Many of you reading this will have a colleague, friend or relative who’s reported having a “slipped” disc, or knows someone else who’s had this condition. So, what exactly is a slipped disc?
If you noticed the speech marks round the title, it probably won’t be a surprise to learn that discs really don’t “slip!” The discs are a series of pads made from cartilage, which sit in between the bones of the spine (vertebrae) and act as shock absorbers. They have a jelly-like centre, and together with the tough cartilage they’re made from, they can absorb the repeated shocks which run up through the body from walking, running, bending, stretching and lifting.
If too much force is pushed through them (often as a result of lifting something too heavy, or by lifting and twisting at the same time) the out ring of cartilage can be damaged and bulge into the space where the nerve root emerges from the spine – this causes local pain from the damaged disc and often, pain along the course of the nerve (one of the causes of sciatica, for example).
In serious cases, the outer part of the disc may rupture completely, allowing the centre of the disc to leak out. In either case, although the disc is damaged, it doesn’t actually slip out – it’s held in place by too many really strong structures – it’s better to refer to it as a disc prolapse, or a disc herniation.
So, can it be treated? The honest answer is, “sometimes.”
If the prolapse isn’t too bad, treatment involves soft tissue work to relieve the spasm which occurs and mobilisation to open the space between the vertebrae and take the pressure off the damaged disc while it attempts to heal. Ultrasound is often used too, to promote healing.
If the injury is going to respond to treatment, the patient can usually tell by the third or fourth session as things will be improving slowly, but steadily. If, on the other hand, it’s too serious to respond to manual therapy, the pattern will be of temporary relief following treatment after which the pain returns – if this is the case, referral may be necessary and surgery may have to be considered. The good news is, that in many cases, manual therapy proves to be helpful, and with care, many patients make a good recovery.