Is it a slipped disc?

Feeling the pain first zip down an arm or leg, this is very often the first question that leaps to mind. The answer isn’t necessarily Yes. But why would it “slip?”

When you first feel that pain in the very lower part of your back, the electric sensation in your calf, and that immobilizing feeling that makes you want to drop to the floor—you might want to heed your body’s request and lie down for a moment. Then reach for this newsletter again, and recall the following:

“Slipped discs” are often assumed to be the cause of sciatica (pain down the leg), but they aren’t quite as common as we think. For example, back pain and neck pain are only rarely caused by disc problems. Still, this is not to deny that discs can cause problems.

Discs are located between each level of the spinal column. They consist of numerous layers of tough fibers surrounding a semi-fluid core. They function, essentially, as shock absorbers. And they do their job very well, for the most part. Over the years, however, discs gradually lose their capacity to absorb shock, and they start to break down, or degenerate. Smoking, overweight, some repetitive physical tasks and positions, and even heredity can speed up this degeneration. The disc may start to bulge to one side (it doesn’t literally “slip.”) If the disc material pushes in the direction of the spinal cord and spinal nerves, these may become irritated. The resulting “nerve pain” is often felt to shoot down an arm (if a disc in the neck) or a leg (if the low back is involved)—the classic pain of sciatica. More rarely, nerve compression can also begin to cause muscle weakness.

While you’re lying down, by the way, I suggest you ice the area for 10 minutes at a time, leaving 45 minutes to an hour between applications. Many people choose to use heat instead, but that may be counterproductive. You should NOT stay in bed all day, and definitely not beyond two days. Try lying on your stomach and easing yourself gently up onto your elbows for a minute, several times a day, but only if it feels good.

You are probably still wondering whether this is a disc problem. Recall that many types of pain that radiate along an arm or leg are not disc-related. For example, a dull, vague pain in the leg or arm is most often not a disc. If, on the other hand, the limb pain gets suddenly sharper or shocklike with bending forward, a disc may be involved. Unfortunately, there are exceptions in both scenarios, and self-diagnosis can be unreliable. If the pain is persistent or severe, it should be examined professionally.

Whether you are recovering from a disc problem, or are feeling fine and simply want to prevent a problem, you can maintain or improve the health of your spine and discs (and stay away from doctors) by:

• not smoking;
• regularly getting moderate weightbearing exercise—especially walking;
• losing weight if necessary
• changing positions at least every 30 minutes if your job or lifestyle is sedentary;
• using appropriate lifting strategies if your job involves physical labor. Always avoid the combination of bending, lifting, and twisting.