At some point in your life you or someone you know has probably stated they’ve “slipped a disc,” pinched a nerve, or “thrown” their back out. This event is often associated with low back pain, and may be debilitating in some cases. So what‘s happening when all this slipping and pinching goes on? Short answer: some sort of disc injury has been sustained. Long(er) answer: continues below.
Well first, let’s talk about what a disc is and its function within ones’ body. An intervertebral disc is made up of two components, a gelatinous middle portion called the nucleus pulposus, and a fibrosis outer ring called the anulus fibrous. Discs sit between each vertebral segment of your spine (minus the top cervical segments) and act as shock absorbers for the spine. They also help with spinal column motion and movement. Overtime, the forces and loads that the discs are asked to endure begin to break their structure down. This commonly presents as a compressed looking structure and is referred to degenerative disc disease (DDD), which is one type of disc injury. DDD symptoms are typically a feeling of stiffness in the area as range of motion is restricted from the disc being compressed and becoming less mobile.
A disc’s outer ring may also weaken overtime and that middle portion, acting as a shock absorber, may actually
push outward into this weaken spot. This creates a bulge which can impact the nerves around the area creating pain and/or symptoms down the legs (or arms, depending on the location). This event is a second type of disc injury called a disc bulge.
The third type of disc injury is a herniated disc. This can happen from either sudden trauma or a disc bulge progressing and breaking through the outer fibrocartilaginous ring. You can think of an intervertebral disc as a jelly donut. In this case the jelly (nucleus pulposus) is actually squirting out of the donut (anulus fibrous). This herniated portion of disc can affect movement of the spine, impinge the nerves in the area or actually impact the spinal cord itself.
It’s not uncommon for disc injuries to cause some level of pain. This could be from the disc itself, the spine, muscles trying to guard the area or the inflammatory response as the body tries to heal itself. Any one of these occurrences could also impact the nerves surrounding the area and create radicular symptoms (pain in areas other than the specific disc injury site). These disc injuries are permanent but their symptoms do not need to be. Many athletes and active individuals function at very high physical capacities with these types of issues. Conservative care has been found to be the most beneficial, and least expensive, first course of action in treating disc injuries. When these injuries occur the muscles around the area will spasm to protect itself often making the symptoms experienced more extreme. Manual therapies have been shown to be very helpful in relaxing these muscles and “calming” the area down. Once that has happened, a specific rehab protocol for your case can be employed to help strengthen the area, thus reducing symptoms and limiting future episodes.
Being properly diagnosed and undergoing a thorough exam is very important because, in some cases, weakness in the extremities or specific numbness patterns should not be ignored. Chiropractic sports physicians are trained to recognize and treat these injuries. At TCSS, we have extensive experience successfully treating the symptoms of disc injuries and will refer you to appropriate place if your case requires more aggressive measures.
Still have questions? Give us a call. Let us help you get better, faster.
Dr. Katie Clare, DC, CCSP, ART
Dauntless Sport & Spine Clinic
4510 W. 77th St, Edina, MN 55435