Slipped (Herniated) Disc - Diagnosis & Treatment

How is a slipped disc diagnosed?

In most cases, a slipped disc can be diagnosed based on your symptoms, history and a physical examination.

Physical examination

During the physical examination, your doctor will check your nerve function and muscle strength to look for the source of your pain and discomfort. You may be asked to lie on your back and move your legs in certain ways to determine the cause of your pain.

Your doctor may also:

• Check your back for tenderness
• Perform a neurological exam to check your reflexes, muscle strength, walking ability, and ability to feel light touches, pinpricks or vibrations.

Imaging tests

In addition, your doctor may order one or more of the following tests to confirm the diagnosis and determine which nerves are affected:

• Magnetic resonance imaging (MRI) scan, which is currently the gold standard for diagnosing slipped discs.
• Computerised tomography (CT) scan, which takes a series of X-ray images and combines them to create cross-sectional images of the spinal column and surrounding structures.
• X-rays, to rule out other causes of back pain such as an infection, tumour, spinal alignment issues or a broken bone.
• Myelogram, to examine the spinal cord and nerves.
• Electromyogram (EMG), to evaluate the electrical activity of your muscles when they contract and when they are at rest.
• Nerve conduction studies (NCS), to measure electrical impulses in your nerve signals when a small current passes through the nerve.

How is a slipped disc treated?

The treatment for a slipped disc depends on the severity of your condition. If you have a mild case of slipped disc, your doctor will usually recommend conservative treatment options first.

Non-surgical treatment

Your doctor may recommend one or more of the following:

• Rest
• Topical pain relief such as hot or cold packs. Cold packs can help to reduce inflammation and heat after 2 or 3 days. Alternating warm and cold packs may provide some relief from sciatica pain.
• Pain medication such as non-steroidal anti-inflammatory drugs (NSAIDS) to relieve mild to moderate pain. If your pain does not improve with oral medications, your doctor might recommend cortisone injections or muscle relaxants to help manage muscle spasms.
• Physiotherapy and rehabilitation to reduce pain and sciatica and minimise the risk of recurring injury. A variety of active treatments are available to help address flexibility, posture, strength, core stability, and joint movement.

Surgical options

Your doctor may recommend surgery if:

• Your condition is more severe
• You were unable to gain relief through non-surgical treatment
• Pressure on the spinal cord is causing health-related complications such as incontinence or difficulty walking

In such cases, your surgeon will usually perform a discectomy to remove a portion of the herniated disc. This will alleviate pressure on the nerve, relieve pain and improve leg and back strength.

Speak to an orthopaedic surgeon to determine the most suitable treatment for you.