Can a disc slip? The simple answer is no. It’s a layman’s term that is unfortunately very misleading to the general public.
“My disc has slipped out, can you put it back in” is not an uncommon conversation opener on the telephone. Of course, it’s quite difficult then to get the caller to understand that this can’t actually happen.
Let’s look at the spine’s anatomy and in particular the role of the disc.
The spine is made up of 7 cervical (neck) bones called vertebrae, 12 thoracic (middle) vertebrae and 5 lumbar (lower) vertebrae. The top 2 vertebrae in the neck are a little bit different, so putting those to one side, between each pair of the remaining vertebrae there is a disc, the purpose of which is to provide shock absorption and allow movement. The disc itself is attached strongly to the vertebrae and cannot slip out.
A disc is made up of a tough fibrous structure on the outside, layered in exactly the same way we make cross ply tyres. On the inside there is a soft, crab paste like moist material. As we age this tends to dry out. There are also end plates in contact with the vertebrae. The disc is 70% to 90% water, so making sure you are well hydrated is very important to disc health.
There are two major types of damage to these discs. The first is when the disc is overloaded sufficiently to cause a protrusion, or bulge in the outer wall, as in the MRI above. This is similar to what you see on the side of a car tyre when it has hit a curb. Sometimes this is referred to as a slipped disc. It’s not possible to just push the bulge back in, but specific exercises can help to relocate this and over time the disc may heal itself.
The second, and more serious damage is when the overload has been sufficient to rupture the outer fibrous structure and force the inner material to squeeze out. This is called a herniated or ruptured disc.
What Are The Implications Of A Disc Bulge Or Herniated Disc?
A disc bulge will cause pain if it is central and compresses the central spinal column, or if it bulges to one side into the exiting nerves. In either case, if the compression is significant enough, it will cause pain and / or numbness and weakness and possibly loss of control in the limbs.
If the disc bulge is central it could cause problems down both sides of the body. If the bulge is on one side, it will only cause problems on that side.
If the disc has been ruptured, or herniated, the same problems with compression of the central spinal column and exiting nerves can occur. In addition, if chemicals from the inside of the disc come into contact with the nerves, it can cause severe pain even without any compression of the nerves. In such cases a course of anti-inflammatories will most likely be prescribed.
Can Physiotherapy Treat A Disc Bulge or Herniated Disc?
In many cases a bulging disc and a herniated disc will over time heal itself. The time required may depend on the severity of the problem and may take from weeks to months to resolve. Physiotherapy treatment can help reduce the pain much more quickly. The key is to get an accurate diagnosis through a physiotherapy assessment, possibly needing an X-ray or MRI. Treatment can include specific exercises to help reduce the bulge, Gunn IMS dry needling, electro- acupuncture, laser, shockwave, core stability rehab and postural rehab. Manipulation is contra indicated. In severe cases, surgery may be needed.
If you have suffered a recent back injury or had a long term problem then it’s advisable to get your condition assessed and treated. We have extensive skills in treating spinal pain and clients travel from all over the UK and abroad to seek our help.
Call Now 01889 881488. Erica & Jean will be happy to help