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Discs don’t slip!

You may have been told in the past by a healthcare professional that you have a “slipped disc”. This often used to describe any condition where the disc (the connective tissue/cartilage in between the vertebrae of the spine) has been irritated. This is very common and does not necessarily mean you will experience any pain (Brinjikji et al., 2015). There are numerous ways that the discs can be affected, and these are detailed below:


Unfortunately, the changes seen in disc conditions lead many to believe that surgery is needed to remove the excess material. However, recent research has started to show that this may not be the case. Instead, it appears the body is capable of reabsorbing this excess material. This was especially so in those conditions that appeared to be more serious.

Disc Sequestration (Figure 5.) had a massive 96% reabsorption rate! This means 96% of the patients with this had fully reabsorbed the excess disc material.
Chiu et al. (2015) also found that disc extrusion (Figure 4.) – the type that is most likely to cause pain – had a 70% resorption rate!
To add to this, a recent systematic review (the gold standard for research) by Lee et al. (2017) assessed low back pain patients with shooting pain down the back of their thigh and/or calf. 50-75% of these patients had both reabsorbed the disc material and had a reduction of symptoms within 6-12 months of the original trigger.

So what does this all mean?


The body is strong and adaptable, and has its own self-regulatory mechanisms to help itself.
It also reassures us that even if we have a scan that tells us we have a disc bulge, we don’t need to be running to the surgeon for disc removal surgery.
It shows us is that although you may have irritated a disc in the past, it does not necessarily mean that you will have back pain forever!
Back pain can and will get better with time.


Some important things to note!


As always, this article is informational and not diagnostic, so please check with a medical professional when you have back pain. This is especially so if you have any of the following signs or symptoms:

Groin numbness or loss of sensation when going to the toilet
Severe weakness of limbs
Changes to your bowel or bladder function
Constant, unremitting pain that doesn’t get better with rest
Night pain
Fall from a great height
Infection (fever, weight loss etc.)


If you’ve read this blog and thought 6-12 months is too long to have back pain, osteopathy may be a great option for you. Osteopathy has been shown to help reduce pain, improve quality of life, and reduce disability in low back pain patients (Orrock and Myers, 2013). It is actually how you react to your back pain/irritated disc is often a better predictor of whether this pain continues in the long term.

If there is one thing to take away today…

It is that discs do NOT slip, or move, or fall out of place. They are firmly attached by strong ligaments and connective tissue, and are surrounded by numerous strong muscles. They can be irritated, but this is not permanent and there is plenty that you do help reduce its impact on your life!

Harry

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REFERENCES

Brinjikji, W., Luetmer, P. H., Comstock, B., Bresnahan, B. W., Chen, L. E., Deyo, R. A., . . . Jarvik, J. G. (2015). Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol, 36(4), 811-816. doi: 10.3174/ajnr.A4173

Chiu, C. C., Chuang, T. Y., Chang, K. H., Wu, C. H., Lin, P. W., & Hsu, W. Y. (2015). The probability of spontaneous regression of lumbar herniated disc: a systematic review. Clin Rehabil, 29(2), 184-195. doi: 10.1177/0269215514540919

Lee, J., Kim, J., Shin, J. S., Lee, Y. J., Kim, M., Jeong, S. Y., . . . Ha, I. H. (2017). Long-Term Course to Lumbar Disc Resorption Patients and Predictive Factors Associated with Disc Resorption. Evid Based Complement Alternat Med, 2017 doi: 10.1155/2017/2147408

Orrock PJ, Myers SP. Osteopathic intervention in chronic non-specific low back pain: a systematic review. BMC Musculoskelet Disord. 2013 Apr 9;14(1):129.

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