Why you don’t have a slipped disc

“Have I got a slipped disc?” asks Mr Smith, shifting uncomfortably in his chair after describing his low back pain. How do I know the answer to this question is “no” before I’ve even examined him?

Spinal discs don’t slip 

Intervertebral discs are soft tissue structures that sit between the individual bones (vertebrae) in your spine. They provide shock absorption and allow a certain amount of spinal mobility.

spine vertebrae intervertebral disc nerve root foramen all pll ligamentum flavum

Fig1: The spine – note distinct lack of disc slippage potential…

Each disc is made up of layered rings of tough fibrous tissue around a jelly-like central nucleus. They are strongly attached to the vertebrae above and below, with thick ligaments behind and in front of them. This makes the possibility of a disc slipping anywhere extremely remote.

So what does happen to discs?

“Slipped disc” is an old-fashioned term for a disc prolapse. That’s where the disc’s central jelly-like material is forced outwards through a tear in the fibrous tissue around it.

A prolapse is usually the end result of long term strain on a disc. With age, the nucleus of a disc gradually dehydrates, making it less springy and reducing the disc’s height.

Unsurprisingly, this affects shock absorption and allows the disc’s outer fibres to bulge outwards. It may also permit more horizontal movement between the vertebrae.

The additional strain on the disc can lead to tears in its fibrous outer layers. Material from the central nucleus may then squeeze (herniate) into a tear. Or if the tear’s big enough it might prolapse right through the outer layers.

Sounds scary? Not necessarily…

So, discs can dehydrate, bulge, tear, herniate and prolapse. All these sound nasty and may well contribute to back pain. But they might also cause no symptoms whatsoever.

Research using MRI scans has shown that many people have disc injuries and degenerative changes but no low back pain. That’s one reason why scans aren’t necessary in most cases of back pain.

So, er… what about my back pain?

Well, your first step with back pain should be a professional assessment. We all get the odd twinge, but don’t ignore anything more severe or persistent. Just occasionally it may reflect a more serious underlying problem, and even simple backache could develop into chronic pain if it’s not dealt with.

The good news is that even pain relating to disc prolapses, degenerative change and sciatica usually improves with some simple steps.

Keep moving and talk to a pharmacist about painkillers if you need them in the short term. Then visit your osteopath for some gentle hands-on treatment and advice to take the strain off your back.

 

If you’re struggling with back pain, neck pain or any painful problem, we’re here to help. Call us on 07732 006691 or email [email protected] if you’d like some advice or want to book an appointment with one of our osteopaths. Or you can visit our clinic in Paddington W2 – easily accessible from Maida Vale, Marylebone, Bayswater and central London.