Slipped Disc (Herniated Disc)

What is a spinal disc?

A spinal disc is the “cushion” that is between your vertebrae. A spinal disc has two parts: a tough outer layer with a softer inner section. The outer portion consists of concentric layers of collagen fibres, while the inner portion consists of a loose network of fibres within a gel-like substance. At birth 80% of the disc consists of water, but as we get older, the discs start dehydrating. This makes it less efficient in absorbing spinal loads.

What does a disc do?

Discs are cushions and shock absorbers for the spine and also plays a part in connecting one vertebra to the next.

What happens when a disc herniates (slips)?

Some of the collagen fibres of the outer layer of the disc tears. The softer, inner part then pushes out of that tear. That fluid can then press on one of your spinal nerves, or even the spinal cord. This can cause pain locally or cause referred pain along the path of the nerve that is being irritated. In very bad cases it can cause pins and needles (tingling), numbness and muscle weakness.

See for an illustration of this.

What are the causes of a herniated disc?

Disc herniation can be caused by wear and tear. This can occur in jobs where the person sits for very long periods, but most commonly a job that requires heavy and regular lifting. A herniation will typically happen when you are lifting something while the back is flexed and rotated. Minor back pain and chronic “tiredness” of the back are often indicators of wear and tear. Another cause of a herniated disc can be direct trauma to the spine, as in a car accident or a fall. 

How to prevent a disc herniation.

It is important to be mindful of how you perform your work and play activities. Learn proper lifting techniques, practice weight control and make sure that you do moderate, sensible exercising on a regular basis, focussing on strengthening the deep stabilisers of the spine at all levels.

How can physiotherapy make a difference?

A physiotherapist can firstly get involved in screening you for possible risk factors and prescribing a stability programme in order to prevent the disc herniation in the first place.

Once the disc has ruptured, a physiotherapist can assist in alleviating the pain, using various modalities. They can then treat the associated muscle spasms and intervene in controlling the subsequent compensations the body will adapt in order to “get away” from the pain.

Finally a physiotherapist can assist you in gradually strengthening and stretching the surrounding muscles and tissues in order to actively support that area of the spine and take the pressure off.