A slipped disc occurs when the soft cushion of tissue between the bones in the spine pushes out. It can happen in a moment of bending, twisting and lifting – especially if you’re making these motions at the same time. In other cases, poor posture is a contributor as is heavy lifting and poor muscle control.
We’ve asked consultant rheumatologist Dr Anthony Hammond for his advice on how to prevent a slipped disc and what the treatment options are if it does unfortunately happen.
Is it possible to prevent a slipped disc?
Yes and no. The disc can just 'go' from bodyweight and with normal or trivial excess use it is not possible to avoid these problems completely if you have been “blessed” with weak discs.
These problems run strongly in families and twin studies have shown a highly heritable component, so there may be nothing you can do to completely avoid issues arising. That said, keeping fit, maintaining posture and abdominal muscle strength can all help.
In short, you should do as gran said: “sit up straight, don’t slouch and walk upright….”
Disc problems and sciatica (a compressed nerve) are very treatable but frequently badly managed. Usually, a brief spell of rest of two days might be needed with painkillers to help relieve the worst of it. Then physiotherapy is accessed.
Many episodes will settle with this but if they do not or if the pain is severe or if there is weakness or numbness then specialist help should be sought early. An MRI scan will usually be taken.
In my practice, sciatica can readily be treated by targeted steroid injections to the affected nerve root called transforaminal epidural steroid injection. These are evidence-based and proven techniques for the rapid control of pain, while nature takes its course.
Many patients will need no more than one or two injections. If this does not settle things then I can perform an endoscopic discectomy. This is the equivalent of conventional open surgical “micro” discectomy but performed through a 1cm skin incision without opening the spinal canal using a medical scope. It can be performed as a day case and recovery from the operation takes only a few days.
What about a partially slipped disc – what are my treatment options?
Finally, the most difficult and most neglected issue is mixed back pain and sciatica due to a bulging but not fully slipped disc. There is no conventional surgery for this, MRI scans are frequently under-reported and patients may be left to suffer long-term.
I have a day case minor operative procedure to reduce the bulge by decompressing from the middle of the disc and heat sealing the back wall called DISC-FX. The procedure is routinely effective in reducing or abolishing disc-related back pain even after decades of trouble.
Do not hesitate to book an appointment with Dr Hammond if you need to have your back pain checked.
Dr Anthony Hammond is a highly respected consultant rheumatologist and leading specialist in minimally invasive pain management based in London. He is renowned for his expertise in rheumatoid arthritis, inflammatory arthritis and in the interventional management of spinal pain problems, including slipped disc and trapped nerve, amongst others. More recently, Dr Hammond has continued to develop his range of treatment options gaining expertise and collaborating with leading experts in Regener...
DrAnthonyHammond is a highly respected consultant rheumatologist and leading specialist in minimallyinvasivepainmanagement based in London. He is renowned for his expertise in rheumatoidarthritis, inflammatoryarthritis and in the interventional management of spinalpainproblems, including slippeddisc and trappednerve, amongst others. More recently, Dr Hammond has continued to develop his range of treatment options gaining expertise and collaborating with leading experts in Regenerative Medicine including stem cells (BMAC and Lipogems) and activated plasma (PRP and Goldic) treatments for advanced osteoarthritis of joints, degenerative disc disease, spinal stenosis and other common and hard to treat problems.
Dr Hammond qualified in medicine from Edinburgh Medical School in 1980 before pursuing further training in general medicine and rheumatology in Bristol, Bath and London. During this period, he trained at a number of esteemed institutions including The Royal National Hospital for Rheumatic Diseases (the Mineral Water Hospital), Bath, The Royal Postgraduate Medical School, Hammersmith Hospital and St Bart’s Hospital, London. In 1992, he was awarded a medical doctorate, with his thesis specialising in the immunopathology of systemic lupus erythematosus (SLE). Dr Hammond served for many years as a general physician and rheumatologist at Maidstone Hospital, later establishing the rheumatology department while combining his practice with clinical research.
He developed his interest in spinal pain management through the teaching and training of the International Pain and Spinal Intervention Society (IPSIS) and is now a senior tutor for this prestigious organisation. He was a founding partner of The KIMS hospital, Kent and now works in private practice in a number of prestigious organisations including: The London Clinic, HSSH Harley Street Specialist Hospital, Living Room Health, The Castle Quay Medical Practice, London Medical, the highly respected musculoskeletal centre The Fortius Clinic London, and is also part of The Regenerative Clinic group for collaborative development of stem cell therapy for spinal pain. After spending a year on Jersey as part of a States led review of service he is establishing a private practice in St Helier. He is a registered Medical Cannabis prescriber for complex chronic pain and fibromyalgia syndrome.
With an extensive portfolio of academic publications, Dr Hammond is widely regarded as a leading practitioner due his rare expertise in both medical rheumatology and advanced interventional pain management. He continues to be an active researcher and collaborator in a number of ongoing clinical trials. He also holds various teaching responsibilities and is a European instructor and member of the International Spinal Intervention Society. With his wealth of clinical experience, Dr Hammond also serves as a highly esteemed medicolegal expert.
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