What does ‘doing a disc’ actually mean?
Many people come in to us and think that they have ‘slipped a disc’ or ‘done a disc’. Now what does it actually mean to ‘slip a disc’ or does the disc actually slip? Every vertebrae in our spine has an intervertebral disc between them creating a cushion to help with joint flexibility and protected the spinal cord. Does our disc actually slip? Not really when people use this phrase it is not really correct. When a disc is injured it is commonly in a form of herniation that is broken up into 4 stages. A study conducted by Mustafa et al, shows that almost 80% of the population will have or has some form of disc herniation in their lifetime. However, just because you have a disc herniation does not mean you will necessarily have back pain.
Lets take a look at the 4 stages of Disc Herniation
- Stage 0 - Normal Intervertebral Disc. The disc has a solid and non compromised Nucleus Pulposus, Inner annulus fibrosus and outer annulus fibrosus.
- Stage 1 - Intervertebral Disc Inflammation. The disc still is not compromised however there is weakening within the disc that can create some back pain.
- Stage 2 - Intervertebral Disc Prolapse. The disc has weakened to a point where it is beginning to budge outwards. The Nucleus Pulposus, and annular fibres are still present without any breaking of the wall of the disc. This sometimes can result in radicular pain where the pain is felt not just in the back.
- Stage 3 - Intervertebral Disc Extrusion. The inner gel within the disc has broken the wall of the disc. Again this can create more radicular signs and is often more complex with healing times.
- Stage 4 - Intervertebral Disc Sequestration. Fragments of the disc are breaking free from the disc and into the spinal canal. This is the final stage of disc herniation and may be a sign of surgical intervention if conservative management does not improve symptoms and function.
What are the signs of a back injury that may originate from the intervertebral disc?
- Radicular Pain. This is pain that is not localised to the specific point in the back. E.g. a disc injury in the neck may show as pain down the arm into the hands, whereas a lower back disc injury may show as pain in the foot or down the leg.
- Localised back pain. This pain is pretty specific to an area of the back and without other signs may be a sign of low level injury to the disc.
- Sensation changes in a dermatomal distribution (altered feeling that follows a direct path)
- Weakness with a specific action that will be related to the nerve root innervation of that area of the body.
- Pain with coughing, sneezing, and bowel movements.
- Increase in pain when bending forward
How long does a disc injury take to heal?
Like any injury it is tough to give a specific timeline as every persons body responds differently to treatment. Other factors can influence recovery as well including diet, hydration, activity levels prior to injury etc. It is seen in most cases that disc injury can be managed conservatively within 6-12 weeks. However sometimes these can be more long term and require surgical intervention which then will also result in a further recovery period.
What does conservative management look like at Newman Chiropractic?
At Newman Chiropractic the team tailor treatment to each particular person. However some things you could expect to see or have done when coming in are;
- Chiropractic Adjustments (to improve joint mechanics and help desensitise painful areas)
- Soft tissue therapy (muscle releases and stretching)
- Dry Needling
- Functional Release Cupping
- Home Advice (diet, sleep, hydration, supplementation)
- Rehabilitation Programs (at home exercises, pilates programs, gym programs etc.
So when people come in and say ‘I’ve slipped a disc’ it is not just us ‘pushing’ it back in to help you recover. When we are suspecting a disc injury we often will come up with a plan that initially looks at managing the symptoms but then be more focused on creating stronger bodies to lower risk of re-injury and need to be seeing us all the time.
References: