Prolapsed or ‘slipped’ discs in the back are a common cause of pain, and may occasionally cause more serious health problems such as nerve damage and bowel or bladder difficulties. You may wonder just how easy it is to know if you have a slipped disc, and whether it is possible to feel one with your hand if it happens. In this article we look at if this is something that can be done, and the correct way to have a possible slipped disc investigated. First, let’s remind ourselves about the anatomy of our spine (our backbone).
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A slipped disc, also known as a herniated or ruptured disc, is a common medical condition that affects the spine. The spine is composed of vertebrae, and between each pair of vertebrae is a rubbery disc that acts as a cushion or shock absorber. These discs have a tough outer layer (annulus fibrosus) and a soft inner gel-like substance (nucleus pulposus).
A slipped disc occurs when the soft inner material of the disc pushes through the tough outer layer and protrudes into the spinal canal. This can happen due to age-related wear and tear, injury, or other factors that put stress on the spine. When the protruding disc puts pressure on nearby nerves, it can cause pain, numbness, and weakness in the affected area.
Slipped discs are often caused by excessive strain or pressure on one part of the spine. Things that make slipped discs more likely to occur include:
Increasing age. As we get older, the discs in our spine lose water content and so can become less flexible, making them more prone to tearing or rupturing even with minor strains or twists.
Incorrect lifting techniques. Lifting heavy objects awkwardly in general or during weight training can contribute to disc herniation. Doing things like bending over at the waist instead of using the legs to lift, or lifting and twisting at the same time, can put excessive strain on your back.
Genetics. If your family has a history of disc problems, you may be more slightly more at risk of developing one yourself.
Repetitive strain. Being involved in activities that involve repetitive movements or constant vibration, such as heavy lifting or driving for long periods, can be a factor in causing a slipped disc.
Being obese. Excess body weight can put increased stress on the spine, leading to disc problems.
Trauma or an acute injury. Sudden injury, such as a fall or a blow to the back, can cause a disc to rupture.
Smoking. Smoking has been linked to an increased risk of disc degeneration, which in turn can make a slipped disc more likely.
Poor posture. Slouching or sitting for extended periods without proper support may increase the risk.
There are four main stages of a slipped disc, ranging from mild to severe:
1. A bulging (protruding) disc
This is the earliest and mildest of disc prolapses and is sometimes known as an incomplete herniated disc. In this stage, the jelly-like disc centre (called the nucleus pulposus) starts to move out of its normal position and pushes or ‘bulges’ outwards. This may cause few symptoms and sometimes none at all.
2. A prolapsed disc
With a prolapsed disc, the disc bulge presses further outwards against the outer shell of the disc. It is at this stage that symptoms often develop, such as pain, numbness and tingling.
3. An extruded disc
Unlike the previous two stages, the disc centre is now no longer contained completely within the disc and symptoms start to worsen. This typically means worsening pain along with tingling, numbness or weakness.
4. A sequestrated disc
The most severe stage of disc herniation is when the inner disc material comes completely out of the disc shell and may fully break off from the disc. By now, pain may be severe enough to cause someone to have difficulty moving, and surgery is the usual treatment.
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No, it is not possible to feel a bulging disc with your hand.The spine discs are too deep inside your body to be felt by your hand, with layers of muscle and ligaments over them.
Some people think they may be able to feel a slipped disc, when in fact they are feeling a knot of muscle spasm in the back muscles that can occur when a disc prolapses.
In the early days of a slipped disc, it may be tricky to distinguish between it and a pulled muscle. However, the symptoms of a muscle strain typically last one to two weeks, usually in one part of the body, and cause stiffness in the lower back, pain in one muscle area, and difficulty standing up straight. Over time though, these symptoms settle away as the muscle strain heals.
With a slipped disc, symptoms can occur in other areas such as shooting pain going down into the legs, weakness, numbness or tingling (like an ‘electric shock’) into the legs (or arms if the slipped disc is high up in the back), pain when standing straight, pain that doesn’t get better, or occasionally bladder or bowel problems. Slipped disc pain can be worsened by sitting, bending, lifting and coughing or sneezing. Slipped discs also usually take much longer to settle than a pulled muscle.
Slipped discs should not hurt when pressed. However, changing your body position can make the pain ease a little for some people - this is because it takes the pressure off the nerves being pushed on by the prolapsed disc.
You should not try to diagnose a slipped disc yourself. You should always see your doctor if you think you may have a slipped disc, or have back pain that does not improve. They will examine you thoroughly, including assessing your pain, muscle reflexes, sensation and muscle strength. They may also arrange for you to have tests such as a magnetic resonance imaging (MRI scan, which is the most accurate imaging test for a suspected slipped disc as well as X-rays to help rule out other causes of back or neck pain.
As a general rule, if you develop severe neck or back pain following an injury you should seek urgent medical attention.
If your symptoms have any of the following associated features, you should seek urgent medical attention;
Severe pain: if you have intense and persistent back pain that doesn't improve with rest or over-the-counter pain medications.
Numbness or tingling: if you are experiencing numbness or tingling, especially in the arms or legs.
Muscle weakness: if you notice weakness in your muscles, particularly if it's affecting your ability to walk or move normally.
Changes in bowel or bladder function: any changes in bowel or bladder function, such as difficulty controlling your urination or bowel movements, may be signs of a more serious issue and should be addressed promptly by a healthcare professional.
Pain going down your legs: pain that radiates down one or both legs - usually known as sciatica - may indicate a significant problem with a disc in your spine.
If you do not have any of the above features, you should see your doctor if your back pain has failed to improve after six weeks or if it is associated with swelling, pain worse at night or recent unintentional weight loss.
Because you cannot tell by touching your back if you have a slipped disc or not, always seek medical advice if you think this may be a possibility so that you can get a prompt accurate diagnosis as to the cause of your symptoms, and have the correct treatment programme commenced.
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