Throughout my career, I have had many patients come in and describe their low back pain, leg pain, sciatica, hip pain, neck pain, and spinal stenosis as being caused by a ‘Slipped Disc”.
I’ve often thought that the term slipped disc was a funny one because it really doesn’t fit with human anatomy. A spinal disc is the cushion between two vertebrae so how can it be “slipped”?
A disc segment consists of a vertebrae above, the spinal disc, the vertebrae below and the contents that are contained within that segment such as spinal nerves, fat, and blood vessels.
So, for a disc to be slipped, there is the assumption that the disc slides out of place or that it isn’t where it belongs. That once again just doesn’t make sense anatomically.
What is a Spinal Disc?
A spinal disc is made up of annular rings and a jelly filled center called the nucleus pulposus. The annular rings are in concentric circles and surround the nucleus pulposus. Nucleus means the “center”.
The best way to visualize the annular rings is that they look like the age rings on a tree. You know how when you cut a tree down, you see the rings and that is how you can tell how old the tree was? The annular rings go in circles and surround the nucleus pulposus.
The annular rings inside of a disc give the disc its’ strength and really are the difference between whether a disc is bulged or herniated. When the inner annular rings tear but the outside rings are still intact, it is called a bulging disc.
When the inner and outer annular fibers are torn and there is complete rupture of the disc, it is called a herniated disc. With a herniated disc, some of the nucleus pulposus can “leak” out and pinch a nerve or contact the spinal cord.
So, the term slipped disc is an old fashioned or generic term that can apply to both a bulging disc and a herniated disc. I don’t know where the term originated, but I do know that it isn’t a technically accurate term.
The nucleus pulposus of the disc is in the center of all of the annular rings or annular fibers. Inside of the nucleus pulposus is a jellylike substance. The jelly is what can leak out of a herniated disc and cause a pinched nerve in the low back.
Does a Slipped Disc Hurt?
Some people with a “slipped disc”, will have horrific back pain and others won’t. The difficulty with a slipped disc is that it can cause no low back pain at all. Sometimes pain caused by a disc problem can radiate to other locations.
Spinal discs that are slipped can cause severe leg pain, hip pain and even tingling and/or numbness into one foot or both feet. In severe cases, slipped discs can even cause permanent nerve damage in the form of muscle atrophy or foot drop.
Even though a slipped disc isn’t really a correct anatomical term, it is pervasive in the fact that it will continue being a term used by physicians, therapists, chiropractors, and patients.
The reality is that a slipped disc can cause serious pain and ultimately lost quality of life and even long term disability. That is why even minor disc problems should be taken seriously.
Should Surgery be done on a Slipped Disc?
With my extensive experience in working with herniated disc patients, most herniated discs and bulging discs will regress with my treatments. Or, at least if they don’t regress, most of the time the pain can be minimized or eliminated.
It is my sincere belief that all possible options should be tried before any surgical procedures are performed. Once you go under the knife, you can’t turn back the hands of time.
So often, people have low back or neck surgery and regrets are all that they end up with in the end. I talked a lot about this topic in my article Failed Low Back Surgery Syndrome.
Many times, people will have a neck or low back surgery and still have the same pain and dysfunction they had before the surgery and sometimes they are worse. They tell me how they are still unable to enjoy time with family and friends or go anywhere and do any of the things that they enjoy.
Are Spinal Injections Safe?
Even though I personally don’t like steroid injections or epidural shots and other common minimally invasive therapies done to treat slipped or herniated discs, even they are preferred over surgery. Surgery should be the absolute last resort.
The real issue I have with steroid shots or epidural injections are that even though they are minimally invasive, they are still invasive and have risks and possible side effects. Also, steroids weaken the immune system, and can cause weight gain which is already a problem for people who can’t exercise due to pain.
Most of my new patients are carrying extra weight and tell me how their doctors, family, and friends tell them that they will have less back pain if they lose weight. Anyone who has ever suffered from low back, hip, or leg pain knows how hard it is to exercise.
That’s one of the aspects of patient care that I also enjoy the most. Patients usually start getting relief fairly quickly and then they can become more active. At the same time, most of my patients do my Currie Panel blood work and I analyze their inflammatory markers.
By helping my patients become less inflamed and healthier overall, they can reduce weight in a healthy way while at the same time becoming more mobile which helps them keep their weight down for the long term.
I hope you enjoyed this article. If you need help, call my office today to get the ball rolling towards your new and improved life.
Health is Happiness,
Dr. Keith Currie