Oh, I do like a controversial topic!
However, this is a very important issue so let’s get stuck in.
In my practice as an osteopath I hear it said a lot that people have been diagnosed with a slipped disc or they have had one in the past. It’s a commonly used term and generally conjures great fear and anxiety. Think about it for a moment. What does the term ‘slipped disc’ mean to you? Well, to me, I think of a frisbee-like structure, shooting across the room. Or, do you remember that game tiddlywinks we used to play as kids (before I-pads were invented)? That’s how I imagine people think of a slipped disc – literally popping out of place. I can tell you now, this does not happen.
Image 1: This is not a spinal disc.
Discs are very badly named. They are not like discs at all, although they are portrayed as such in textbooks.
In reality, they are strong but flexible structures firmly attached to the vertebrae above and below them and designed to help adjust load in the spine. They are made of cartilage (the same material as your ear) and very strong ligaments – just like in other parts of the body. They are then packed in by many layers of supporting muscles and ligaments. Those babies aren’t slipping anywhere!
“Well, mine slipped because I saw it on my MRI!”
Ok, so what can happen is that discs can age, bulge, herniate and sometimes squeeze out some chemicals that may irritate a nerve, causing pain. However, there are two important points to make here:
1. If these changes happens they do not always cause pain. Many people have these findings on a scan and NO PAIN. We cannot assume that pain will always result from these changes. In fact, check out this table for some stats on that. Look in particular at ‘degeneration’ and ‘bulge’:
Ref: Brinjikji et al 2015 This systematic review was carried out on over 3000 people with no back pain.
2. If some damage does occur to your discs and it is painful, this is usually no different to a strain anywhere else in the body, such as your ankle. This means that in time, just like your ankle, it will heal. It may take a little while, but it will heal.
But what if the pain persists?
Well, in a nutshell, this is what this blog aims to tackle. Working out why pain persists in some cases but not in others is a complex issue and there is not one simple answer.
Understanding that pain is an alarm – and not a reliable indicator of damage - is an important place to start. Your brain will always alert you to danger if it feels you are under threat. We assume this is physical danger, but this is not always the case.
Once you have established that your pain does not signify serious injury; or perhaps there was an injury and this healed many months ago; the next step is finding ways to dampen the danger signal to the brain, thereby reducing the 'volume' of your pain. Essentially, you want to communicate to the brain: “thanks for alerting me to this but I know I’m safe”.
One effective way to do this is to develop a short but regular practice of relaxation or meditation. Just a brief but regular session where you find a quiet spot, get comfortable and listen to some music or a meditation or simply breathe. This can really help to send a message of ‘safety’ to the brain and reduce your pain.
Have a go and see how you feel. Do let me know how you get on.