Let’s cut through the myths and misinformation regarding back pain as I reveal:
- Can discs really slip? Can they cause pain and if so how?
- How do you get problems like sciatica and pinched nerves and how best to treat them?
- How to decrease your chance of back surgery by 42% (it’s easier than you think)
- The best exercise to do when you have back pain (hint:it’s NOT about strengthening your core)
– Hi, in this short video we’re going to talk about the truth about slipped discs, how you actually injure your back and cause disc problems, what can happen when you injure the disc and what you can do about it. So, stay tuned.
Hi, it’s Dr Leevi from Wises Road Chiropractic and we’re talking about slipped discs today. Now, the truth is even though this is a commonly used term, you can’t actually slip a disc. You can injure discs and what I want to do in this video is explain to you a bit about what actually happens to the disc when you injure it. So to do that, we’ll use the models and I’ll get to that. One really common question people wonder is, well, how did I injure my back or the discs in my back? And, it’s a great question.
Quite often we think that it’s from doing something crazy or out of the ordinary or lifting something really heavy. The truth is, research has shown and with a lot of the patients I see here at the clinic, it’s our everyday tasks that we do. Typically, it’s a repetitive task that we do day in, day out and they just build up and they take a stress on the disc or the joints of the spine and eventually you reach a little tipping point where quite a menial or trivial event such as, waking up in the morning and getting out of bed, tying up your shoelace, bending over in the shower, picking up a newspaper. Those are the types of things you may have heard someone say, ah, my back just went out or I slipped a disc. So, truth be told you can injure your disc, but it’s typically not done with crazy heavy lifting, it’s done with those trivial sort of menial events.
Let’s dive in and have a look a little bit more about the anatomy of the spine and the discs so you can better understand how an injury happens to the disc and I’ll talk about the common injuries that we have. To do that, I’m gonna use my model of the spine here. And, you can see here with the model of the spine the spine is facing this way. So, this is the front of the spine and your ribs would be here and you would be facing that way. At the back of the spine you can see all these processes here, these bony processes. These are the ones that you can actually feel and sometimes see on your actual back.
Now, when we look at the spine here we see that there are three normal curves, forward curve in the neck, a forward curve in the lower back and then a reverse curve through the mid-back. Between the bones of the spine you’ll see the discs. So, let’s have a closer look at the discs. So, here with my little spinal model let’s have a closer look at the disc. So, once again just to orientate ourselves, this is the front of the spine and this is the back of the spine, those are those bony processes that you can sometimes feel and see at the back. We’ve got the bones of our spine and between the bones we have the disc.
Now the discs acts like a shock absorbed between the bones and you’ll actually see it actually is connected to the bones above and below. Above and below each disc is a bone and the disc is connected to those. So, the disc itself can’t actually slip out and physically go anywhere. What can happen is you can injure this disc and it can get tears in it and it can start to bulge and even herniate. Now, what’s really important is if you start to have a look at, the disc is actually a shock absorbed between the bones that acts as a spacer to allow this to come out, these things. These are spinal nerves coming off your spinal cord. So, the brain up in our heads sending messages down the spinal cord, out to the body and it’s talking to your muscles, your organs and your tissues through these nerves and you can see the disc is an integral part of supplying space to that nerve.
Let’s have a look at a bird’s eye view of the disc and to see what happens when it gets injured. Alright, so to gain a better understanding of the disc let’s have a look at a bird’s eye view of the disc. Now, we are looking at the same little spinal model just from the top so let’s orientate ourselves. This is the back here, those spiny processes and this is the front of the disc of the spine. Now what you see with the disc is, we’ve actually got a fibrous outside layer made out of rings. These are quite fibrous, tough connected rings and then inside you’ll see a different sort of a substance, this is the nucleus of the disc. This is quite a viscous jelly like substance like a toothpaste type of substance. Now, these fibrous outside layers, even though they are quite thick and connective tissue, what can happen is over time repetitive injury can start to chip away at these fibrous outside layers and start to cause tearing in them or peeling away in them. And, what you’ll see can happen is, if enough damage is done over time we get damage to those fibrous layers and that inside layer can start to leak out and what can happen is it can start to cause bulges.
Now, what’s really important to understand is, there’s a few key things going on. We showed previously before that the nerve has to come out of this hole, so if that disc starts to bulge it can put pressure or irritation on that nerve. Also, if we have a look at the bird’s eye view, we remember that the spinal cord is actually here and if that disc bulges it can also put pressure on the spinal cord. Now, regardless of that, when this disc starts to bulge and it gets close enough to the edge in the outer third, that area can be painful and sensitive so you will start to feel pain there when that disc gets injured enough, even without it affecting the nerve. So, quite often people wonder what can they do about disc issues.
So, let’s talk about a few scenarios.
Number one, let’s talk about preventing disc issues. Really important to understand how everyday stresses that we are putting on the spine with our posture and the tasks that we do everyday, they’re the things that are going to add up. So, we need to be mindful about posture on a daily basis. Nowadays, really common, people racking up a lot of time at computers. So, we need to make sure our ergonomics are really good. Within the framework of good ergonomics we need to make sure we are regular with our breaks. Research is showing every 20 minutes we must get up and walk around because after 20 minutes of loading the disc doesn’t get much fluid exchange, it depends on our movement to help exchange fluids to keep it nice and healthy. So, set your timer, set a watch, the phone, something like that so you get up from your desk every 20 minutes and break up that sitting. Other thing that’s really important is, if we’re starting to have some issues it’s really important to address them.
So, I spoke previously about how the disc gets injured and it’s a slow process over time. The body will let you know. You’ll have warning signs that areas are getting stiff, achy and sore. They may be inconsistent, they may not be that severe, do not wait till they are consistent and severe. It’s best to do something in those early stages and really get on top of things. So, get things sorted out in those early stages. Don’t procrastinate with your health. Secondly, if we are getting to the stage where things are feeling quite uncomfortable, it used to be recommended that bed rest was a good thing to do. Much research has shown that, that isn’t a good thing to do. What will happen is, that lack of movement will cause a de-conditioning of the muscles that help stabilize your spine and helps support you. That can happen quite quickly with those important back stabilizers. So, movement is really key. It doesn’t have to be anything crazy, within your pain-free limits just walking on a nice flat surface.
I often tell my patients, in those early stages if they are very acute and inflamed, walking up and down the hallway with bare feet is the best thing that they can do for their disc or their back issues. The other thing that’s really important to understand is, some really interesting research came out a couple of years back talking about the incidents of spinal surgery and back surgery and they were saying that if your first port of call for your back problem is a medical doctor or a surgeon, there’s a 42% chance that you’ll end up with surgery.
On the other hand if your first port of call for your back problem was a chiropractor, there was only a 1.5% chance that you would end up with surgery. So, I urge people to really explore their conservative options first. I think that that’s really, really important.
Now, if you know someone, if you enjoyed this video, thanks for watching and if you enjoyed this video and got something out of it, do me a favor and share it on your timeline. You may have friends or family who are suffering with back pain and the information in this video could really help them out.
If you’ve got any questions about anything that we chatted about in this video, about chiropractic, about your back problem, disc problem, leave them in the comments below and I’ll do my best to try and answer them.
Thanks again for watching and I’ll speak with you soon.