Dr. Sanjay Arora

BDS, MDS( Endodontist),
Special interest: TMJ ( Neuro Muscular Dentistry/ Cranio-Sacral Dentistry, Occlusion,
Special interests in Cranio facial Epigenetics, Master Ceramist,
BSc (Physics)
Location: New Delhi, India

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Slipped Disc

Also referred as PROLAPSED DISC OR HERNIATED DISC. The word slipped disc is a misnomer as in this condition; the intervertebral disc doesn’t actually slips out from its position.

This condition is characterized by weakening of the outer part of the disc through which the nucleus pulposus (inner soft portion of the disc) bulges out. This bulging disc then cause pressure upon the adjacent structures like nerve emerging out of from the spinal cord thereby causing different types of pain the body. Prolapsed disc also results in some inflammation around it.

Slipped Disc

Any intervertebral disc in the spine can undergo herniation or prolapse. The prolapse can differ in size from one disc to another vertebral disc. Usually lumbar part of the spine (lower back region) is commonly seen associated with prolapsed disc. The severity of symptoms is usually directly proportional with the size of the prolapse meaning larger the size of prolapse, more severe is the symptoms.

Back pain is a very common problem experienced by many people. Majority of cases of simple lower back pain are the result of problem in the muscle, ligament or any other structure in lower back. Only very few cases of acute (sudden onset) back pain are found associated with prolapsed disc.

Prolapsed disc is commonly seen affecting people in the age group of 30-50 years. Males are affected twice commonly than females.

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How Is Slipped Disc Caused?

The exact cause for prolapsed disc has not been still clearly understood. It is generally observed that few people suffer from slipped disc, while other people in the same profession or doing similar kind of work remain absolutely fine without being associated with the slipped disc. The main cause for occurrence of slipped disc is thought to be the weakening of the outer part of the affected disc, thereby resulting in herniation or prolapse of inner soft portion of the affected disc through the weekend outer part of the disc. This herniation of inner soft part of disc may be triggered by many factors like exertion of some extra pressure on the disc due to sneezing or heavy lifting of some object in an awkward position. People having already a weakened disc, sneezing or lifting heavy object in abnormal position is sufficient to cause a prolapse.

What Factors Increases The Risk Of Prolapse Disc/Slipped Disc Development?

  • TMJD (Temporomandibular Joint Disorder)
  • TMJD may play a major role in causing slipped disk.
  • Malocclusion of teeth or mal-alignment of jaws or TRAUMA to the jaw joint causes the joint disc (articular disc) to get displaced medially.
  • This happens due to abnormal teeth grinding, which causes a tilt in the jaw joint leading to abnormal residual forces in the jaw joint.
  • Inside or on the inside of joint exists major structures travelling from and to the brain like nerves and blood vessels. This leads to compression of these structures.
  • The first nerve to be encountered, at a distance of just 0.5 cm or an ants length is the accessory nerve or the number 11 cranial nerve. The job of this nerve is to maintain the head on shoulders at the “COG” or the center of gravity.
  • Irritation of this nerve alters the muscle function and hence the head position, thereby ultimately resulting in cervical or neck pain.
  • This causes slippage of the disc.
  • Job involving lifting of heavy items
  • Sedentary types of  jobs involving sitting for long hours (especially driving)
  • Weight-bearing sports (weight lifting)
  • Smoking
  • Obesity
  • Age- risk of development of disc weakness increases with increasing age.

Symptoms Of A Slipped Disc

Back pain

Intensity is often severe and usually of sudden onset. The pain usually gets relieved on lying down flat, and it often worsens with movement of back, coughing, or sneezing.

Nerve root pain (usually SCIATICA)

Nerve root pain refers to the pain that arises because of pressure on the nerve coming out from the spinal cord by a prolapsed disc or due to irritation of the nerve caused by the inflammation around the prolapsed disc. Slipped disc not only causes pain in the back but also along the course of the nerve. Therefore patients of slipped disc may experience pain even down the leg up to the calf or foot. The intensity of nerve root pain may vary from mild to severe, but mostly the pain is worse than the back pain. Most common nerve to be affected by prolapsed or slipped disc is sciatica nerve. The sciatic nerve is a large spinal nerve composed of several smaller nerves that exists from the spinal cord in the lower back region. Sciatica nerve travels down deep inside the buttock and then further down to the back of the leg.

Other nerve root symptoms: Apart from causing pain, irritation or pressure on the nerve coming out of spine may also result in-Pins and needles pricking sensation, weakness or numbness in area of buttocks, leg or foot. The exact location and kind of symptoms experienced by the patient of slipped disk depend on the spinal nerve affected.

Cauda Equina Syndrome

Cauda Equina syndrome is a rare serious type of disorder of the nerve root resulting due to pressure on the nerves coming out of the very bottom of the spinal cord by a prolapsed disc. This is a rare disorder where the nerves at the very bottom of the spinal cord are pressed on. Symptoms of Cauda Equina syndrome-

  • Low back pain plus
  • Bowel and bladder dysfunction usually causing difficulty in passing urine,
  • Numbness in the saddle area (around the anus), and
  • Weakness in one or both legs.

This condition requires urgent treatment to protect the nerves supplying to bladder and bowel from becoming permanently damaged. You must immediately consult the doctor if you are experiencing such symptoms.

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Treatment Of Slipped Disc

Exercise and follow your normal routine

Slowly try to resume back to your daily routine activities even if it causes little bit of discomfort. But avoid doing things that causes severe pain.


  • PAINKILLERS- it is better to take them regularly than just when the pain is very bad to be relieved of the pain for longer periods so that pain doesn’t interfere with your exercise and normal activities.
  • PARACETAMOL- Often enough to take care of your pain. Adult dose- 1000 mg (usually two 500 mg tablets), four times a day.
  • NSAID (non-steroidal anti-inflammatory drugs)- For some patients it works better than Paracetamol. Example- Ibuprofen, Diclofenac, Naproxen. Must be avoided in patients with high blood pressure, kidney failure, asthma or heart failure.
  • Codeine- It is a strong pain killer. Can be given in patients in whom anti-inflammatory drugs are ineffective. Codeine is often prescribed along with Paracetamol. Most common side effect of codeine is constipation. Drink a lot of fluid and have food with abundant fiber in order to avoid constipation.
  • MUSCLE RELAXANT - Diazepam is sometimes indicated in patients with tense back muscles making the pain worse.

If the underlying cause behind SLIPPED DISK is TMJD, then it needs to be treated to get relief from symptoms of SLIPPED DISK. It is done through correction of TMJ residual pressures through the dental occlusion correction.It becomes utmost important to confirm it with the aid of various sophisticated and most advanced diagnostic technology(AVAILABLE ONLY AT Zental Tmj & Body Pain Division  BODY PAIN TREATMENT CENTRE, only Superspecialized Dental clinic in INDIA and Perhaps In Asia Too), like-

Once the diagnosis is confirmed and connection between TMJD and slipped disk has been established, various treatment procedures can be done to eliminate back aches from the roots. It includes-

  • Home care remedies
  • Medicines-pain relievers, muscle relaxants, anti-depressants.
  • Orthotic/splint
  • Orthodontic treatment
  • Veneers, Crown and bridges
  • Botox

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Spinal Injections

Includes Injections like the Cervical, Thoracic, Lumbar, Interlaminar, Epidural and Transforaminal injections, given into the opening at the side of the spine from where the nerve roots exits. These injections aid in decreasing the inflammation and swelling of spinal nerve roots and other tissues around the inflamed spinal nerve root thereby providing relief from pain, tingling and numbness and other symptoms.

Ozone Discectomy (Ozonucleolysis)

involves Injecting of Ozone-Oxygen mixture into the disc. This is a new technique which is considered superior and more efficacious than other conventional treatments.

Radiofrequency Ablation (RFA)

It is a procedure wherein electrical current produced by a radio wave is utilized to heat up a small nerve tissue area, thereby reducing pain signals coming from that particular area of pain. RFA is usually indicated in patients of chronic (long-term) pain. Considered safe and effective method of pain management. Usually well tolerated by the patient and rarely found associated with any complication.


considered as the last treatment option when all other treatment modalities have failed. The surgery is performed to cut out the prolapsed/herniated part of the disc. Not helpful in all cases of prolapsed disc. May result in complications.

Consult Best Body Pain Treatment Centre In Delhi, India.