My doctor tells me I have a “slipped disc” What is it?
In my experience, when people are told they have a “slipped disc”, it is rare that it is actually a genuine injury to the intervertebral disc.
Most of the time the pain is caused by an awkward movement, leading to inflammation in the spinal joints triggering a severe muscle spasm.
Disc structure
Intervertebral discs are composite structures. They have an outer section with layers of tough, stretchy fibres. The fibres are made of collagen, much like ligaments and tendons. Each layer lies in the opposite orientation to the previous layer, providing strength and resistance in rotation, compression and tension.
The outer layers surround a shock absorbing gel. This gel has a high water content which helps to cushion any compression the spine goes through.
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During the day, the compression of the disc as we stand upright pushes the water content out of the disc. When we lie down at night, the comparative traction in the disc causes fluid to re-enter the disc. This also brings in the nutrition that the disc needs.
Disc analogy
A lot of people find it easier to understand the outer layers a bit like the layers in an onion made of elastic. Fibres stretch and then return to their original shape due to the highly elastic collagen. The inner section is like a water balloon filled with toothpaste. (Don’t worry, there isn’t any toothpaste in your spine, the fluid just has a similar consistency to toothpaste.)
Disc ageing
Discs spend a lot of time in compression while we are upright, reducing the water content in the intervertebral disc over time.
The gel-like fluid becomes much thicker from the age of about 65 onwards, as the water content that gets squashed out of the disc whilst upright does not move back in as fast later in life. This means that beyond the age of around 60 to 65 genuine disc prolapses are much more rare.
Genuine ‘Slipped Disc’
When a disc is stretched in a combination flexion and rotation movement enough times, the outer layers can be damaged. It happens slowly. Micro-trauma to the collagen fibres – one or two fibres breaking every time you bend can accumulate to weaken the outer disc layer. Eventually, the outer structure can be injured enough to inadequately support the inner fluid. This leads to a bulge or even a complete prolapse. A prolapse is where the inner contents escapes through the outer layer.
This can result in a lot of pain as the disc pushes into other tissues. and there is usually a lot of inflammation. If the disc is pressing on a nerve, you can get pain in an arm or leg, even weakness, numbness or tingling.
The usual ‘Slipped Disc’
Normally, things aren’t that bad. It is common to jar or strain your back and trigger muscle spasm. Sometimes something quite small can set off inflammation of the joints in the back and cause pain.
Most of the time, it can easily be fixed with some osteopathy. We relax the muscles, improve the blood flow, stretch and move the joints and try to take any strain out of the area.
Pain usually improves the same day and if you catch it quickly, you can find that most of the pain from an acute episode is gone within a couple of weeks.
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