Slipped disc or herniated disc?

Dr Nigel Kellow,

As we grow older the first degenerative changes generally seen in the spine are within the intervertebral discs themselves.

The nucleus of the spine starts to become dehydrated. As this drying out progresses the nucleus shrinks and the disc starts to lose it's cushioning effect. The annulus can also weaken and split (see diagram), most often at the back of the disc, where the spinal cord and nerve roots to the arms and legs lie. With the high pressures inside intervertebral discs as a result of standing upright a split in the annulus allows material from the nucleus to push backwards towards the weakness. This causes a bulge in the disc, which is known by several different terms, such as disc bulge, prolapse, or herniation, but it is more widely known as a “slipped disc”. Sometimes the annulus splits completely allowing nuclear material to enter the spinal canal. 

Disc Herniations, Sciatica and Brachialgia

Slipped discs - or what we now call disc herniations tend to occur most at the lower end of the lumbar spine and also in the lower levels of the cervical spine. These herniations can cause pain in the back or in the neck, but more often they cause severe burning pain in a line down the leg or arm due to pressure from the bulging disc or nucleus material pressing on a nerve root. This nerve root pain is generally excruciating and does not respond very will to conventional painkillers. When the nerve pain is in the leg and due to a lumbar disc herniation it is called sciatica. When it is in the arm and due to a cervical disc herniation it is called brachialgia.

The pain from disc herniations tends to subside after a few days or weeks with simple painkillers. If it is problematic injections of steroids guided by x-ray or CT around the affected nerve root can be very effective at relieving pain. If pain persists despite several image guided spinal injections of steroids or if there are neurological complications such as weakness in the arm or leg, then the an operation is indicated to remove the offending material.

For further information - see The Ageing Spine and Understanding Pain and Pain Killers

Relating either to the cervix (the neck of the womb) or to the cervical vertebrae in the neck (cervical spine). Full medical glossary
A condition that is linked to, or is a consequence of, another disease or procedure. Full medical glossary
The abbreviation for computed tomography, a scan that generates a series of cross-sectional x-ray images Full medical glossary
The basic unit of genetic material carried on chromosomes. Full medical glossary
When part of an organ pushes through the wall of the body cavity that normally holds it. Hernias can develop in many different parts of the body. Full medical glossary
An abnormal protrusion (sticking out) of tissue Full medical glossary
One of the tough pads of fibre and cartilage that separate the vertebrae and act as cushions to absorb forces on the spine. Full medical glossary
The part of the back between the lowest ribs and the top of the pelvis. Full medical glossary
Bundle of fibres that carries information in the form of electrical impulses. Full medical glossary

Associated with the nervous system and the brain.

Full medical glossary
Displacement of part of the body below its normal site. Full medical glossary
A pale yellow or green,creamy fluid found at the site of bacterial infection. Full medical glossary
Pain that radiates along the sciatic nerve, which is the main nerve in each leg and the largest nerve in the body. Full medical glossary
Compounds with a common basic structure, which occur naturally in the body. The term may also refer to man-made drugs administered because they act like hormones. Full medical glossary
Relating to the urinary tract. Full medical glossary
Affecting the vertebrae, the bones of the spine, or the joints between them Full medical glossary