Dr Kerryn Phelps, Health Editor, with Steve Liebmann, Channel Nine, 'Today'
LIEBMANN: Now if you've ever had a herniated or slipped disc or what we lay people refer to as just 'bad back', you'll know how painful and indeed limiting it can be. And joining us now to talk about all that and what you can do about it is our health editor, Dr Kerryn Phelps. Morning to you.
PHELPS: Good morning, Steve.
LIEBMANN: Herniated disc. Everybody says, you know, they probably do not use that term. 'I've got a bad back, slipped disc.' But what is it?
PHELPS: Well there's lots of causes of bad back but, particularly if you're looking at slipped disc or herniated disc, it's a very specific problem and it's very common because almost - I think it's about a third of people over the age of 20 - will show some sign of damage to their discs. And what happens is, as you get older, the discs which are these substances between the vertebrae in your back, or the bones in your back, they start to get thinner, flatter. They get dried out and they start to crack.
LIEBMANN: Now I can understand incidentally why that happens in older people. But why younger people?
PHELPS: Tends to happen more in the 30s and 40s. I think probably general activity levels may have something to do with that but it's also that's about when the discs start to wear out.
LIEBMANN: Right.
PHELPS: Unfortunately, sad but true. And if you have a look at what actually happens, you've got this jelly-like substance in the middle of the disc and the disc itself doesn't actually slip. That's where I think people get a little bit confused about it. What happens is that the substance in the middle gets ruptured out of the internal part of the disc. And what that does is it presses on the spinal nerves and that's where you get the pain of sciatica.
LIEBMANN: Okay, so you develop the problem, the symptoms.
PHELPS: You do.
LIEBMANN: What do you do about it?
DR PHELPS: You scream in pain usually when it first happens.
LIEBMANN: It can be, can't it?
PHELPS: Oh shocking, shocking.
LIEBMANN: I mean I haven't, but I know people that have and it's just awful.
PHELPS: Well you can see there where it's pressing on the nerve. Anything that squashes a nerve is going to cause a lot of pain. But it doesn't only cause that. It can also cause shooting pains down your legs, into your buttocks. It can cause weakness in your legs and in some severe instances where the problem is lower down, it can actually cause people to lose control of their bladder or their bowels and that's an emergency. And so, if those - if there's severe pressing on the nerves where you've got muscle weakness or loss of bladder or bowel function, that becomes an emergency that needs to be dealt with surgically right from the outset. But not everyone needs to have surgery.
LIEBMANN: I mean, there is non-surgical treatment. I worry about surgery and backs. You know, spines and discs and everything. What happens if you're scheduled for a Monday morning and the surgeon comes in and he's had a rough weekend? I worry about them working on your spine and all that sort of stuff.
PHELPS: into the part of the substance that was pressing on the nerve to dissolve it. It seems to be a lot less popular now. They did have some problems with that. So it's still an option but a much less popular one. So…
LIEBMANN: Okay, so non-surgical treatment first.
PHELPS: Very much so. And also rehabilitation is really important because, if you lose your flexibility, you often lose your function and you need, a lot of people will need to have their muscles strengthen up with some physiotherapy, some abdominal exercises, back muscle exercises and some flexibility exercises so that they can basically get back to normal function as quickly as possible.
LIEBMANN: Good to see you, doc.
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