly caused by:

  • Ageing – As we age, the nucleus pulposus gradually loses water and weakens, this leads to the gradual disc herniation, leading to symptoms.
  • Wear and tear – Another common cause for slipped discs include wear and tear of the intervertebral discs. This leads to tears or fissures on the annulus pulposus, leading to herniation of the nucleus pulposus.
  • Trauma – Injuries or traumas can also lead to the tearing of the annulus, leading to the nucleus herniation.
  • Congenital disorders – Congenital disorders such as short pedicles can also increase the likelihood of disc herniation due to a narrower spinal canal.
Ageing
As we age, the nucleus pulposus gradually loses water and weakens, this leads to the gradual disc herniation, leading to symptoms.

How are slipped discs diagnosed?

Physical examination
Prior to your examination, your doctor may take your symptoms and medical history.

Slipped disc diagnosis is typically done by imaging tests. You should visit your healthcare provider if you experience sharp, shooting back pain that does not go away. Typically, your doctor will diagnose a slipped disc with the following tests:

  • Physical examination – Prior to your examination, your doctor may take your symptoms and medical history. A physical examination for slipped discs often involves your doctor palpating for signs of paraspinal muscle spasms, and asking you to move your body or limbs to assess your range of motion. Often, pain will limit your range of motion.
  • X-ray radiographs – X-ray imaging is an important tool for the diagnosis of herniated discs to look for signs of fractures, degeneration, or spinal abnormalities. X-ray radiographs can be accompanied with other imaging tests.
  • Magnetic resonance imaging (MRI) – MRI scans are a sensitive method to diagnose herniated discs. MRI scans are able to visualise structural changes or abnormalities of soft tissues and identify the nerves affected by the herniated disc.
  • Computed tomography (CT) scan – CT scans are a more sensitive method to study the bony structures of the spine, and can be used in the diagnosis of calcified herniated discs.
  • Myelogram – A myelogram is a diagnostic test involving the use of a contrast dye that lights up with x-ray or CT scans. The test is used to look for abnormalities of the spinal cord and spinal nerves.
  • Laboratory tests – Laboratory tests are not always necessary, but can be used to look for markers associated with inflammation, infection, or cancer.

How are slipped discs treated?

Most cases of slipped discs can be treated with rest and pain management. Common treatment methods of herniated discs include:

  • Rest – Resting for several days can typically relieve you of the back pain caused by a herniated disc. Most cases of slipped disc resolve within a few weeks of the onset of symptoms.
  • Non-steroidal anti-inflammatory drugs (NSAIDs) (link to page) – NSAIDs can be taken to relieve back pain. Common types of NSAIDs include ibuprofen and naproxen.
  • Opioid analgesics – In cases where NSAIDs are ineffective, opioid analgesics can be prescribed. However, the use of opioid analgesics needs to be discussed in detail with your doctors beforehand to minimise potential adverse effects and drug interactions.
  • Physical therapy (link to page) – Physical therapy is often recommended after appropriate rest and medication. A physical therapist can teach you exercises to relieve pressure from your spine and nerves to minimise pain from the herniated disc.
  • Epidural injections and selective nerve root block (link to page) – Steroid injections are common treatment methods for nerve inflammations and radiculopathies. The procedure involves precise injections of steroid drugs to relieve pain and inflammation on the affected nerve through the epidural space. The procedure is also done with the help of imaging such as fluoroscopic x-ray.
  • Operative treatments – Operative treatments for herniated disc are typically the last resort when other treatments have failed. Common surgical procedures include:
    • Laminectomy – Laminectomy involves removing the lamina of the vertebrae in order to relieve pressure from the spinal canal. The lamina is the part of the bone that covers the spinal canal.
    • Discectomy – Discectomy surgeries involve removing all or part of the damaged disc from the spine. The procedure can be done as an open surgery, or as a minimally invasive surgery involving an endoscope.
    • Laminotomy – Unlike laminectomy, laminotomy removes part of the lamina, typically the portion that causes the nerve compression.
    • Artificial disc replacement – Disc replacement or disc arthroplasty is a procedure that replaces the damaged disc with a disc replacement device. Studies have reported that cervical disc replacements have improved outcomes and lower rates of complications compared to anterior cervical discectomy and fusion.
    • Spinal fusion – Spinal fusion involves removal of the ruptured disc and fusing the bones together with a bonelike material, this procedure essentially prevents movement between the bones and provides stability.

Summary

Slipped discs or herniated discs are a common cause of back pain due to the nerve compression caused by the ruptured intervertebral disc. This condition is often caused by wear and tear of the intervertebral disc due to ageing, or from traumatic injuries.

With the right pain management treatments, living pain-free with a slipped disc is possible. From targeted therapies to minimally invasive options, patients can experience lasting relief, regain mobility, and get back to their daily lives without constant discomfort holding them back. Schedule a consultation with us today for a detailed diagnosis and personalised treatment plan.

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