03 Sep What’s the Best Treatment for a Slipped Disc?
A slipped disc can cause severe and intense back pain. This intense pain is chronic and often unrelenting. Back pain is a common condition across the United States and accounts for the single biggest contributor to sick days across the country. Some 80% of Americans will experience back pain in their lives – with 10% of Americans experiencing this pain on a day to day chronic basis. A significant proportion of these has a slipped disc. But what is a slipped disc and what treatments are best?
What is a slipped disc?
The spine is made up of bone known as vertebrae that give us our posture and protect the spinal cord. Between these bones are spongy discs of cartilage that stop bone on bone contact (which is incredibly painful), absorb shocks and provide movements and flexibility to the spine. A slipped disc occurs when the inner layer of the disc (the nucleus pulposus) breaks out of the outer layer of this disc (annulus fibrosus). The slipped disc can compress the nerves in the back and cause significant pain.
What treatments are available?
Treatments for patients with less than 3 months of back pain:
- Paracetamol or NSAID (non-steroidal anti-inflammatory drugs). These painkilling drugs work by reducing the inflammation surrounding the slipped disc. This inflammation causes pain signals to be sent to the brain and so reducing it reduces the pain felt by the patient.
- Patients may be offered opioid drugs like codeine or morphine. These aren’t long-term solutions as they are addictive but can be a short-term solution
- Muscle relaxants can also be offered like acupuncture or yoga. This can reduce muscle spasm that contributes to the pain.
- Facet joint injections of anti-inflammatory corticosteroids can also be offered to reduce inflammation and pain.
- Some patients may be offered surgery to reduce the pain if the nerve that is being compressed is at risk of being permanently damaged
Treatments for patients with more than 3 months of back pain:
- At this point – patients will continue to be offered the treatments suggested above but now pain specific teams are often involved.
- Some patients benefit from a small dose of the antidepressant amitriptyline. The drug is good at reducing the electrical shooting like pains caused by nerve compression. It may also help patients sleep.
- Rehabilitation classes that provide emotional support can also be an option
- Again, alternative therapies such as acupuncture can help some patients
- Drugs like pregabalin (which is an antiepileptic) is helpful in some patients.
- If other options have failed then surgeries such as spinal fusion or nerve decompression can be tried.
Which is best?
Unfortunately, there is no one size fits all treatment for a slipped disc – and treatment is dependent on the individual. As such it is essential that if you or somebody you know is suffering from a slipped disc that you get in contact with a specialist clinic that can tailor make a plan of action for your specific needs.