Back Pain Explained - What is a Prolapsed Disc?

So what actually happens with a prolapsed disc? Well, for a start there's no difference between them. Just different names for the same thing!

A Doughnut...

We first need to understand a little more about the disc. Hmmm, the best way to describe it is a jam doughnut! Yes, a jam doughnut just like the one Homer Simpson eats!

I say this because the disc in your spine has a similar structure. The disc is made up of a lot of water with an inner core (which is the jam in our doughnut example). People talk about maintaining a good posture because it will keep the disc in a good position. The central core is in a safe place with minimal pressure on it.

Like a doughnut, the jam can be squeezed around depending on where you put the pressure on the bun. If you squeeze it too hard, then the jam will escape.

It is just the same in the spine. When you bend forwards, the pressure is place on the front part of the disc. This has the effect of squeezing the disc core (shown in red) backwards. The more bending you do, the more you are encouraging the disc to move in a backward direction.

If you decide to lift something with your back bent, then you are adding a tremendous force to your disc. Basically you are asking for trouble!

Prolapse, Herniation...it's all the same thing!

And so, if pressure is placed onto a part of the disc, the central core material will be squeezed to the area of least pressure (think of the doughnut!). In the diagram you can see what happens when someone bends over. The disc material tends to move backwards (the word 'bulge' and 'prolapse' mean the same thing).

As the disc core moves backwards it bulges out into the outer wall. This is when you get a disc bulge, prolapsed disc or slipped disc! In some cases, the outer casing is weakened so much that the central core breaks through the outer disc layer. It then escapes into the spinal canal and can put pressure onto the nerves!

What, Who and Treatment?

Symptoms of a prolapsed disc can vary widely. It ranges from simple localised lower back pain to full blown sciatica with raging leg pain and/or numbness.
It can occur in any age group but tends to be between the ages of 20-40 when the disc is at its most mobile.

Treatment is usually conservative with physiotherapy but it depends upon the severity. Modalities to relieve the pain and to strengthen up the core muscles of the trunk are required. In the most extreme of cases, surgery may be necessary to remove the fragments of disc to take the pressure off the nerves.

Disc Prolapse, Disc Herniation or Slipped Disc?