Spinal disc problems

What are spinal discs?

There is a spinal disc between each of the bones (called vertebrae) in your spine. The spinal discs act as shock absorbers. The rubbery discs, also known as intervertebral discs, are filled with gel-like fluid, making the spine flexible.

The spinal cord is the bundle of nerves that connects your brain to the nerves in your body, and together, the vertebrae and the discs surround and protect your spinal cord.

What are different spinal disc problems?

Spinal disc problems include:

• prolapsed disc (also known as a slipped or herniated disc) — this is when the inner gel-like material bulges out of a disc and presses on a nerve
• degenerative disc disease this is the natural change that happens to your discs as you age
• infection of a disc known as discitis

What are the symptoms of spinal disc problems?

Back pain

Spinal disc problems often cause back pain. The location and type of back pain will depend on which disc is affected and what the problem is. If a disc in your neck is affected, you may experience pain in your neck.

If you have a prolapsed disc, the pain usually starts suddenly and improves when you rest. However, some people with a prolapsed disc have no pain.

Nerve symptoms

Nerve pain can occur if the affected disc is pressing on a nerve. You may feel pain along the path of that nerve. The pain may be shooting, stabbing, or like an electric shock.

A common type of nerve pain caused by disc problems is sciatica. This is where the affected disc presses on the sciatic nerve, which travels from your lower back down the back of your leg.

Sometimes the pressure on the nerve can make your leg feel numb or weak.

What causes spinal disc problems?

As you get older, the outer layer of the disc becomes weaker, the gel inside becomes harder and the disc becomes thinner.

A prolapsed disc occurs when the outer layer of the disc tears, allowing the gel to leak out. It can tear because of an injury — for example, if you lift something heavy, making your spinal bones squeeze the disc in between. It can also tear because of age-related changes.

You have a higher chance of developing disc problems if you:

• are aged 30 to 50 years
• do plenty of heavy lifting, especially if you don’t use the correct posture
• sit for long periods
• have had an injury or infection in your spine

Discitis is caused by infection spreading to a disc through your bloodstream.

When should I see my doctor?

See your doctor if you have back or neck pain that interferes with your usual activities or doesn’t get better after a few weeks.

See your doctor if your pain is worse at night. This could be a sign of a more serious problem in your spine.

Go to the emergency department immediately if you have back or neck pain with:

• a fever
• trouble controlling your urine or bowel motions
• difficulty moving your arm or leg
• numbness in your arm, leg or genital area

How are spinal disc problems diagnosed?

Your doctor will diagnose your disc problems by:

• talking to you about your symptoms, including pain
• examining you, including checking the movements of your spine and legs, your muscle strength and reflexes

Depending on your symptoms, you might also need to have imaging scans, such as x-ray, CT or MRI scans. This is to rule out any potential rare or serious causes, including spinal cancer, infections, fractures or narrowing of your spinal canal. Age-related changes can be seen on an x-ray. Discs can be seen on an MRI or CT.

However, most people with back pain feel better within 2 weeks and won’t need any scans. Scans can be expensive, may involve radiation and won’t make you get better any faster, so talk to your doctor about whether you need them.

If your doctor suspects your problems are due to an infection, a blood test can help identify the type of bacteria causing discitis.

How are spinal disc problems treated?

The treatment you have will depend on the cause and severity of your symptoms and might include:

• pain medicines, including medicines for nerve pain
• physical treatments such as massage, physiotherapy or osteopathy
• complementary therapy such as acupuncture
• placing a heat or cold pack on the affected area
• keeping active
• exercises to strengthen your muscles and improve your posture
• surgery, such as discectomy or laminectomy — this is used rarely, but may be needed if you have severe nerve symptoms or if you don’t get better with other treatments

If you have discitis, you will need antibiotics for at least 6 weeks.

Can spinal disc problems be prevented?

You can reduce your risk of a prolapsed disc by:

• keeping your body in the correct posture for sitting, standing and sleep
• lifting heavy objects safely, by bending your knees rather than your back
• taking regular breaks to move if you need to sit or stand for a long time
• doing exercises to strengthen your core stomach and back muscles
• maintaining a healthy weight

What are the complications of spinal disc problems?

If a disc presses on the lower part of the spinal cord, it can cause an emergency called ‘cauda equina syndrome’. This is where the nerves needed for bladder and bowel control and sexual function are at risk of damage.