Many of us have heard the term ‘slipped disc’ and it can spark doom for those that are told they have it. It can, understandably, be scary to hear.
What has happened? What does this mean for my future? How is it treated, and does it require surgery?
We see this almost too often at Chirolink and we are here to give you the good news! You are not doomed. You’ve been told (including Dr. Google) that you have ‘slipped a disc’ and we will tell you that with a little bit of help, the body can adapt and recover.
To fully understand what is happening, we must break it down starting with the basics.
What is an intervertebral disc (IVD)?
The intervertebral discs are the cushion-like structure that sits between each vertebra. They have two separate parts. The tough outer annulus fibrosis and the central softer nucleus pulposus. Our spines work hard for us – every tiny structure plays an important role to allow this. The IVDs’ main functions are shock absorption and load distribution but also allow flexibility and a greater range of motion for us to function and move the way we do.
What does it mean if the disc has ‘slipped’?
An intervertebral disc can’t slip however, when someone says this, it means that the disc has herniated. The tough outer fibers (the annular fibers) of the IVD have weakened or torn, possibly allowing some of the softer nucleus pulposus to protrude through. This can be gradual or sudden, occurring at varying degrees and in different directions. The pain you feel is due to the inflammation that results from the stretching or tearing of these fibers but can also be due to this herniated tissue compressing a nerve nearby.
A herniated IVD is relatively common and can occur within any part of the spine. The most common location for it to happen is the lower back (lumbar spine – specifically the discs between L4/L5 and L5/S1). The next in line for the likelihood is the neck (cervical spine), followed by the mid back (thoracic spine), which is much less likely.
What are the symptoms?
Due to the varying locations, directions, and degree of herniation, the symptoms can differ from person to person, but the most common symptoms are:
- Local pain around the injured disc.
- Referred pain from either the disc itself, surrounding muscle spasm, or compression of a nearby spinal nerve.
- This is often down the leg and into the foot or down the arm and into the hand.
- Can radiate over the groin or up into the neck or over the front of the chest.
- Pain is usually worse in the mornings, after prolonged periods of sitting or standing, and specific movements that result in disc compression.
- Pain is usually made worse with increased abdominal pressure (coughing, straining, laughing, or sneezing).
- Pain is relieved with movements or positions that reduce compression of the disc.
- Possible weakness, loss of sensation, or pins and needles
Why does this happen?
The mechanism by which this occurs is often due to either chronic overloading where the injury is gradual or can be with a twisting or asymmetrical load on the disc where the injury is sudden. It is more likely to occur in individuals who have poor core strength, increased curves of the spine, and in those who live a more sedentary lifestyle.
Our spines are resilient and can withstand a fair amount of stress but like anything, it can only handle a certain amount before things get too overwhelming. At Chirolink we believe that knowledge is power. It’s like a recipe – all the right ingredients are put together for a good result.
So, all we need is to know the vulnerable things and apply them to our daily lives.
When we lift a 20kg box with incorrect posture (lifting by hanging from the hips with the knees straight), the pressure in the discs of the lower back increases by 169%. These are simple ingredients with bad results. The added pressure puts the disc in a vulnerable position for injury be it sudden or gradual. It almost doesn’t seem fair to put this kind of pressure on them, doesn’t it?
The big question – how do we treat this?
Firstly, prevention is better than cure!
As we’ve discussed, certain movements or positions add more pressure to the intervertebral discs. We need to be cognoscente of these positions as we do them so often.
There will always be fluctuating pressure on our discs with everyday life, such as sneezing which increases pressure on the discs by 40%-50%. It is simply wiser to not sneeze in a position where there will be an uneven load on the disc such as with your head turned to the side and flexed forwards.
This also applies, and is possibly even more important, for those who have existing disc injuries. We have one body for this lifetime. We must take care of it.
A disc herniation is commonly perceived as a surgical disorder however, this is not always the case. Most cases can be treated conservatively and with phenomenal results. Your Chiropractor will assess for any red flags that could be presenting. If warranted, you will be referred for an x-ray or a specialist consult. If you are given the ‘all clear’, you will be assessed for which disc is injured, in what direction, and to what extent. Then treatment will commence. The chiropractic adjustment accompanied by some gentle soft tissue work works wonders for our patients!
Homework is non-negotiable. Avoiding painful movements is number one! This accompanied by very specific stretches and proprioceptive exercises, we have our patients up and about, better than before in no time. We find that the patients who have the best outcome are the patients who are diligent with their treatment and their homework. The long-term goal is to build the back’s resilience and we have seen it time and time again. The effort pays off!