Do I have a slip disc?
M.D. (Medicine), D.M. (Neurology)
Fellowship in Multiple Sclerosis (UWO Canada)
Fellowship in Movement Disorders (UWO Canada)
Consultant Neurologist
Q: I am a 36 years old male underwent a MRI scan which showed slip disc in L5-S1. After that I consulted many doctors but all doctors have their own different opinion about this. Even some doctors are saying l have no slip disc. My uric acid is 6.5. Am I suffering from slip disc?
A:Slip disc is a very common occurrence. Our vertebral column has 33 bony vertebrae arranged one atop another with a rubberlike disc between each pair except first two and last 5. This disc joins the vertebrae, allows movement and flexibility of spine, and absorbs shock and pressure over the vertebral column. Just behind the disc, in the hollow of the vertebral column, lies the bundle of nerves called spinal cord which connects the brain to all other parts of the body below neck. At the level of each disc, a pair of nerve roots (small bundles of nerves) come out from the spinal cord on each side and proceed to become the nerves of the body (hands / trunk / leg according to the level of exit). These nerves carry all sensation to the spinal cord and above up to the brain, and also carry out movements as guided / ordered by the brain. Hence, when any of these structures (spinal cord / nerve roots / nerves) are affected by disease or compressed, they produce either weakness or numbness or tingling over the region they supply.
Many a times, due to aging, strenuous activity, twisting, accidents, etc., the intervertebral discs move out of their place. This may cause transient pain at the level of such slipped disc, or in some cases, the disc may compress the nerves. Many of us have such slipped discs after the age of 35. However, not all discs slip enough to cause pressure on the nerves. Hence, unless the slipped disc is associated with either severe persistent pain (beyond 6 weeks), or neurological symptoms like weakness, pain or loss of sensation / tingling, it is advisable not to operate. It is advisable to try conservative approach with physiotherapy, lifestyle modification, yoga etc.
Nowadays, because of MRI scans (which show minor and major slip discs) many patients are often given a wrong impression and advised surgery without justification. It must be remembered that unless one has persistent pain, weakness or loss of sensation or bladder / bowel control, a surgery for slip disc is rarely required.