Slip Disc Types
Latest On The 8 Slip Disc Types & How To Treat Them?
We are pleased to bring you the latest news on all eight slip disc types to help you understand your condition and what kind of treatment is best to get rid of them.
Slip-disc or slipped disc are interchangeable terms often used as an all-encompassing term for eight diagnostic names that categorize them based on their unique features. The eight types of slip-disc include:
- Bulging Disc
- Disc Protrusion
- Disc Prolapse
- Ruptured Disc
- Herniated Disc
- Disc Extrusion
- Disc Fragmentation
- Disc Sequestration
The eight slip disc types mentioned above can further be classified based on their presentation. Classification based on a slipped disc's presentation is an additional tool that doctors and clinicians use to assess the severity and prognosis of various slipped discs. Clinicians often use the terms "contained" or "non-contained" when referring to ruptured discs, herniated discs, disc extrusion, disc fragmentation, or disc sequestration.
The spinal disc comprises two main parts: the nucleus pulposus and the annular fibrosis. The nucleus pulposus is the soft inner part of the disc, resembling jelly. In contrast, the annular fibrosis or the annular ligament component refers to the outer, more sturdy interwoven supportive layers. The primary function of the annular fibrosus is to connect the spinal discs to spinal bones and support the nucleus by maintaining it at the center of the disc. In short, a healthy annular fibrosus prevents a disc from sliding, slipping, bulging, or herniating.
What Cause A Slip-Disc?
The Primary cause of bulging, prolapsed, herniated, and other slipped discs is premature wear and tear, leading to degenerative changes in the spinal discs. The wear and tear or early degenerative changes result when the malnourished due to dehydration and inefficient flow of nutrients. The spinal disc is considered the largest avascular structure. To survive, it needs a constant diffusion of fluids and nutrients from the endplate of the vertebral bones.
The vertebral endplates are cartilaginous structures that are about 1-2milmeters thick. The vertebral endplate provides attachment points between the spinal disc and the bony vertebrae. Moreover, the end-pates serve as a transit point for the diffusion of fluids and nutrients. Increased loading, poor posture, and congenital deformities of the spine, spinal discs, or end-pates contribute to decreased diffusion or inward flow of nutrients into the disc, causing the disc to wear out and become degenerative and causing slip disc symptoms of pain, numbness, or tingling.
Slip disc types range from mild to severe, causing a host of symptoms, including pain, weakness, bowel & balder loss, or paralysis. The type of slipped disc you have dictates the treatment you need for full recovery without limitation. The good news is almost all slip disc types are treatable and recoverable without spine surgery or steroid injections; we can help! Learn more about your non-invasive option by calling one of our treatment centers today.
Do Slip-Discs Occur In Stages?
Generally, slipped discs occur in stages. Before a spinal discs slip, the disc dehydrates. A dehydrated disc is a "desiccated disc disc" or disc desiccation. Advanced dehydration or desiccation is the primary cause of spinal disc degeneration.
A dehydrated disc (disc desiccation) is readily diagnosable on MRI. As the desiccation stage progresses, degenerative changes develop, causing the spinal disc to lose height or volume.
Degenerative Disc Disease (DDD) results in the loss of nutrients, volume, height, and resilience rendering the disc weak predisposed, and susceptible to bulges, slips, ruptures, or herniations. The presence of degenerative disc disease is the best and most accurate precursor to developing slipped discs in the neck or back. In other words, for the spinal disc to bulge, protrude, or herniate, there must be some den generative changes. We consider the degenerative stage the initial or pre-slip-disc stage a disc goes through.
Slip discs can occur in three stages mild (early), moderate (mid-point), or severe (late-stage). A bulging disc is the starting point, mild-stage, or early phase of slipped disc hierarchy. The moderate stage is the mid-point stage of a slipped disc, representing the worsening from early-stage (bulging disc) to disc prolapse or protrusion slip disc types in slipped disc classification.
The severe stage is the late-stage phase in the hierarchy of slipped discs. Late-stage (severe phase) is reserved for the non-contained slipped discs, including ruptured discs, herniated discs, disc extrusions, disc fragmentation, and spinal disc sequestrations (sequestered discs).
What Is The First Stage Of A Slip-disc?
All eight slip disc types mentioned on this page are impossible unless the disc is desiccated or degenerated. A desiccated or degenerated disc is a situation where the disc is dehydrated due to insufficiencies of the life-sustaining nutrients a spinal disc needs. The first stage of a possible slipped disc is disc degeneration, followed by a disc bulge, also called a bulging disc. We have listed all stages in the slipped disc, starting with the precursor condition below:
- Degenerative disc disease
- Bulging Disc
- Disc Protrusion
- Disc Prolapse
- Ruptured Disc
- Herniated Disc
- Disc Extrusion
- Disc Fragmentation
- Disc Sequestration
What Is Degenerative Disc Disease?
Degenerative disc disease is the precursor or a predecessor to disc bulges and herniations (slipped or slip-discs). A healthy, well-nourished disc will not herniate, slip, or bulge without some level of degenerative changes. Degenerative disc disease is a condition that causes drying or dehydration of the disc. A dehydrated, desiccated, or dry disc is a weak and damaged disc predisposed to tears and slippage.
Published peer-reviewed studies have proven spinal disc degenerative conditions such as disc desiccation and degenerative disc disease as the primary factor in developing eight slip disc types mentioned on this page.
A study by spine surgeons Jill Urban and Sally Roberts reported degenerative disc disease as the leading cause of neck and back pain. The authors of this award-winning published study said the main influencing factor in herniated and bulging disc development is weaknesses and eventual degenerations that damage discal fibers, causing them to protrude or slip. The authors attributed slipped discs along with several other related conditions to the disc degenerations, including:
- Spinal arthritis & bone spurs
- Facet degeneration & facet hypertrophy
- Hypertrophy of ligamentum flavum
- Spinal canal stenosis and stenosis of the intervertebral foramen(foraminal stenosis)
Please watch our linked video on this page that details how a spinal disc gets damaged to understand this better.
What Is A Bulging Disc?
The eight types of slip discs start with a bulging disc and may progress to other states. The most common term for slipped disc is a disc bulge or bulging disc. However, it is often misrepresented and not accurately defined.
A bulging disc, by strict definition, is an outward widening, swelling, or slippage of the spinal disc that does not compress the spinal cord or spinal nerve. Spinal discs widen to accommodate stresses placed on them during standing, sitting, or activity. The spinal discs are highly elastic. Their elastic nature allows them to change their shape during stressful or compressive events such as increased loading.
Like a balloon underweight, the axial loading on the spine or stressful activities (sitting and standing) compress the disc, forcing it to widen or bugle outward. However, bulging during activity or stressful events rebounds once the compressive force is removed. Therefore, a bulging disc can be expected if they occur during sitting, standing, or activity.
Please watch the short video above to understand what is a bulging disc. A bulging disc is best classified as a contained slip-disc and is readily treatable and recoverable without injections or surgery. A disc bulge at rest or in non-stressful conditions, such as lying on your back, is not normal and can become a source of neck or back pain. In other words, bulging discs observed on MRI indicate spinal disc damage, classified as a slipped disc.
Spinal discs that are desiccated (dehydrated) and degenerated (a combination of dehydration with loss of height) have difficulty rebounding back to a normal position following the removal of axial load or with the stoppage or at the end of stressful activity.
What Is A Disc Protrusion?
For the most part, a disc protrusion is descriptive of more prominent bulges that lead to slight migration of the nucleus prolapsus. The nucleus pulposus is the soft inner part of the disc that enables mobility. In a bulging disc, the nucleus pulposus maintains a centered potion within the disc. However, protruded disc results from continued stressful events, causing the nucleus to protrude or move from the center outwards. A disc protrusion and a bulging disc are the only two types classified as contained slipped discs. You should watch the short video below for a better understanding of what a protruded disc is:
A disc protrusion is a disc bugle where the nucleus has shifted from the center. The hallmark of diagnosis in disc protrusions is the slippage or bulging of the disc's outer fibers (annular fibers) with an outward shift in the position of the nucleus pulposus (the soft inner part of the disc). In short, a disc protrusion (protruded disc) is a contained slip-disc stage following the development of a disc bugle.
Protrusions of spinal discs can cause neck and back pain. Additionally, they may lead to pain, numbness, or tingling in the arms or legs. The good news is that protruded discs are treatable without surgery and can be reversed with focused therapies or treatment programs.
What Is A Disc Prolapse?
A prolapsed disc is a damaged or injured disc where the supportive annular fibers are torn, allowing the soft jelly-like inner part known as the nucleus to get pushed out of its confined or enclosed space at the center of the disc. Disc prolapse is the third slip disc type that results when a protruded disc progress or worsens. There are two types of disc prolapses; contained disc prolapse and non-contained prolapsed disc. Non-contained disc prolapse is the progression of contained disc prolapse. Please watch the disc prolapse video below o understand the slippage or prolapse of the nucleus in a prolapsed disc:
Spinal disc prolapses are "contained," or stable slipped disc types in the neck or back. In contrast, the non-contained refers to an unstable disc where some but not all of the disc’s protective outer fibers (annular fibers) are torn, allowing the center of the disc (nucleus pulposus) to prolapse or get displaced. Progression of a prolapsed disc leads to a ruptured disc or disc herniation, more damaging and dangerous forms of slipped discs.
What Is A Ruptured Disc?
The fourth slip disc type or stage of a slipped disc is a ruptured disc. A ruptured spinal disc is a non-contained slip disc indicative of tears in the protective mechanisms that enable the nucleus to rupture through its protective encasement at the center of the disc. Watch the linked video in the herniated disc section below to understand how the tears or damage to the disc’s protective barriers (annular fibers) cause it to rupture and herniate.
Spinal disc ruptures are a leading cause of pain, numbness, tingling, and weakness in the arms or legs. To recover from a ruptured disc, you need focused treatments that fix and repair the torn annular fibers while stimulatingly redrawing the inner part (nucleus) back towards the center. Ruptured discs and herniated discs are often interchangeable, and they are readily treatable without surgery with specialized methods of care described on this page.
What Is Disc Extrusion?
A spinal disc extrusion is the 6th slip disc type where disc material starts to seep into the canal, causing crowing, compression, impingement, and damage to the spinal cord or spinal nerve. Extruded discs can occur in the neck, upper back, mid-back, or lower back.
The most common site for an extruded disc is in the lower back’s L4-L5 or the L5-S1 spinal motion segments. Disc extrusion in the neck commonly occurs at C4-C5, C5-C6, or C6-C7. The C5-C6 is the neck's most common site of an extruded disc. The short video below helps you understand how the nucleus pulposus (inner jelly-like material of the disc) seeps into the disc:
A disc extrusion is a progression of a large herniated disc where the inner parts of the spinal disc (nucleus pulposus) are forced outwards as it slips and extrudes, seeping into the spinal canal where it compresses and pinches the spinal cord or spinal nerves.
What Is A Herniated Disc & How It Differs From A Ruptured Disc?
Herniated discs are classified as unstable and non-contained slip disc types that can cause life-alerting pains and weaknesses. Disc herniations, also referred to as herniated disc ruptures, are descriptive of degenerative tears, or an injury that tears in the protective ligaments of the spinal disc called the annular fibrosus or annular ligament (annular fibers). Disc herniations are the leading cause of lost productivity and the number one cause of disability in patients under 45. The most concerning aspect of a herniated disc is spinal cord or nerve damage resulting from impingement and compression.
A herniated disc occurs when the jelly-like center of the spinal disc breaks through the protective layers that encase the nucleus. Disc herniations are larger, more severe slipped discs than bulges, protrusions, or prolapses. If neglected, they can lead to paralysis, failure, or dysfunction, and damage other body parts, including the lungs, heart, bowels, balder, and reproductive organs.
A herniated disc is treatable without surgery, regardless of what your spinal surgeon says. Therefore, we encourage all patients with a herniated disc to enroll in slip-disc treatment programs that focus on a herniated disc through manual methods combined with therapy devices such as spinal decompression therapy, high-intensity laser therapy, shockwave therapy, flexion-distraction therapy before thinking of getting surgery for a herniated disc.
Spinal disc herniations are serious health issues that need urgent non-surgical treatment to avoid worsening. If neglected, a herniated disc progresses to the fragmentation stage, followed by sequestration, the leading cause of paralysis or life-long disabilities.
What Is Disc Fragmentation?
Disc fragmentations are massive disc herniations or extrusions, where the soft inner layers or the spinal disc known as the nucleus pulposus are torn and dangling in the spinal canal. Disc fragmentation is the initial stage in tears of the nucleus pulposus: where a ruptured or herniated disc is associated with tears of the annular fibrous (a strong rubber-like outer part of the spinal disc. Neglecting a fragmented disc leads to chipping the nucleus pulposus, causing it to float in the spinal canal.
According to a published study, up to 70% of bulging, herniated, or extruded discs progress to the fragmented disc, a severe stage in the hierarchy of slipped discs. Spinal disc fragmentation can occur suddenly or over time when patients ignore their degenerated, bulging, herniated, or extruded discs. Learn more about disc fragmentation by watching the video below:
A published study in the Annals of the Royal College of Surgeons of England reported significant successes with conservative treatments of patients with severe disc herniations and fragmentation. Therefore, if you have a fragmented disc or a large disc herniation, you can recover through focused non-surgical treatments.
Herniated discs are slipped discs where the slippage can migrate in one or more directions occupying the spinal canal or neural foramina. Disc fragmentations are massive disc herniations that occupy the canal or foramina, severely pitching, obliterating the spinal cord, exiting nerves, or traversing spinal nerves.
What Is Disc Sequestration?
Disc sequestration is the last stage in a slipped disc. It is also the most severe and challenging condition to treat and recover from. A sequestered disc is a fragmented disc with a chipped nucleus pulposus floating in the spinal canal.
A fully chipped or torn fragmented disc is called disc sequestration or a sequestered disc. Disc sequestration is a surgical emergency that needs careful planning and surgical intervention, often a nightmare for the spine surgeon.
Contained Versus Non-Contained Slip Disc Types
Contained slip-discs are mainly applicable to bulging discs, disc prolapses, and disc protrusions. However, doctors use them for the early stages of a ruptured or herniated disc.
In short, disc bulges, prolapses, and protrusions are contained slip disc types, as the nucleus pulposus is still maintained at the center of the disc. As the bulging, prolapse, or protrusion types of slip-disc worsen, some of the annular fibrosus layers tear, allowing the nucleus to slide or herniate. As such, "non-contained" slip-disc is dangerous as they can lead to severe slip-disc types such as fragmentations or disc sequestration.
What Is The Best Treatment For A Slipped Disc?
All except slipped discs except disc sequestration are treatable and recoverable without surgery. NSD Thera[y® is the best non-invasive method of slipped disc treatment provided through therapy devices, chiropractic, physiotherapy, and customized rehabilitation.
Medication and painkillers can reduce pain and swelling, but they will not fix or repair the cause of a slipped disc. If the cause is not treated in the early stages, a slip-disc progresses and worsens in time to a point where medication, including opioids and steroids, becomes ineffective.
Surgery should be the last option if you suffer from bulges, ruptures, herniation, extrusion, or fragmentation. We recommend spine surgery for a slipped disc if your slipped disc has progressed to the final stage, disc sequestration. The most critical aspect of therapy is specificity. In other words, recovering from various slip disc types requires a specialized skill-set and advanced therapy devices and technologies; contact us today for more information.