Your Disc Does Not Slip!!
Updated: Nov 26, 2019
What is a disc?
A disc is a fibrocartilagenous structure that acts like a cushion between the bony vertebrae that make up our spinal column.
The disc is made up of a central nucleus pulposis and and outer ring called the annulus fibroisis. The nucleus pulposis is a gel like structure that has the composition of toothpaste while the outer ring of annulus fibrosis keeping this gel intact and has the consistency of chewing gum, its main role being to keep the gel inside the nucleus while still being able to move itself.
The disc is anchored in place between two vertebrae
by a cartilagenous layer of the end plates.
The disc has no direct blood supply and depends
on the end plates to diffuse nutrients to them.
What happens to a disc when it gets injured?
Disc slipping, disc herniation, disc extrusion, disc protrusion, disc bulging all very confusing terms!
The most important question here is - Is the annulus fibrosis (the outer ring) intact or is it torn?
If the outer layer tears it causes all the inner gel (nucleus) to spill out irritating the nerve with chemicals causing severe pain, this is caused a herniation.
If the outer layer is intact but misshapen due to injury or repeated forces this is called a protrusion, and while it can cause pain most disc protrusions resolve well with accurate and time sensitive treatment.
Look after it sooner rather than later. A disc cannot ‘slip’, it is held firmly in place by cartilage between the vertebrae so it cannot ‘slip’ anywhere to be ‘put back in’ by any medical professional, including Gandalf himself.
A disc can be squeezed, stretched, and twisted in minor degrees and can be degenerated, herniated, and protruded but it cannot slip anywhere.
How does physiotherapy help?
Physiotherapy is key to the successful management of disc protrusions.
The role physiotherapy plays in the early stages is to provide pain relief by reducing muscle spasm responses and normalising movement patterns to prevent any harmful movement compensations that could have long term consequences for a client’s back health.
A combined management approach with a client’s general practitioner (GP) yields the best results.
Once the acute bout of back pain has settled physiotherapy plays its most important role in minimising the compensatory movement patterns ensuring the correct muscles do their job at the right time.
Movement sequencing or using the correct muscles for the job at the right time, ensures your movement patterns are smooth and pain free. Through manual therapy or ‘hands on’ release of restricted soft tissues and individualised exercises targeting both strengthening and endurance of the muscle fibres, physiotherapy guides your movement to restore its optimum sequencing getting your back on track.
Is a scan necessary?
X-rays for low back pain are almost always (99% of the time) inconclusive as regards the source of the pain and thus useless!
An MRI may be required, but only in certain circumstances. An MRI would only be indicated if you have loss of power into your legs, loss of bladder and bowel function, numbness in the buttock or saddle region, complete loss in sensation down your leg/s.
All the above issues would be considered a medical emergency and you should be contacting your GP or attending Accident and Emergency should you experience any of these symptoms.
At Fox Physiotherapy you’re always in good hands