Slipped Disc

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Dr Kau Chung Yuan (许医生)


MRCS (Ireland)

MMed (Ortho)

FRCSEd (Ortho)


What is a Slipped Disc?

The spine, consisting of 33 vertebrae, protects the spinal cord and provides structural support to the body. Intervertebral discs are positioned between these vertebrae, providing flexibility and absorbing shocks.

A slipped disc, more accurately termed a herniated or prolapsed disc, occurs when an intervertebral disc, which acts as a cushion between the vertebrae in the spine, becomes damaged and presses on the nerves. This condition often results from age-related wear and tear, known as disc degeneration.


The development of a herniated or slipped disc is often attributed to a combination of factors that contribute to the degeneration and subsequent injury of the intervertebral disc. Some of the common causes include:

  • Natural Wear and Tear
    As people age, intervertebral discs lose hydration and elasticity, becoming more susceptible to tearing or rupturing, even from minor strain or twisting movements.
  • Reduced Disc Height
    The dehydration of discs over time leads to reduced disc height, increasing the likelihood of disc herniation due to lessened shock absorption.
  • Heavy Lifting
    Improper lifting techniques, especially lifting heavy objects, can exert excessive pressure on the spine, leading to disc injuries.
  • Sudden Movements
    Sudden, awkward movements can cause the soft material of the disc to protrude.
  • Obesity
    Excess body weight increases the load and stress on the lower back, contributing to the risk of developing a slipped disc.
  • Sedentary Lifestyle
    Lack of regular exercise can lead to weak back and core muscles, less support for the spine, and an increased risk of disc problems.
  • Family History
    There can be a genetic component, predisposing individuals to disc degeneration and associated complications.
  • Repetitive Activities
    Jobs involving repetitive lifting, bending, or twisting can increase the risk of a slipped disc.
  • Prolonged Sitting
    Occupations requiring long periods of sitting, especially with poor posture, can contribute to spinal disc deterioration.


The symptoms of a slipped (herniated) disc can vary significantly depending on the location of the herniation and the type of soft tissue that becomes involved. Common symptoms include:

  • Localised Pain
    Often experienced in the lower back or neck depending on the location of the slipped disc.
  • Radiating Pain
    Pain that occurs along the path of the affected nerves, often radiating down the legs (in lumbar disc herniation) or arms (in cervical disc herniation).
  • Numbness and Tingling
    Sensations in the extremities served by the affected nerves, such as in the arms or legs.
  • Muscle Weakness
    Weakness or a decrease in reflexes in the areas supplied by the affected nerves.
  • Reduced Mobility
    Difficulty in bending or rotating the back or neck, often accompanied by pain during movement.
  • Changes in Bowel or Bladder Function
    In severe cases, such as with cauda equina syndrome, there may be changes in bowel or bladder control, which is a medical emergency.


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Accurate diagnosis of a slipped (herniated) disc is crucial for effective treatment. The process typically involves several steps to understand the symptoms and determine the exact cause of the pain:

  • Initial Evaluation: An orthopaedic surgeon will start with a thorough medical history review. This includes questions about the onset, nature, and severity of symptoms, as well as any activities or incidents that may have triggered them.
  • Physical Examination: The examination focuses on identifying the source of pain and neurological deficits. This may include checking for tenderness over the spine, assessing the range of spinal motion, testing muscle strength and reflexes, and conducting specific manoeuvres to replicate the pain.
  • Neurological Assessment: To evaluate nerve function, the orthopaedic surgeon may test muscle strength, reflexes, walking ability, and the ability to feel light touches, pinpricks, or vibration.
  • MRI (Magnetic Resonance Imaging): This is the most commonly used imaging test for diagnosing a slipped disc. It provides detailed images of the disc, spinal cord, and surrounding structures, helping to pinpoint the location and extent of disc damage.
  • CT Scan (Computed Tomography): Sometimes used in conjunction with or as an alternative to MRI, a CT scan provides detailed cross-sectional images of the spine and can reveal slipped discs and other spinal abnormalities.
  • X-ray: Although X-rays cannot detect a slipped disc, they can be used to rule out other causes of back pain, such as spinal fractures or misalignment.
  • Electrodiagnostic Testing: This includes electromyography (EMG) and nerve conduction studies, which can help confirm nerve compression caused by a slipped disc and provide information about the severity of the nerve damage.

Non-Surgical Treatment Options

Non-surgical treatments are often the first line of therapy for a slipped disc. These options aim to alleviate pain, improve mobility, and promote healing. Common non-surgical treatments include:

Physical Therapy

Tailored exercises and stretching routines to improve flexibility, strengthen the back and core muscles, and reduce pressure on the nerve.

Pain Management
  • Over-the-Counter Pain Relievers: Such as ibuprofen or acetaminophen, for managing mild to moderate pain.
  • Prescription Medications: Including stronger painkillers, muscle relaxants, or nerve pain medications.
Epidural Steroid Injections

Injections of corticosteroids into the epidural space to reduce inflammation and pain.

Heat and Cold Therapy

Applying heat or cold packs to the affected area to reduce pain and muscle tension.

Weight Management

Maintaining a healthy weight is crucial in reducing the load on the spine. Strategies for weight management may include a balanced diet and regular exercise. Consulting with an orthopaedic surgeon can provide tailored advice for effective weight management.

Surgical Treatment Options

Surgical intervention for a slipped disc is typically considered when non-surgical treatments fail to provide relief, or in cases where there is significant nerve impairment or severe symptoms. Common surgical options include:

  • Microdiscectomy
    This is the most common surgery for a slipped disc in the lumbar region. It involves the removal of the portion of the disc that is pressing on the nerve root.
  • Laminectomy
    In some cases, especially when there is a narrowing of the spinal canal (spinal stenosis), a laminectomy may be performed. This involves removing part of the bone, the lamina, from the affected vertebra to relieve pressure on the spinal nerves.
  • Artificial Disc Replacement
    This is a newer surgical procedure that involves replacing the damaged disc with an artificial one. It is mostly used for the cervical spine and aims to maintain more natural movement of the spine compared to traditional fusion surgery.
  • Spinal Fusion
    In cases where there is instability in the spine, a spinal fusion may be necessary. This procedure involves fusing two or more vertebrae together to prevent movement and alleviate pain.

Dr. Kau Chung Yuan

MBBS (S’pore)

MRCS (Ireland)

MMed (Ortho)

FRCSEd (Ortho)

Dr Kau (许医生) is a Fellowship trained Orthopaedic Surgeon with a subspecialty interest in Hip and Knee surgery and has been in practice for more than 15 years.

He is experienced in trauma and fracture management, sports injuries, and joint replacement surgery.

  • Fellow of the Royal College of Surgeons Edinburgh, Orthopaedics (FRCS, Edin) 2014
  • Master of Medicine (Orthopaedics), Singapore (MMed) 2013
  • Member of the Royal College of Surgeons Ireland (MRCS, Ire) 2009
  • Bachelor of Medicine and Surgery (MBBS, Singapore) 2004

Prevention Strategies

While it is not always possible to prevent a slipped disc, certain measures can be taken to reduce the risk and maintain spinal health. Key prevention strategies include:

  • Regular Exercise: Engaging in activities that strengthen the back and core muscles helps support the spine. Low-impact exercises such as swimming, walking, or cycling are beneficial. It is also important to include flexibility and stretching exercises in the routine.
  • Proper Lifting Techniques: When lifting objects, it is crucial to use the legs rather than the back. This means bending at the knees and hips, keeping the back straight, and holding the object close to the body.
  • Ergonomic Workstations: For people who spend long hours at a desk, ensuring an ergonomic setup can reduce strain on the back. This includes a chair with proper lumbar support, keeping the computer monitor at eye level, and taking regular breaks to stand and stretch.
  • Avoiding Smoking: Smoking can reduce blood flow to the discs, leading to quicker degeneration and increased risk of injury.

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Patient Feedback

Ethan Chan
Dr. Kau is an exemplary doctor who is experienced in his field and is very patient with his patients. He walked me through the details of my knee condition and addressed all my concerns. Thanks to Dr. Kau, I had a better understanding of my ACL and MCL injury and the various treatment options available. His advice and treatment have been very valuable to me.
Ming Lee Chua
Dr Kau was very careful and explained clearly the surgery procedures. After surgery, the care while I was in hospital was closely monitored and he even came during weekends! The hip so far has recovered and healed. His ‘predictions’ of when what can happen are so accurate. Trust him.
Teo Pek Suan Diana
I had a very successful total hip replacement done by Dr Kau 4 years ago. 4 months after the operation I was back walking, cycling and swimming. The beautiful job gave me much confidence Dr Kau is most professional and has such great doctor patient communication.

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    Frequently Asked Questions (FAQs)

    Can a Slipped Disc Heal on Its Own?

    In many cases, a slipped disc can heal on its own over time. The body may reabsorb the protruding part of the disc, relieving the pressure on the nerve. Non-surgical treatments like physical therapy, pain management, and lifestyle modifications can support this natural healing process.

    How Long Does It Take to Recover from a Slipped Disc?

    The recovery time varies depending on the severity of the condition and the individual’s response to treatment. Generally, symptoms improve within a few weeks to a few months with conservative treatment. However, complete healing may take longer.

    Can I Continue to Exercise with a Slipped Disc?

    Yes, but it is important to choose low-impact exercises that do not strain the spine. Activities like swimming, walking, and specific stretching and strengthening exercises can be beneficial. Consult a physical therapist for a personalised exercise plan.

    Can a Slipped Disc Occur Again?

    Yes, it is possible to have a recurrence of a slipped disc. Adhering to preventive measures, maintaining a healthy lifestyle, and incorporating regular exercise and good posture can reduce the risk of recurrence.