What is a ‘slipped’ or bulging disc?
There are many terms used to describe damage to spinal discs and the associated pain syndromes that go with them. One of the major misconceptions is that discs can ‘slip out’ and then be pushed back in or they go back in on their own. If this was the case, we are walking around with these structures in our back that are a ticking time bomb for some people that can just fall out and then fall back in just as easily.
How do they occur?
In medical terms, discs can bulge, rupture, herniate, desiccate, and even sequestrate. Many terms can be used to describe what happens to the disc. Rather than concentrating on which term is best to describe the disc, it is more useful to gain a clear understanding of the precise medical diagnosis. This diagnosis identifies the specific cause of the individual’s back pain, leg pain or other symptoms.
Our chiropractors here at Neurohealth are specifically trained in how to identify the cause or the underlying issues. We look at the whole picture as in your physical, emotional, and nutritional status. Then we take a detailed review of the patient’s history, conduct a complete orthopedic, neurological and functional exam of the body to identify the underlying insufficiencies. They are also able to refer for diagnostic tests such as X-rays or MRI if needed.
Whats causing my pain?
On average, there are two types of causes of the pain. Either a nerve being irritated (pinched) or the disc causing pain.
- Pinched nerve – is caused by inflammation in the Intervertebral foramen (IVF) caused by swelling in the disc or the material inside the disc leaking out into this space causing the nerve to be entrapped and irritated. This type of pathology causes radicular pain (nerve root pain) leading to pain that may radiate to other parts of the body, such as down the back of the leg if the nerve is pinched in the low back, or in the arm if from the neck. Leg pain that goes down the back of the leg is typically called sciatica. Other signs of radicular pain are numbness or pins and needles in the hands or the feet.
- Disc pain – is when the individual has a symptomatic degenerated disc in the back or neck. It can often be called degenerative disc disease (DDD). DDD is usually caused by lack of movement in the area due to repetitive trauma such as poor posture or from sitting too long or can be caused by larger trauma such as motor vehicle accidents.
Either of these two conditions can occur anywhere in the spine. The discs go from the base of our skull (C1/C2), all the way to our tailbone (L5/S1). The most common discs damaged in the spine are in the lower back because this area takes the most torque and force on a day to day basis from our upright posture. The levels L5/S1, L4/5 and C5/6 are typically damaged the most.
To diagnose a disc definitively, an MRI is preferable or at least a CT scan. One must keep in mind that disc bulges can be quite popular in the ageing population and can still be asymptomatic. Meaning no pain at all. Journal of Radiology published a systematic review in 2014 showing disc bulges occurred in 30% of 20-year old’s, 50% of 40-year old’s, and 77% of 70-year old’s. Each age group reported no symptoms. Therefore, a diagnosis of a disc needs to be correlated between the history, examination and the imaging findings before deciding on what is the most successful treatment protocol.
If you would like more information or would like to book an appointment at Neurohealth Chiropractic please call the clinic on 9905 9099 or firstname.lastname@example.org or fill in the contact form from our website www.neurohealthchiro.com.au
This article is written by Dr. Steven Cannon, Chiropractor at Neurohealth.