Lumbar Disc Injuries and Chiropractic Treatment

What is a ‘Slipped Disc’?

You may have heard the term ‘slipped disc’ but this is a rather inaccurate term, as discs actually cannot slip out of place.

The discs are firmly attached to the vertebrae. They can wear, split or herniate, but they can’t slip!

The normal, healthy disc is very strong. It is stronger than the vertebrae themselves. If you have a compression injury in a healthy spine it is more likely to cause a fracture of the vertebrae rather than a disc injury. Over time as the disc undergoes wear and tear, following cumulative strain from repeated bending, twisting, lifting and prolonged sitting, the strong fibres of the annulus can tear, allowing ‘leakage’ of the nucleus out of the centre of the disc. This is known as a disc herniation.

This ‘leaked’ material may then cause an inflammatory reaction and sometimes put pressure on the spinal nerve that runs next to the disc, resulting in leg pain (Sciatica), if it affects the discs in the lower back or arm pain if it affects the discs in the neck.

You can also get pain from the disc even if there is no herniation, just ‘internal’ damage, but then you are less likely to get the typical signs of sciatica.

Are disc injuries a common problem?

The term ‘slipped disc’ is used quite frequently as a diagnosis of back pain, but contrary to popular belief, disc herniations are not a common problem.

The most common cause of sciatica is referred pain from the muscles, joints and ligaments of the spine. Not disc injuries (see Part II of Disc Injuries and Sciatica).

It is estimated that approximately 3-5% of patients who consult a physician with lower back pain do so as a result of a disc herniation.

The annual incidence is only in the region of 0.1 – 0.5% of the general population between the ages of 24 and 64 years and it is most commonly seen in the ages between 30 to 50 years.

Although not common, a disc injury can potentially be a very serious injury. It is the sort of injury that sometimes requires surgery but fortunately only in a small number of cases.

It is important to know that it isn’t the herniation per se that causes the pain, but the inflammation. In a study where MRI scans were taken of people who were without symptoms, it was found that up to 4 in 10 people had herniated discs.

So, the good news is that it is not always necessary to remove the disc herniation by surgery! If you are interested in research read this.

Surgery is sometimes necessary, especially if your bowel and bladder control is affected. These may be symptoms of a rare but important complication called cauda equina syndrome.

If you experience any changes in your bowel or bladder control or numbness in the ‘saddle’ area, you should consult the hospital as soon as possible. The symptoms are reversible when treated quickly.

What shall I do to Prevent Disc Injuries?

There are different degrees of injury ranging from mild tears on the outside of the disc to the more severe, disc herniation.

The risk of developing a disc herniation increases every time you bend forward, especially if you are holding a load and you sit whilst doing it.

The following points will help to reduce the pressure on your discs:

• Avoid prolonged sitting, bending, twisting and carrying.
• Wear a support belt when you do manual work.
• Avoid prolonged driving.

Some of the risk factors for developing a disc injury are, if:

• You have had episodes of back pain in the past.
• You have poor physical fitness and poor core stability.
• You do a heavy manual job involving bending and lifting.
• You have a job involving prolonged sitting and vibration ie. driving.
• You smoke.

If your back and stomach muscles are strong, you bend correctly and you sit correctly, you will protect the spinal structures, including the discs.
If you exercise regularly, it is also important to avoid exercises that involve repeated bending and twisting, especially whilst sitting.
Sit-ups and twisting stretches of the back are not as good as you might think!

Chiropractic Treatment

Chiropractors do treat disc herniations and many scientific studies have shown that a high proportion of patients find relief with this kind of treatment. It has also been shown that Chiropractic treatment is superior to the application of heat, exercises, postural education and also conventional physiotherapy.

A study published in the very prestigious scientific journal, Spine, in 2006 showed excellent results of Chiropractic manipulation in the treatment of disc injuries and sciatica! If you are interested in research read this.

At the Isis Clinics, we use a combination of highly specific manual techniques, followed by a rehabilitation exercise programme, utilising our on-site gym, following tried and tested methods.

We also have a new treatment specifically for disc injuries called Intervertebral Differential Dynamics (IDD) Therapy, which is a real game changer for treating disc injuries.

How long will it take to get better?

Your Chiropractor will discuss with you the frequency of visits required for treatment. The healing process takes time and varies from person to person, often depending on the severity of the condition and the history of the complaint.

However, how active and compliant you are in your own treatment will influence your recovery time.

Meanwhile, if you have any questions, please ask your Chiropractor.

Please read Self help for Disc Injuries.