Discs don't slip!
Ahhh, the spinal “disc”. This elusive, fragile structure in our back that may “pop out” at any moment and bring us significant pain and disability. For many people, a little back pain see’s them head to a GP who may prescribe some pain medication. This situation gets worse to the point or debilitating pain, so you are sent for an X-ray, and maybe an MRI and CT scan if you’re lucky just to make sure nothing nasty is going on. You find out you have a “slipped disc” and your world comes crumbling down. You move with fear when lifting anything heavier than the 2L of milk in your fridge and have nightmarish visions of ending up in a wheelchair or off for surgery to cut that nasty disc out.
As physio’s we see this spiral all too often and we are here to tell you, discs don’t slip! When professionals discuss changes to the disc they are usually talking about a “herniated” or “bulging” disc. And these things are far more common than you think.
What is a spinal disc?
Picture a circular rubbery children’s chew toy. Spinal discs have strong, fibrous collagen outer layers that are designed to withstand LARGE compressive forces and a soft, toothpaste like gel on the inside. Together these structures are designed to withstand LARGE compressive forces and act as shock absorbers for the spine. Each vertebral joint in the spine has a disc that sit between each bone, and these are surrounded by many spinal ligaments. They are purposely designed to withstand high forces and are strongly connected in the vertebral complex, making it impossible for the disc to just slip on out of place like a bar of soap in the shower.
What happens when a disc bulges?
If you place an incredibly large amount of increased strain on the spinal disc, this toothpaste like substance in the centre can push towards the outer edge creating a “bulge” in the surrounding collagen layers of the disc. This more commonly happens when uneven or torsional loads are placed on the spine (think bending and twisting in the same motion!). In some instances the bulge can put pressure on sensitive surrounding structures such as nerves and cause an incredible amount of pain.
If your doctor was to tell you that you had a bulging disc you might find that pretty darn worrying. What if we were to tell you that approximately 50% of 40 year olds without back pain will likely show disc bulging? It is actually incredibly common! And just because your disc is bulging doesn’t mean you will have debilitating back pain. For this reason, getting rigorous and expensive tests is not always the best option for treating your pain.
How can you fix a bulging disc?
Thorough assessment by a physiotherapist is required to determine all the contributing factors to your pain and is more useful than an X-ray or MRI. In fact national guidelines recommend against these scans in those with typical low back pain as they are often misleading and not useful in care.
The most important thing is to get moving, and to get strong. Treatment options after assessment may include:
- Rehab and conditioning exercises
- Advice and education on safe lifting techniques
- Postural advice and retraining
- Manual therapy
Whilst injections or even surgery may be required in RARE cases, the majority of symptoms of a disc bulge can be relieved by working with your physiotherapist. Spontaneous regression of a bulging disc can occur, and can completely resolve after conservative treatment.
Moral of the story:
- Discs don’t slip, so your “slipped disc” is not an excuse to quit the gym or stop playing sport
with your kids
- Discs are incredibly strong, but can be damaged by shearing and torsional forces, so it is not
a good idea to lift heavy items off the floor with an extremely flexed spine and a jerking or
- Discs bulges and the symptoms associated with them are common. They can and do improve
with a little physio and lots of exercise.
Been using your slipped disc as an excuse to avoid activity? Have back pain that isn’t going away?
Just want someone to care for your spine? Phone us on 9629 4608 or book online today.