: : Ruptured Disk

Ruptured Disk - Explained Simply

A ruptured disk is a very common back injury. It is also known as a ruptured disc (different spelling), a herniated disc, bulging disc or even a 'slipped disk'.

Regardless of what it is called, the pain caused by this sort of injury can range from mild back pain to excruciating back pain, with associated symptoms, such as pain and numbness, that goes down one or both legs.

What is a Ruptured Disk?

The spine is basically made up of bones, called vertebrae. Between the vertebrae are layers of 'padding' called intervertebral disks. The disks act as 'shock absorbers' and help to stabilise the spine.

The intertebral disks are made up of a tough, outer ring, called the annulus fibrosus, and a jelly-like core, known as the nucleus pulposus.

In most cases, when a ruptured disk is diagnosed, there is a tear to the annulus fibrosus, which then allows the jelly-like core to leak out from the disk.

To help you further understand what a ruptured disk is, I've added this short video from WorkSafeBC. It's only a short clip, but I think it illustrates the condition better than photos could.

 

 

Causes

Many things can cause the tough, outer layer of the intertebral disk to weaken and tear, leading to a ruptured disk. Some of these are:

  • Weakness in disk caused by the normal aging process.

  • Repetitive strain on the disk from repeated bending and lifting. This is often seen in occupations such as brick laying or concreting.

  • A sudden strain on the spine from a heavy lift or twisting action. Sometimes a sneeze or cough can be the 'final straw' that causes a disk, that is already weakened, to rupture.

Symptoms

The symptoms associated with a ruptured disk can vary greatly. The main reason for this is that there are varying degrees of disk damage and thus leakage of the jelly-like centre of the disc.

Here are the common symptoms associated with a ruptured disk:

  • Pain. The amount experienced can vary from no pain at all, to debilitating back and leg pain. The back pain is usually made worse by bending or sitting for long periods.

  • If the ruptured disk presses on surrounding nerves, pain, numbness and pins and needles can be felt in the buttocks and down the leg/s. This pattern of pain and nerve symptoms is sometimes referred to as 'sciatica'.

  • If the pressure of the surrounding nerves is severe, weakness can be felt in the legs. Bladder and bowel functioning can also be impaired. These associated symptoms can lead to serious condition known as Cauda Equina Syndrome.

If you are experiencing abnormal bladder or bowel functioning, tingling or numbness in the groin region, or marked weakness in one or both legs, please go to your nearest hospital emergency department immediately for medical attention. 

Diagnosis

Most cases of disk injuries are diagnosed by a doctor, or a physiotherapist, through taking a detailed history and doing a physical examination.

If the symptoms are very severe, the doctor or therapist may need to organise for an Magnetic Resonance Imaging (MRI) scan to be done. On an MRI scan, the amount of disk damage can be seen, as well as the amount of compression of nearby nerves and spinal structures.

Computer tomography (CT) scans can also be of use to see the bony structures of the spine more clearly.

Treatment

If you have been diagnosed with a lumbar disk rupture, you will be glad to know that over ninety percent of disk ruptures in the lower back do not need surgery.

Most cases of disk injury that do not require surgery, will improve within six months. In my experience as a physiotherapist, many cases can improve dramatically within 2-4 weeks.

In cases where back surgery is not required, these treatment guidelines are generally helpful:

  • Relative rest (not complete bed rest) with a gradual increase in activity.

  • Taking prescribed medications to help control pain and inflammation.

  • Performing specific exercises given by a physiotherapist, or doctor, to help gently move and strengthen the back. You can find exercises that can be beneficial for disk injuries here: Flexion Pain - Exercises for back pain





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This article was last reviewed and updated October 2010

 

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: : Ruptured Disk

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