Can you really slip your disc?
This common phrase has been used for decades by many individuals with neck and lower back pain. This is a common misconception, as in the literal sense it is virtually impossible for your disc to slip out of your spine.
A better and more correct way to refer to this pain is to say that you are experiencing a disc bulge or disc herniation.
So what really happens?
Repetitive bending of the spine over a prolonged period of time, repetitive high load activities, incorrect lifting techniques, degeneration, inactivity and obesity can all result in a bulging or herniated disc. A bulging disc is a displacement of the jelly-like central disc material outwards into the thicker fibrocartilaginous layers surrounding it. A disc herniation occurs when that jelly-like material actually escapes through a weakness in that surrounding layer.
One can use Oreos and doughnuts to better understand these concepts. If you squeeze the 2 biscuits of an Oreo together on one side, the cream filling will bulge on the opposite side. This is very similar to what happens with a disc bulge. If you squeeze a jam doughnut, some of the jam will come spilling out of the doughnut and this is very similar to what happens with a disc herniation
So what does this mean?
As the disc is protruding into any area of the spine that is generally unoccupied it can put pressure on other structures. For instance, it can press on one of your nerves, eliciting pain or a tingling sensation or even just plain old numbness. In many cases though there are few symptoms and very little pain. However in more severe cases this can result in pain, numbness, tingles or weakness in the middle or on one side of your spine. It may also result in you experiencing these symptoms in your gluteal region or leg if a lumbar (lower back) disc is affected or into your shoulder region, arm or hand if a cervical (neck) disc is affected.
- Bulging discs are normal. Approximately 40% of people WITHOUT lower back pain have a bulging (swollen) disc in their back. (1,2)
- Bulging discs SHRINK. A bulging disc on the initial MRI compared with a second MRI taken two months later usually shows that the bulge is 50% smaller and completely gone after 1 year. This is due to the body reabsorbing the fluid while the disc heals. (3,4)
- Disc bulges can and do change shape as well as size throughout the day. Discs are 20% more swollen in the morning compared to the evening and thus the time of day an MRI is taken can influence the results.(Ref 5)
- An MRI is just a picture, meaning that its shows that you have a bulging disc at the time the MRI is taken (lying down usually) but doesn’t show how the disc behaves with movement. There is the possibility that the disc above or below can actually be the culprit of your pain.
So what can I do about it?
- Go see your physiotherapist. Physiotherapists are highly skilled clinicians who will be able to assist in: diagnosing your condition, helping to ease your pain, providing you with vital advice on how to manage your condition as well as referring you to any other medical professionals if they deem it necessary. Your physiotherapist may ask you to consult with your GP or pharmacist if you are in extreme pain and require medication.
- Not all back and neck pain is related to a bulging disc and therefore an accurate diagnosis is vital for a speedy recovery. The sooner you seek assistance for your pain, the sooner you can get moving and the quicker you will recover overall.
- Alyas F, Turner M and Connell D, MRI findings in the lumbar spine of asymptomatic, adolescent, elite tennis players. Br. J Sports Med 2007; Nov 41(11): 836-41
- Videman T, Battle MC, Gibbons LE, Maravilla K, Manninen H, Karprio J. Associations between back pain history and MRI findings. Spine 2003; March 15; 28(6): 582-588.
- Autio, RJ, Karppinen J, Ninimaki J, Ojala R, Kurunlahti M, Haapea M, Vanharanta H and Tervonen O. Determinants of spontaneous resorption of intervertebral disc herniations. 2006 May 15;31(11):1247-52.
- Komori H, Shinomiya K, Nakai O, Yamaura I, Takeda S, Furuya K. The natural history of herniated nucleus pulposus with radiculopathy. Spine (Phila Pa 1976).1996 Jan 15;21(2):225-9.
- Malko JA, Hutton WC, Fajman WA.An in vivo magnetic resonance imaging study of changes in the volume (and fluid content) of the lumbar intervertebral discs during a simulated diurnal load cycle. Spine (Phila Pa 1976).1999 May 15;24(10):1015-22.