The term “a slipped disc” is not correct, these structures cannot slip. Mother Nature has the ability to heal most disc injuries.
Our spine is a series of bones stacked on top of each other. In between these bones is a structure called a disc. A disc is built similar to a jelly doughnut. There is tough outer wall called the annulus, and a watery jelly inside the disc called the nucleus. A normal disc acts as a shock absorber pad, and also allows movement in the spinal column.
Spinal Discs and Aging
As we age, the water inside the disc will dry. Over time, the discs will lose height and bulge. This is the typical cause of loss of height as we age and can cause significant problems. These changes will be seen on an MRI in everyone by the age of 40. A study of 10-year-old children also demonstrated that these changes were present in 10% of the children at age ten, this is likely genetic. Sadly there is not a way to prevent disc degeneration. These changes are sometimes called degenerative disc disease, however, these are actually degenerative changes that are normal for age, rather than a specific disease.
A disc rupture and a disc herniation is the same thing. This is when the outer wall of the disc tears and the jelly inside the disc is extruded. The term “a slipped disc” is not correct, these structures
cannot slip. This injury is seen on an MRI scan. A disc herniation can narrow the nerve canal and pinch a nerve, causing radiating pain into an extremity. This can be a serious injury that can lead to permanent weakness. Please seek immediate medical care if you develop weakness in a limb.
Mother Nature has the ability to heal most disc injuries. The jelly inside the disc is 80% water, and over time our bodies can absorb this water which will make a large disc rupture look smaller over time. You will often see photos of this used to claim that spinal decompression traction treatment has healed the disc injury. This is not accurate, the disc rupture becoming smaller over time is the process of natural healing. Once a disc is ruptured, the disc cannot maintain the water inside of the disc, and it will become a degenerative
disc earlier than the other discs.
Treatment options for disc rupture/herniation fall into several categories:
Do nothing. The passage of time and the body reabsorbing the water in the disc jelly can heal the majority of disc injuries.
Steroid epidural injections. This is a cortisone injection at the site of the ruptured disc. Cortisone is our strongest anti-inflammatory, this can reduce inflammation and pain, and for some can speed up natural healing.
Surgical Intervention. There are a number of surgical options that are beyond the scope of this article. Spinal decompression surgery, where the ruptured part of the disc is surgically removed, is done for disc injuries that compromise the nerves in the spinal canal. Discs can be surgically fused, and disc replacement surgery is available as well.
Physical therapy. PT can help muscle spasm, tightness, weakness, and pain.
Spinal traction or decompression is not effective for low back or lumbar disc injuries. It will not cause a dehydrated disc to reabsorb water. It will not cause a disc rupture to become smaller in size. Spinal traction can be effective in the neck to alleviate pressure on a pinched nerve.
Future developments include stem cell injections, whether or not this will turn out to be an effective treatment is unknown at this time.
Preventing Disc Injuries
Disc ruptures usually occur on the back wall of the disc. The curve in the low back puts the back wall of the discs on slack and protects the disc. Bending your knees when you lift maintains the curve in the low back. Twisting can also stress a disc. Making certain not to twist when you are carrying a heavy weight is important. Remember, “If you move your nose, move your toes,” when carrying a heavy weight.
Our spine is a wonderful structure. The spine provides a protective case for the nerves housed inside it, yet allows movement. The spinal discs are a critical part of this amazing design.
To schedule an appointment with Dr. Katharine Leppard, please call her office at 719-575-1800 or visit www.medical-rehab.com