Dr. Andrew Arnold talks about ‘The Slipped Disc’, and what’s really going on? A Chiropractic Perspective.
When a patient tells me they have a slipped disc I am immediately skeptical. How do they know this, who told them, and how was it described. There is an evidence-based criterion for disc problems, used by all health professionals from Orthopaedic surgeons to Chiros and Osteo’s. It’s imperative to sort fact from fiction, at least the best we can with the resources we have.
So let’s break this down. A spinal disc is basically comprised of several fibrous ‘onion ring’ layers around a central material called the nucleous pulposis. The role of the disc is to act as a shock absorber. Age increased abnormal load bearing, injuries etc. may compound and lead to damage to the disk. This can happen over a long period of time or acutely and produce an array of symptoms. Most commonly patients present with what I call uncomplicated back pain, i.e. an inflamed, bulging disc and associated structures including the nerve root possibly, with the possibility of a ‘papercut’ type tear in one of the ‘onion layers’. This can be a pain generator and cause the muscles to react by spasming and causing pain. This is not a slipped disc. Chiropractic manipulation/mobilization, electrotherapy, soft-tissue etc. all help to restore circulation and mobility to this area and reverse the altered joint mechanics. These people do not have referred pain.
The next stage is protrusion where more ‘onion rings’ have been disrupted. The nucleous pushes along a weak spot and produces a focal or broad bulge outside the normal parameter of the disc. This may impinge the nerve root. This person may have referred pain down the legs and be bent off to one side. Pain can still be variable. This is more like a slipped disc. A protrusion may still be amenable to Chiropractic care.
The next stage is extrusion where the nucleus material has broken thru all the ‘onion rings’ and maybe sitting in the hole where the nerve roots exit the spine. This will produce referred pain down the legs, much more painful and often requires pain meds and orthopedic assessment.
The next stage is sequestration which not good. This certainly could be a medical emergency. You will be in severe pain, and certainly, this is beyond Chiropractic care.
Your Chiropractor will start with plain film xrays. If you referred pain, or more significant pain, not responding to treatment, he/she may refer you for CT scan via your GP. In some cases, an MRI may be indicated. These provide more detailed views of the disc.
So a disc will slip relative the vertebrae above if it has torn in some way. Chiropractic care can not reverse this slip. The putting your back, back in phenomenon relates to improving circulation and nerve supply to the area thus facilitating scar tissue repair and helping reduce inflammation and therefore pain.
Orthopedic surgeons, for the most part, will always encourage conservative, Chiropractic/Physio care before considering any surgery.
The rule of thumb is if you can get yourself to the clinic then it is unlikely you have a very serious disc problem. Chiropractic can certainly help your discs heal, and aid muscle rehabilitation, as well as aid prevention from something more serious, occurring.
For more information visit www.cranbournefamilychiro.com.au or call us on 59984554.
About the Author:
Dr. Andrew Arnold is a Chiropractor from Cranbourne Family Chiropractic and Wellness Ctr.