Everything You Need To Know About Discs
”You are as young as your spine is flexible”- Joseph Pilates
The spine is made up of 24 segmented vertebrae to make up the cervical (neck), thoracic (mid back) & lumbar spines (lower back), in addition to 5 fused vertebrae and the coccyx bone to form the back of the pelvis and the tail end of the spine. In between the segmented vertebrae within the cervical, thoracic and lumbar spines are what is known as intervertebral discs or more commonly “discs”.
Have you ever heard someone say they have “slipped a disc”? Or maybe you’ve even heard of someone having “blown a disc”. These references to disc health are important to understand because they actually paint a picture of what a person believes to have happened within their very own body. This picture that they paint then becomes a distinct picture within your own mind… very influential!
Before going into detail of what has actually happened by ‘slipping’ or ‘blowing’ a disc, we need to understand the structural anatomy of the intervertebral disc (IVD).
The IVDs act as shock absorbers for the spine. They sit, stacked on top of one another with the vertebrae in between. Imagine a jam donut sitting in between each vertebra of your spine. You have the spongy outer layer of the donut, with the (delicious) jam center. The spongy outer layer or the ‘annulus’, acts to provide strength and stability to the disc, with the ‘nucleus pulposus’ (the jam center) acting to distribute forces between the vertebrae.
The annulus (the outer layer of the disc) is very tightly bound to the vertebrae sitting above and below it, in addition to having a connection to very strong ligaments running along the front and the back of the vertebral column. With sustained force or posture (eg sitting for long periods of time), continuous repetitive movements (eg gardening) or with natural aging, the discs can undergo a number of changes. With dysfunction occurring most commonly in the lumbar and cervical spines, the types of disc injuries are listed below: (Please not that these injuries can occur at a single or multiple levels).
The annulus can simply become irritated resulting in irritation to surrounding structures
The annulus can tear or become disfigured resulting in a ‘bulge’ which may or may not impinge on a nerve or move within a space that a nerve sits
The nucleus pulposus (the jam center) can leak out from within the center of the disc resulting in a ‘herniation’ or a ‘prolapse’ which again can impinge on nearby structures including nerves
The nucleus pulposus can actually break off and wedge itself within the spine in what is known as ‘sequestration’
One thing that is important to note in any of these scenarios is the body’s immediate response - that is to spasm the muscles in the surrounding area to protect the injury and prevent any further ‘damage’.
What these presentations look like could include one or multiple of the following:
Altered posture to avoid loading the affected disc
Sharp, acute and usually quite painful spasms in the surrounding musculature
Pain referral down one or both legs / arms (based on whether the injury is within the neck or lower back)
Dull and achey pain down one or both extremities
Altered sensation in one or both extremities
Muscle weakness and/or altered reflexes in the upper or lower extremities
Another aspect to complicate and make things more unclear, is imaging. Although imaging can give us a good idea as to where and what is affected in terms of the disc injury, it doesn’t always give us a clear answer in regards to the degree of the pain presentation. For example: 2 people may have MRIs on their lower back which return to show a disc bulge at the L5/S1 segment. The first person may present with intense pain through one leg, soreness through the lower back and difficulty getting into and up from a chair. The second person may only present with tightness and stiffness in their lower back.
Imaging should only be used to assist in the treatment and management of such cases, and in most cases should not be used as the primary reason for someone’s pain. This can be a tricky concept to get grasp, particularly in chronic presentations.
Disc health can be complicated, chronic, exhausting and sometimes very confusing...if you believe to be. A mindful approach to such cases is of utmost importance - more than any stretch, exercise or treatment you may have. In fact, disc health is thought to closely be related to an individual’s stress levels. This is why considering someone’s psychological health at the time of the injury is paramount. Physically speaking there are countless things you can do to maintain good disc health which we will definitely cover over time however the numero uno thing to do is to KEEP MOVING. As Joseph Pilates so simply put, “you are as young as your spine is flexible”. Keeping the spine moving is the single best thing you can do to maintain good disc health. Doing it in a safe and efficient way for your own body is of course the priority.
Understand and improve the awareness around your body so you can paint your own picture when you have discussions around spinal health. It might just be the best thing for you.
If you need help understanding the health of your discs and spine, get into contact with us or book an Osteopathy appointment online by clicking the button below.
