Disc ruptures have a number of synonyms, the most common being “disc herniation” and “slipped disc”. Intervertebral discs do not actually slip because they are tightly bound to the bones of the vertebral bodies above and below and their structure is similar to that of a very thick walled car tyre where the wall is thick fibrous tissue and rather than having air in the middle of the disc we have a jelly-like material called “nucleus pulposus”. The wall of the intervertebral disc (“annulus fibrosis”) has a tendency to split at the back, normally to one side or the other but occasionally in the middle.
All our nervous tissue, so the spinal cord and all the nerve roots, sits behind the intervertebral discs so if you get a split in an intervertebral disc and the rupture or herniation of some of the nucleus backwards onto nerve tissue nerves can be compressed. When nerve roots are compressed or chemically irritated, because the disc material is highly irritant, this can cause severe pain in a line along the course of the affected nerve root. The nerve roots most likely affected are those in the low lumbar spine, so the nerves at S1 and L5 and to a lesser extent L4, and in the neck the levels most commonly affected are those from C5 to C7.
If you have pain in your neck or your upper back, around your shoulder blade, going into your shoulder or down your upper arm into your forearm or hand you may well have a ruptured disc in your neck. Similarly, if you have pain not so much in your low back but more in your buttock or the outside or back of your thigh, the outside of your calf or ankle then you may well have a ruptured lumbar intervertebral disc.
We have a particular interest in managing patients with these problems and can help keep most patients away from surgery so please contact us to come to see us. We will arrange the appropriate investigations, which could include an MRI scan, and will offer you the most appropriate treatment to control your symptoms and get you moving again normally as soon as possible.