A slipped disc sounds alarming, and the pain can be intense. Many people recover without surgery, and knowing what helps, and what needs urgent attention, takes much of the fear out of it.
What is a slipped disc?
Between the bones of your spine are discs with a tough outer ring and a soft, jelly-like centre. When the outer ring weakens or tears, part of the centre can bulge out. If it presses on a nearby nerve, it can cause pain, numbness or weakness along that nerve. The medical name is a herniated or prolapsed disc.
It happens most often low in the back, at the L4/L5 and L5/S1 levels, and also in the neck.
Common causes
- Age-related changes, as discs lose water and become less flexible
- Repeated bending, lifting or twisting, especially with heavy loads
- A fall or accident
- Family history, as disc health partly runs in families
Symptoms
- Lower back or neck pain
- Pain travelling down the leg (sciatica) or into the arm
- Numbness, tingling or pins and needles
- Weakness in the leg, foot, arm or hand
Warning signs: go to a hospital urgently
- Numbness around the groin or buttocks
- New trouble controlling your bladder or bowels
- Leg weakness that is quickly getting worse
Do I need an MRI?
Not always. Disc bulges are very common in people with no pain at all, and become more common with age (Brinjikji, AJNR 2015). So a scan alone does not explain your pain. An MRI is useful when there are nerve signs such as numbness or weakness, when symptoms are not settling, or when surgery is being considered. Your chiropractor will tell you if you need one.
What research says about non-surgical care
- A review of pooled studies found that many disc herniations shrink on their own over time (Chiu, Clinical Rehabilitation 2015).
- In a randomised trial of people with acute back pain and sciatica from a disc protrusion, active spinal manipulation led to more pain-free days than simulated manipulation (Santilli, Spine Journal 2006).
- UK guidance for sciatica recommends exercise, with manual therapy as part of a package that includes exercise (NICE NG59).
- A trial comparing early surgery with prolonged non-surgical care for sciatica found surgery gave faster relief, but results were similar after one year (Peul, NEJM 2007).
How BP Chiro helps with a slipped disc
Care starts by watching how you walk and move, then your history, range of motion, reflexes, sensation, strength and orthopedic tests. If there are nerve signs, we may advise an MRI before going further.
- Gentle spinal manipulation in a side-lying position, with minimal twisting on the affected disc
- Spinal flexion-distraction and traction to ease pressure on the disc and nerve
- Soft tissue therapy for tight, guarding muscles
- Physiotherapy exercises such as McKenzie, core control and gradual strengthening
- Referral to a spine specialist if there are warning signs or symptoms do not improve
Recovery differs from person to person. Your clinician explains the plan and how progress will be checked before you start.
Related reading:
- Lower back pain: causes, warning signs and non-surgical care
- Neck pain: causes, warning signs and non-surgical care
Book a slipped disc assessment
Every first visit at BP Chiro starts with a full spinal assessment. Choose the clinic nearest you:
- Chiropractor in Johor Bahru (Uda Utama and Johor Jaya)
- Seri Kembangan, for south Kuala Lumpur, Puchong and Putrajaya
- Kepong, for north Kuala Lumpur
- Kluang
- Penang
References
- Brinjikji W, Luetmer PH, Comstock B, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015;36(4):811-816.
- Chiu CC, Chuang TY, Chang KH, Wu CH, Lin PW, Hsu WY. The probability of spontaneous regression of lumbar herniated disc: a systematic review. Clin Rehabil. 2015;29(2):184-195.
- Santilli V, Beghi E, Finucci S. Chiropractic manipulation in the treatment of acute back pain and sciatica with disc protrusion: a randomized double-blind clinical trial of active and simulated spinal manipulations. Spine J. 2006;6(2):131-137.
- National Institute for Health and Care Excellence. Low back pain and sciatica in over 16s: assessment and management (NG59). 2016, updated 2020.
- Peul WC, van Houwelingen HC, van den Hout WB, et al. Surgery versus prolonged conservative treatment for sciatica. N Engl J Med. 2007;356(22):2245-2256.