What actually is a “slipped disc” / “bulging disc” / disc prolapsed / disc herniation?
So you’ve been told you have damaged a disc in your spine? This article helps us to understand what it is and how it can be treated.
The above terms all indicate damage to the soft intervertebral discs that sit between the bones in your spine (vertebrae.) The discs have some important functions such as:
- Shock absorption
- Allowing for movement in your spine
- To limit the range of movement between individual vertebrae (the disc attaches to the underside of the vertebra above and the top side of the vertebra below.
The structure of the disc is sometimes described as being like a jam doughnut. There is a soft jelly / fluid centre known as a nucleus pulposus, there are strong collagen rings called annulus fibrosus surrounding the nucleus pulposus. This structure is strong enough to support the weight of the head and spine while at the same time allowing for movement between adjacent vertebrae.
What can commonly go wrong?
- A disc bulge / herniation: The nucleus pulposus bulges through the wall of the annulus fibrosus. This may or may not affect the adjacent nerves. If it does compress or inflame adjacent nerves patients may experience pain in the back of the leg (sciatica) or arm pain (this depends on the location of the compressed nerve). If it doesn’t compress the nerves pain may only be reported in the back. (see images above)
- Degenerative disc disease: This is the equivalent to wear and tear of the discs. It results in a reduction in height and hydration (water content) of the disc. This results in more pressure on the bony joints between the vertebrae and eventually can result in spinal segments virtually fusing together.
Disc pain can be varied and ranges from mild to severe and debilitating. Some patients may have one episode and never feel pain again; others may have recurrent issues over a prolonged period. Research now shows that up to 75% of the population with no pain may have disc bulges on MRI scan. These confusing statistics probably indicate that disc bulges don’t always result in significant inflammation affecting the pain sensitive nerve endings, without this inflammation the brain doesn’t recognise there being an injury and consequently we don’t experience pain.
What can be done if I am in pain?
Freedom clinics osteopaths train for 4 or 5 years in the specialised diagnosis and treatment of spinal pain, and as a result are in a position to identify pain arising from different structures in your spine (vertebra, disc, ligament, muscle).
The goal of treatment is to improve the bodies chance to heal itself without the need for surgery or spinal injections. This normally involves a combination of manual ‘hands on’ treatment, home stretches and lifestyle advice to help reduce the strain on the injured area which enables your body to naturally return to full function.
Rarely disc injuries are too advanced for conservative treatment (osteopathy / chiropractic). In the unusual situation that osteopathic care won’t help your spinal pain referral to a local spinal surgeon or pain management specialists can be made.
Rod Gillingham, Freedom Osteopath.
For more information, or to book a free assessment, call your local clinic.