This is perhaps one of the most common phrases I hear day to day. But did you know it doesn’t actually happen? A disc can’t slip! A rather important piece of anatomy that seems so misunderstood by so many. Your 23 discs are strategically positioned between the bones of your spinal column, attached to the vertebra, they act as shock absorbers and assist with movement. A disc is comprised of a tougher outer ring structure and a softer, jelly like inner portion.
Despite many popular yarns claiming the contrary they don’t and won’t slip. This may seem like semantics but with over 11 years of experience as a chiropractor in Newcastle helping people with disc complaints, it’s vital you understand the type of disc injury you are dealing with. You see a disc has many paths it could take, it may degenerate, bulge, prolapse, herniate or even sequestrate and the best course of action, management plan and outcome can be quite different for each.
Often disc injuries will start with a small weakness or tear in the outer ring fibres, leading to some of the soft material migrating outwards. This can lead to the irritation of sensitive nerves, which may result in pain travelling down the course of the nerve. The well known example is the “sciatic nerve”.
The 4 stages of disc damage
Stage 1: Degeneration
Hydration of the disc is lost, it therefore becomes less elastic and more brittle.
Stage 2: Prolapse
Tiny tears of the outer fibrous ring make way for the softer inner gel-like part of the disc to bulge out or produce a “bubble”. This is often referred to as the bulging disc. The material from the inner part of the disc is still contained.
Stage 3: Extrusion
Once part of the inner disc breaks through the outer fibrous layer but still remains within the confines of the disc we have an extrusion.
Stage 4: Sequestration
The final development occurs when the inner gel of the disc leaks through the outer annular layer of the disc and moves into the spinal canal.
Disc degeneration and prolapse are often referred to as incomplete stages, whereas stages 3 and 4 are complete disc herniation’s. Pain as a result of disc changes may be combined with what’s called a radiculopathy, which is a neurological deficit. The deficit that’s experienced may include motor changes (weakness or reflex loss) and/or a sensory change ( tingling, numbness). Many people walk around every day with bulging discs and experience no pain because there is no chemical irritation to the disc or to its surrounding structures. I hope this encourages you to understand your disc injury beyond a “slipped disc”.