Slipped disc: what is it and how can physiotherapy help?
A herniated disc is a disease of the spine in which a part of the disc that lies between the vertebrae protrudes from the normal space and can press on the nerve roots. This can lead to severe pain, numbness or paralysis in the spine or arms and legs.
The most common forms of herniated disc are
- Lumbar disc herniation: this affects the lower spine (lumbar spine) and can lead to pain radiating down the lower back, buttocks or legs. It is the most common form of herniated disc.
- Cervical disc herniation: This affects the upper spine (cervical spine) and can lead to pain in the neck, shoulders or arms. It is less common than lumbar disc herniation, but is often more serious.
- Thoracic disc herniation: This affects the middle spine (thoracic spine) and can lead to pain in the chest, abdomen or ribs. It is
very rare and often difficult to diagnose.
How does a slipped disc develop?
The intervertebral discs consist of an outer fibrous ring and an inner gelatinous core. They act as a buffer between the vertebrae and allow the spine to move. Various factors such as ageing, lack of exercise, poor posture, obesity or injury can weaken or damage the fibrous ring of the intervertebral disc. As a result, the gelatinous nucleus can protrude from the fibrous ring and press on the nerve roots that emerge from the spinal cord. This leads to irritation or compression of the nerves, which can cause various symptoms depending on the level of the herniated disc.
How is a slipped disc diagnosed?
A herniated disc is diagnosed by means of a medical examination, during which the patient's symptoms, medical history and physical function are recorded. In addition, imaging procedures such as X-rays, computer tomography (CT) or magnetic resonance imaging (MRI) can be used to determine the exact location and extent of the herniated disc.
How is a slipped disc treated?
The treatment of a herniated disc depends on the severity of the symptoms, the patient's general condition and the individual treatment goal. In most cases, a herniated disc can be treated conservatively, i.e. without surgery. Conservative therapy includes the following measures:
- Pain therapy: pain therapy aims to alleviate the patient's acute or chronic pain. Various medications such as analgesics, anti-inflammatory drugs or muscle relaxants can be used for this purpose. However, pain therapy should only ever be seen as an accompanying measure and should not mask the cause of the herniated disc.
- Physiotherapy: Physiotherapy is an important pillar of conservative therapy. It aims to improve the mobility and stability of the spine, strengthen the muscles and prevent incorrect loading. Physiotherapy includes various methods such as physiotherapy, manual therapy, equipment-supported physiotherapy, heat or cold therapy, electrostimulation or Traction treatment. Physiotherapy is individually tailored to the patient and can be used both in the acute phase and in long-term treatment.
- Exercise therapy: Exercise therapy is a supplement to physiotherapy and is intended to motivate the patient to lead an active lifestyle. Regular exercise promotes blood circulation in the spine, relieves pressure on the intervertebral discs and strengthens the muscles. Exercise therapy can take various forms, such as back exercises, yoga, Pilates, swimming or cycling. It is important that the exercise is fun for the patient and is appropriate to their level of ability.
When is an operation necessary?
Surgery is only necessary if conservative therapy does not bring sufficient improvement or if serious complications occur, such as paralysis, bladder or bowel disorders or cauda syndrome (paraplegia caused by pressure on the lower spinal cord). The decision to have surgery should always be made together with the doctor, who will explain the advantages and disadvantages of the various surgical methods. The most common surgical methods include
- Microsurgical disc surgery: in this method, the leaked part of the disc is removed under microscopic vision. The procedure is performed through a small incision near the spine and is gentle on the surrounding tissue.
- Endoscopic disc surgery: In this method, the leaked part of the disc is removed using a thin tube (endoscope), which is inserted through a small incision in the skin. The procedure is performed under local anesthesia and is minimally invasive.
- Intervertebral disc prosthesis: In this method, the damaged intervertebral disc is replaced with an artificial disc made of metal or plastic. The disc prosthesis is intended to mimic the function of the natural disc and maintain the mobility of the spine. The procedure is performed through a larger incision in the abdominal or back region and is associated with a higher risk of complications.
How can you prevent a slipped disc?
A slipped disc cannot always be prevented, as it is often due to genetic factors or age-related signs of wear and tear. Nevertheless, some measures can reduce the risk of a slipped disc or at least slow down the progression of the disease. These include
- Regular exercise: Exercise keeps the spine healthy by promoting blood circulation, relieving pressure on the intervertebral discs and strengthening the muscles. You should make sure you do a balanced mix of endurance, strength and stretching exercises and avoid exercises that can lead to overloading or incorrect posture of the spine.
- Healthy diet: A healthy diet supports the health of the spine by ensuring the supply of nutrients, inhibiting inflammation and preventing obesity. Care should be taken to ensure a balanced intake of vitamins, minerals, trace elements and antioxidants and to reduce the consumption of sugar, alcohol and animal fats.
- Ergonomic workplace design: An ergonomic workplace design prevents incorrect strain or incorrect posture of the spine.