What is Prolapsed Disc?
Written by Neil Badlani, M.D., Chief Medical Officer, North American Spine

A Prolapsed (sometimes referred to as a “slipped” or “herniated”) disc is a medical condition which can cause an individual to suffer from serious pain or discomfort. When this condition occurs, it is referring to the protrusion, bulging, or inflammation a spinal disc. In this situation, the inner parts of a spinal disc have been allowed to stick out through the outer disc’s layer because of a specific weakness in that section of the disc.

The middle-part of the disc is called the nucleus pulposis and the outer-part, in medical terms, is referred to as the annulus fibrosis. The protrusion involved in the establishment of a prolapsed disk can irritate a nearby nerve on the spinal cord or may cause high levels of inflammation, leading to discomfort, pressure, or swelling. No spinal disc is exempt from the development of prolapsing. However, these prolapsed discs are most commonly detected in the lumbar spine, or the lowest part of the back.

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More About Prolapsed Disc

lumbar foraminotomy

Learning the different parts of the human back is important when considering how exactly a prolapsed disc occurs. All of the bones that make up the spine are referred to as vertebrae. There are many vertebrae throughout the spine and in between each of these bones exists a disc to hold them together and also to assist the spine with its’ flexibility and entire range of movement. These discs contain the aforementioned nucleus pulposis and the annulus fibrosis.

A “prolapsed disc” refers to these two specific areas within the spine. If a doctor determines the cause of a patient’s back problems are due to the protruded disc pushing on a nearby nerve, the doctor is referring to a nerve that originates from the brain and descends into the spinal cord. Lifestyle factors, age, dietary habits, and physical stress may all cause the discs to become brittle or weakened over time. 

Even though many terms are used to describe a prolapsed disc, there are distinct differences between the various terms. A prolapsed disc specifically refers to the condition in which the exterior part of an intervertebral disc has become vulnerable to deformation, permitting the less viscous interior part to negatively impact the integrity of the disc as a whole. 


If a patient complains of lower back pain, it is possible that a protruding disc is the cause. A medical professional should be able to determine if a disc has protruded and where in the spine it is located, if at all. Even though any one of the multiple intervertebral discs in the spinal column can be susceptible to prolapsing, they are most commonly found to originate in the lumbar spine. This area is most vulnerable to problems with spinal discs because the lumbar region has more pressure and more demand placed on it than other parts of the back do.

If too much weight, strain, or pressure is placed on vulnerable areas in the spine, the risk of developing a prolapsed disc increases. In the event that a prolapsed disc occurs, doctors are able to treat it with various treatment options.

What are the symptoms?

The most obvious, blatant symptom associated with a Prolapsed disc is the sudden onset of severe back pain. Signs of Prolapsed Disc pain should not be ignored and any individual experiencing this sudden pain should see a doctor as soon as possible. This back pain is usually only mitigated or lessened if a patient is completely still in a reclined, supine position.

Prolapsed Disc pain is sometimes made worse by sneezing, laughing, coughing, or even by participating in small movements that shift the back even in a minimal way. Other symptoms associated with a Prolapsed disc include:

  • Tingling sensations
  • Distinct numbness
  • Overall weakness

If a disc is causing inflammation to occur in a particular area because of its subsequent pressure on a nerve, nerve root pain may occur. This distinguishing nerve root pain can affect any area of the body, not just the back. Although its origin may be the pinching or pressure of a nerve in the back, its effects can be felt as far down as the leg or foot. This pain is often expressed as a mild to severe burning sensation. Even so, a prolapsed disc may occur without a patient experiencing any of these more severe symptoms.

 

 

How is a Prolapsed Disc Diagnosed?

•  Symptom Assessment:

A licensed and qualified medical professional will be able to perform an examination in order to determine if a Prolapsed Disc is the cause of a patient’s ailments. Because a Prolapsed Disc is the top cause of the onset of sudden and intense back aches, if this is a symptom, a doctor may be able to diagnose it or assess it as a prolapsed disc rather quickly. Sometimes these symptoms subside on their own, depending on the severity of the case.

•  Diagnostic Imaging:

A doctor may request the patient go for more testing in order to accurately diagnose a Prolapsed Disc. Other tests such as X-rays or an MRI may be administered. These tests are helpful in pinpointing the location of the prolapsed disc and will be vital information if surgery is recommended to alleviate the patient’s symptoms.

What are the causes of a Prolapsed disc?

low back pain

Our bones and ligaments typically weaken and deteriorate as we age. Thus, age can be a factor in the development of a prolapsed disc. A poor diet can also weaken the structures within someone’s body, rendering them more susceptible to this condition.

Additionally, too much exercise (or the wrong kind of exercise) can cause major stress and strain on the body, sometimes a prolapsed disc occurs because of overdoing it. These spinal discs can become weakened or stressed for a variety of reasons. 

Here is a list of the common factors which increase someone’s risk of having a Prolapsed Disc: 

  • Poor Diet 
  • Lack of Exercise 
  • Heavy Lifting
  • Smoking 
  • Obesity
  • High-intensity sports 

How are Prolapsed discs treated?

Treatment and procedure options for Prolapsed Disc range from conservative options like injections to more intensive procedures like spinal fusions.

Conservative Options

Conservative treatment options include nerve root blocks and steroid injections. These are designed to provide temporary relief (up to one year), and you may elect to have the procedure done multiple times. Other conservative strategies may include the placement of a spinal cord stimulator–or STIM–which is designed not to correct the underlying degeneration, but to lessen the pain the condition causes.

Decompression

Conservative treatment options include nerve root blocks and steroid injections. These are designed to provide temporary relief (up to one year), and you may elect to have the procedure done multiple times. Other conservative strategies may include the placement of a spinal cord stimulator–or STIM–which is designed not to correct the underlying degeneration, but to lessen the pain the condition causes.

Fusion/Stabilization

Conservative treatment options include nerve root blocks and steroid injections. These are designed to provide temporary relief (up to one year), and you may elect to have the procedure done multiple times. Other conservative strategies may include the placement of a spinal cord stimulator–or STIM–which is designed not to correct the underlying degeneration, but to lessen the pain the condition causes.

How Much Does Treatment Cost?

Treatment cost depends on several factors, especially what insurance you have and how much of your deductible has been met. IN the last two years, 90% of our patients have paid less than $2000 out-of-pocket. Some have paid literally nothing, and other have paid much more than that. It depends. The good news is: our Patient Care Managers will handle as much as they can directly with your insurance company, and all your costs will be known up-front.

Important note: spine surgery often pays for itself within a year or two. Many people actually spend more money trying to live with the pain than they do getting the pain fixed. The following calculator is intended to give you a sense of what you spend on managing—rather than eradicating—your pain.

Calculate how much you've spent on back pain this year.
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This past year you have spent on your pain treatment:

Get surgery now. Getting surgery now is the smartest financial move. Over the last two years, the average North American Spine patient spent around $2,000 out-of-pocket for treatment. You’ve spent that much or more this year to manage your back pain than you could to fix it.

Get surgery soon. Over the last two years, the average North American Spine patient spent around $2,000 out-of-pocket for treatment. At your current rate, you will spend that much or more within the next two years. The sooner you get treatment, the sooner it will pay for itself.

Keep an eye on your spending. Currently, you are managing your pain efficiently from a financial perspective but over time, your expenses could add up. Surgery should be strongly considered if you start missing more work or spending more on treatment medication.

Great job! You are spending very little on your back pain. Keep it up!

Equipment Used in Diagnosis and Treatment of a Prolapsed Disc

If a disc is putting pressure on a spinal nerve, an IntelliSpine procedure may be performed. This is a minimally invasive, outpatient procedure which involves the physician making a small incision in the sacrum. Then, the physician will guide a camera into the opening in order to garner a complete view of any prolapsed disc or other spinal condition affecting the patient’s quality of life. This procedure then utilizes a laser in order to reduce the protrusion from the disc. Traditional open back surgeries require an extreme amount of recovery downtime, making laser spine surgery the preferred surgical method. 

How Does Prolapsed Disc Compare to Other Spine Conditions?

Some conditions may mimic or closely relate to the symptoms associated with the development of a Prolapsed Disc. Some similar spinal conditions include:

  • Degenerative Disc Disease
  • Bulging Discs
  • Herniated Discs 
  • Scoliosis 
  • Spinal Stenosis
  • Foraminal Stenosis 
  • Pinched Nerves 
  • Sciatica 
  • Facet Joint Disease
  • Annular Tears
  • Bone Spurs 
  • Disc Extrusion 
  • Sacroiliac Joint Pain 

Some of these conditions may make a patient more susceptible to developing a prolapsed disc, while others may have been caused by a prolapsed disc. Bulging discs and herniated discs are sometimes used interchangeably to refer to a prolapsed disc, although this is not always correct. A bulging disc is generally a less severe deformity of the inner casing of the disc. On the other hand, a herniated disc involves the actual damage and tear of an intervertebral disc. For this reason, protruding discs are most closely associated with bulging discs.

Scoliosis also causes pain in the back but has no known cause and is typically resolved with decompression, fusion and stabilization. There are many different kinds of decompression surgeries as well as fusion surgeries.

Degenerative disc disease may lead to a prolapsed disc. It may also lead to the development of some of the other listed conditions like sciatica.

Sciatica may also be caused by a prolapsed disc if the disc is creating pressure upon the sciatic nerve.

Other conditions, such as bone spurs, can produce the same symptoms that a Prolapsed disc does. Bone spurs, for example, also may be found in the lumbar spine and may produce severe pain, numbness, tingling sensations, burning pains, and general weakness.

Because of the overlap in names, symptoms, and conditions, it is important that each patient see a specialist for accurate diagnosis and evaluation.

Analogy: Blow-Out vs Flat Tire

A bulging disc is like a flat tire, a prolapsed disc is like a blowout. When you have a flat tire, the wheel’s material loses its shape, but it stays more or less together. In a blowout, the inside of the wheel becomes exposed to the outside.

Both conditions can cause pain, and both should be professionally evaluated. And don’t forget: a bulging disc (flat tire) can progress to become a prolapsed disc (blowout).

Blow-Out

Blow-Out = Instant Rupture

Flat Tire

Flat Tire = Slow Leak

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