I'd be a millionaire if I had a £1 for every time I've heard this in practice! It's a phrase we often hear in the clinic "I've got a slipped disc!"
Furthermore, we often hear, "My disc has been clicked back in!" However, these two statements are misleading and actually not true. Let's have a look at why.
The discs are known as Intervertebral Discs, as they sit between 2 bones in your spine called the vertebrae. The discs are comprised of several incomplete rings of ligaments, known as the anulus, with a jelly like substance in the middle, the Nucleus Pulposus and have tougher fibres above and below them, the End Plates, that connect into the bones above and below. Discs allow a wide range of movements in the spine whilst acting as shock absorbers.
The disc's construction is tough and will oppose almost any force placed on them. Thanks to the surrounding ligaments of the spine and the disc's thick end plates, which attach directly into the vertebrae, the disc itself cannot physically "slip" anywhere. Studies have investigated how tough discs are and suggested that squashing a disc 1mm takes around 760 lbs of force! Wow!
There is no way a human can apply that amount of force during treatment to "put a disc back into place"! It's worth noting that when a therapist 'manipulates' or clicks your back, the noise is due to an air bubble popping within the joint fluid and has nothing to do with the disc.
So, why does my back hurt?
The phrase "slipped disc" is a bit of a misnomer, as we've already shown, and should really be replaced with other descriptions of disc pathology, such as a disc bulge or a herniated disc. These generally describe what happens when the disc structure is altered, commonly from a bugle created when the disc's nucleus squeezes through the side of the disc; this can then contribute to the pain felt.
Any disruption of the disc's anatomy can lead to the disc losing height, failing to absorb shock properly and becoming problematic. The disc only has nerves on the outer fibres of its ligaments that create the annulus, therefore, some disc injuries can happen yet are painless, and some produce a strong, chronic ache that is occasionally linked to some movements.
However, more sudden, acute pain that can be accompanied with symptoms of a pinched nerve, such as sciatica, is more likely to be due to disruption to the outer layers of the disc. When a bulge or hernia to the disc occurs like this, it can pinch one of the nerves leaving the spine and cause sciatica symptoms in your leg or nerve pain in your arm. This will depend upon where around the disc the bulge occurs. Severe cases where the bugle heads backwards can cause spinal cord compression and is a medical emergency that requires urgent attention.
When the structure of the disc changes, the disc becomes less able to resist compression and movement from the spine. This increases the workload on the surrounding ligaments, muscles and joints of the spine, making them work harder and often contributing to back pain.
So, how can Osteopathy help me?
When we consider the more acute, sudden onset of back pain, whether or not it relates to a disc, many other structures are involved in the bigger picture, often mistakenly described as a "slipped disc". But it's not just recent injuries that respond to treatment, longer-term issues respond too!
Osteopathy can help to relieve the symptoms in the surrounding structures, such as muscles, ligaments and spinal joints, allowing you to feel better and move more easily, rather than misleadingly "put the disc back in".
Treatments use skills such as massage techniques, joint mobilisations to improve the range of motion a joint has, stretching and strengthening advice to help you improve stiffness and reduce pain levels. Advice on posture and movement patterns to help prevent pain and a range of exercises to help you with further self care to help improve function and reduce pain. We often use osteopathy along with other therapies such as medical acupuncture, cupping, and taping for support after treatment, even laser treatment in some cases, to make sure you have the most effective treatment to suit your needs.
References
Accessed 06/01/2023