What is a ‘slipped disc’?
The familiar term ‘slipped disc’ is a misnomer. The discs between the vertebrae of the spine are firmly attached and cannot actually slip out of place. However, they can wear, split and herniate (bulge out).
A normal, healthy disc is very strong but over time, as it undergoes wear and tear from repeated bending, twisting, lifting and prolonged sitting, the outer ring of disc fibres (the annulus) can weaken allowing ‘leakage’ of the softer, inner tissue out of the centre of the disc. This is a disc herniation, which may result in an inflammatory reaction and put pressure on the adjacent spinal nerve resulting in leg pain (sciatica) as well as back pain.
Is it a common problem?
The term ‘slipped disc’ is used quite frequently as a diagnosis for back pain but, contrary to popular belief, symptomatic disc herniations are not that common and ‘sciatica’ is often due to referred pain from the muscles, joints and ligaments of the spine.
Disc herniation can be a serious injury possibly requiring surgery although, fortunately, only in a small number of persistent cases. Urgent surgery may be indicated if your bowel and bladder control is affected; these may be symptoms of a rare but serious condition called cauda equina syndrome.
If you develop back pain with leg pain/weakness and also experience any changes in your bowel or bladder control, or numbness in the ‘saddle’ area, you should seek medical advice from your local A&E department without delay.
What can I do to prevent disc injuries?
There are different degrees of injury ranging from mild tears on the outside of the disc to more severe protrusions.
The risk of developing a disc herniation increases every time you bend forward, especially if you are holding a load and you twist or sit whilst doing it.
The following points will help to reduce the pressure on your discs.
- Avoiding prolonged sitting, bending, twisting and carrying
- Using a support belt to keep your back straight when you do manual work
- Avoiding prolonged driving
Some of the risk factors for developing a disc injury are:
- Episodes of back pain in the past
- Poor physical fitness and poor core stability
- Heavy manual work involving bending and lifting
- Prolonged sitting and vibration i.e. driving
If your back and stomach muscles are strong, you bend correctly and you sit correctly, your spinal structures, including the discs, are protected. While regular exercise is important, exercises involving repeated bending and twisting, especially while sitting, should be undertaken in moderation. Sit-ups and twisting stretches of the back are not as good as you might think!
Your Chiropractor has the necessary skills to diagnose a herniated disc and to advise on treatment. There are a number of treatment options depending on the severity of the condition and these include chiropractic manipulation (Santilli et al, 2006) and associated physical therapy.