While taking new patients' medical history, we frequently hear a phrase in our Frederick clinic: "I've had a bad back ever since I slipped a disc." This is an interesting way of communicating a complex system of the body. While providers typically don't always agree with how patients and society word or phrase their pain and discomfort, I believe a stance should be taken on the topic.
Spinal Discs Overview
Your spine consists of 24 individual vertebrae stacked on top of each other. Flexible cushions called "discs" live between each set of vertebrae. A disc is made up of two basic components. The inner disc, called the "nucleus", is like a ball of jelly about the size of a marble. This jelly is held in place by the outer part of the disc called the "annulus", which is wrapped around the inner nucleus much like a ribbon wrapping around your finger.
Can Disc Material Slip?
In short, my answer is: yes, disc material can slip.
The spine does NOT slip in relation to itself (bar any extreme trauma such as a motor vehicle accident). For example, one patient of ours visually showed us, with his hands, a mechanism of action whereby he believed his spine "slipped into two pieces" when he lifted snow with a shovel and experienced his excruciating symptoms. While this mechanism makes ideological sense to patients who currently have low back pain, for example, it is important to note that the SPINE IS NOT FRAGILE, is quite robust, and was DESIGNED TO MOVE, BEND, LIFT, AND FLEX.
One of the definitions of the word slip is "go or move quietly or quickly, without attracting notice". In this sense, we would argue that yes, disc material does slip.
How Does a Disc Slip?
A “Slipped Disc” is properly known as a disc lesion. Disc lesions start when the outer fibers of the disc become strained or frayed. If enough fibers become frayed, this can create a weakness and when the disc is compressed, the outer fibers may "bulge" or "protrude" like a weak spot on an innertube. If more fibers are damaged, the nucleus of the disc may "herniate" outward.
Since this progression of disc material is outside of its original position, and is often WITHOUT notice of symptoms (especially pain), we would argue the usage of the word "slip" is accurate. The disc material slips through the annular fibers into the nearby joint space. The most shocking bit to patients is when we tell them that this does NOT always produce pain.
How Does a Slipped Disc Produce Pain?
Surprisingly, disc bulges are present without any symptoms in about 1/3 of the adult population! Another one-third of adults will experience pain from a lumbar disc at some point in their lifetime. Most lumbar disc problems occur at one of the two lowest discs-L5 or L4.
The disc material must make contact with the nearby nerve root for the sensation of discomfort to be triggered. Since the spinal cord and nerve roots live directly behind the disc, bulges that are accompanied by inflammation will likely create lower back pain that radiates into the buttock or the entire lower extremity. This condition is called sciatica.
Risk Factors for Slipped Discs
The condition is more common in men. Smokers and people who are generally inactive have a higher risk of lumbar disc problems. Certain occupations may place you at greater risk, especially if you spend extended periods sitting or driving. People who are tall or overweight have an increased risk of disc problems. The condition is uncommon in children and is most common between the ages of 40 and 60.
Treatment of Slipped Discs
Researchers have shown that disc bulges and sciatica may be successfully managed with conservative care like the type we will provide at Key Spine Care.
Each week at our office in Frederick, MD, we help men and women overcome disc injuries. If you, or someone you know, are suffering from a slipped disc, then please know we can help.
Most of our patients come to us after going to see a physical therapist or their primary care physician, only to be discouraged by a lack of progress or the recommendation of pain pills and muscle relaxers. We know, and our patients know, these are NOT effective long-term strategies for spine pain.
In addition, most of our patients come to us with a specific goal in mind. If you have a health or fitness-related goal, and your spine pain is currently preventing you from doing your favorite activities, such as running, cycling, CrossFit, martial arts, etc, then I have good news for you - we are here specifically for you.
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- Share this article with a friend or family member who has been dealing with constant back, neck, shoulder, hip, or knee pain that we could help!
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Sources:
Lumbar Disc. ChiroUp. (n.d.). Retrieved April 1, 2024, from https://app.chiroup.com
Sources:
Lumbar Disc. ChiroUp. (n.d.). Retrieved April 1, 2024, from https://app.chiroup.com
