This is something that we get asked frequently. We encourage patients to discuss their conditions with us – but we really like everyone to know exactly what is and isn’t going on in their bodies.
So here is an easy-to-understand guide to your spinal discs…
The discs are sort-of like a flat, round tube of toothpaste. They have strong thick fibres stretching around the outside of the disc, called the “annulus fibrosus“. These fibres protect the inner part of the disc, a gel-like substance called the “nucleus pulposus” A bird’s-eye view of a healthy disc would look a bit like this:
You might have heard of someone “slipping a disc”. Strictly speaking this is impossible, the disc cannot physically slip anywhere! A more accurate description would be a disc bulge or a disc herniation.
A disc bulge occurs when the protective fibres surrounding the outside of the disc become damaged and break. This means the gel -like substance within the disc pushes (bulges!) out through the area where the fibres have broken, and sometimes causes pressure on the spinal nerve. This can be extremely painful and can often result in loud expletives!
It is also very unlikely that you will be able to move much at all without very severe pain, usually shooting into the leg and/or foot.
Do I have a Disc Problem?
Officially we cannot say with 100% certainty that a disc is damaged without obtaining an MRI scan of the spine. However, through careful diagnostic tests and experience we as chiropractors can make an educated diagnosis of a disc bulge, and treat it conservatively.
Here are some things to look out for if you suspect you have a disc problem (This is not a definitive list, but these are the most common symptoms) :
- Shooting/sharp pain into the leg, especially below the knee and into the foot.
- Numbness and/or tingling down the back or side of the leg
- Weakness of certain muscles in the foot, resulting in the patient being unable to stand on tip-toes or feeling like the foot is “slapping” the ground when walking
- Standing straight is so painful that you have developed a stooped forward posture
What is the likelihood that I have a disc problem?
Thankfully – it is quite unlikely that the pain you are experiencing is from a disc bulge compressing your spinal nerve. Most studies show an incidence of 3-5% of patients with lower back pain have this condition. (1)
Men are most commonly affected in their 40s, whereas women are most commonly affected between ages 50-60. It is more common in men and out of the people who have this condition, only ~5% become symptomatic!
Furthermore – if you are 50 years old there is a 60% chance that you have some sort of disc bulge, even if you are completely asymptomatic! (2) Which has led many experts to believe that disc problems are massively over-diagnosed, resulting in many unnecessary potentially dangerous spinal surgeries.
What do I do if I suspect I have a disc problem?
This is easy – CALL US! There are many musculoskeletal complaints that can mimic disc problems, many of which are easily fixed. What if you do have a disc problem? Well truth be told – often they are easily fixed too. Whereas we never truly know whether the disc “goes back in” or not, in almost all cases the symptoms do subside. The down side is it often takes significantly longer and requires more treatment, and requires the patient to be very patient! And very careful. It is also essential to perform rehabilitative exercises once things are better.
It is very important to remember just how unlikely it is that your complaint is stemming from the disc. But if you are worried please consult a health professional. Our chiropractors are fully trained in specific spinal assessment techniques, and if we suspect a disc we will keep you fully informed at all times. We will always refer you to your GP if we have any concerns. Make an appointment by calling 01330 824040 or emailing us at firstname.lastname@example.org.
If you ever experience any of the following symptoms, it is important to contact NHS 24 or the relevant emergency health centre. These signs may indicate cauda equina syndrome, which is very rare but is a medical emergency.
- Numbness or tingling in the “saddle” area (between the thighs and/or around the perineum)
- Numbness when wiping yourself after going to the toilet
- Any signs of incontinence (bowel or bladder) that weren’t a problem before
- Severe pain in both legs, specifically the back or inside of thighs
- Tarulli AW, Raynor EM. Lumbosacral radiculopathy. Neurol Clin. 2007 May. 25(2):387-405. (LINK to article)
- Brinjikji et al, Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015 Apr;36(4):811-6. doi: 10.3174/ajnr.A4173. Epub 2014 Nov 27 (LINK to article)