Recovering from a slipped disc

Written in association with: Mr G Michael Hess
Published: | Updated: 03/07/2019
Edited by: Cal Murphy

The spine. The literal backbone of our bodies, it provides structural support as part of the skeleton, as well as hosting a large part of the central nervous system. For this reason, spinal injuries can be very serious. One more common injury is when the spinal discs that sit between the vertebrae herniate, or slip out of place. We asked leading orthopaedic surgeon Mr G. Michael Hess the important questions about slipped discs.

What causes a slipped disc?

A slipped disc usually develops on the base of long-lasting degeneration. The outer part of the disc, which is comprised of several layers of fibres (the annulus), is gradually weakened and one layer after the other is torn due to the degeneration. The inner part of the disc (the nucleus), is then pushing outside and before the last layer of the annulus is ruptured, the patients may feel a constant low back pain.

In this situation, the lifting of a heavy crate or a forward bending posture may be enough to provoke the actual disc herniation. This is usually described by the patient as a severe sciatica, which is an electric shock pain in the leg, whereas at the same time the low back pain stops.

 

How do you diagnose a slipped disc?

The standard examination to diagnose a slipped disc is an MRI scan of the affected part of the spine, in most cases the lumbar spine. However, a clinical exam is also necessary, especially to assess a neurological deficit like weakness or numbness in one or both extremities.

 

Can a slipped disc heal on its own?

Yes, indeed, a slipped disc can heal on its own. More precisely, the extruded disk fragment can be absorbed; after a couple of weeks or months the pain has subsided and it is no longer visible on another MRI scan.

When seeing the disc herniation on the initial MRI scan, it is possible to predict if this is likely to happen or not.

If there has not been any improvement over four to six months, it is very unlikely that the slipped disc will heal on its own.

 

Can you treat a slipped disc without surgery?

While there is still a possibility that the slipped disc will heal on its own, as described above, it is necessary to relieve the patient’s pain as well as possible. This is usually done either with pain medication and physiotherapy or more effectively with image-guided injections around the affected nerve root (transforaminal epidural injections).

These injections help to reduce the inflammation and swelling of the nerve and thus reduce the pain.

 

When does a slipped disc require surgery?

Every indication for surgery is done on an individual basis and after detailed discussion with the patient.

Surgery is indicated if the aforementioned injections are not effective in relieving the pain and the pain is so intense that the patient is severely limited in his daily activities. A very clear indication for an early surgery is the existence of a neurologic deficit with a functionally relevant weakness in arm or leg. In these cases an early surgery is recommended. 95% of all lumbar disc herniations requiring surgery can be operated endoscopically through a 1cm skin incision and in most cases as an outpatient procedure.

 

Visit Mr Hess’s Top Doctors profile to book an appointment.

By Mr G Michael Hess
Orthopaedic surgery

Mr G. Michael Hess is a highly skilled consultant orthopaedic spinal surgeon based at the London Spine Clinic and the KIMS Hospital (Kent). He specialises in minimally invasive and endoscopic spinal surgery, treating conditions such as sciatica, slipped discs, and osteoporosis of the spine. He founded InsightSpine in 2016, offering an in-depth spinal disc pain service in London and Maidstone (with Dr A. Hammond), Munich and Lisbon (with Dr A. Barbosa) respectively. 

Mr Hess, who possesses a PhD in orthopaedics, qualified from the Heinrich Heine Universitat Dusseldorf in 1995, before undertaking training in trauma surgery in St. Moritz, Switzerland and at the Spine Center at Orthopaedische Klinik Muenchen-Harlaching. He also undertook a fellowship in spine surgery and interventional radiology at the University Hospital in Quebec City. Following this, he was made lead of the Back Pain Center at Orthopaedische Klinik Muenchen-Harlaching. 

Mr Hess's years of experience have given him expertise in a wide range of endoscopic techniques and thanks to this, he has gained an excellent, world-renowned reputation in the field of minimally invasive spine surgery and interventional pain therapy. Impressively, he helped to perform the world's first successful fully endoscopic nucleus replacement surgery in 2009 and is currently the principal clinical investigator of an international multicenter study for a novel nucleus implant. To add to what is an already-stand-out medical cirriculum, he is also the former president of the German Interventional Spine Society. 

To-date, the exceptional Mr Hess has presented over 200 scientific papers, and since 2003, has held the position of Master Instructor for Spine Intervention Society (SIS) in the US and Europe. He has recently been offered to be a proctor for spinal endoscopy at the Royal National Orthopaedic Hospital, Stanmore

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