What are disc bulges, disc herniations, disc prolapses and slipped discs??
I think the best way to explain what happens with these problems is to start with the anatomy of a spinal disc and then continue into the terms used to describe what has happened.
There are 23 discs in the human spine, each one can be found between vertebra of the spine. They are made up of many layers of flexible but stiff fibro-cartilage (Annulus Fibrosus) that form a doughnut like casing around a toothpaste gel like centre (Nucleus Pulposus). This toothpaste like centre loves water and during the night absorbs lots of it which makes them more turgid and actually means you’re taller at the start of the day! (average 2cm) By the end of the day some of the water has seaped out after being compressed under gravity and you end up slightly shorter!. This also means that if you have one of the titled problems then avoid any exercises or extreme movements within the first hour of waking up as this is when you are most likely to make your problem worse!
Disc Bulges, Slipped Discs, Disc Prolapses and Disc Herniations
All four of these terms essentially describe the same problem though just to a different level of severity. The term “Slipped disc” is incorrect and misleading as a disc cannot slip, this is a lay man’s term and is used generically. The term “disc bulge” is usually used for a lesser degree of herniation whereas a herniation and prolapse are usually used for more severe and pronounced herniations. for this post I will be referring to them all as a ‘disc herniation’. A herniation occurs after years of incorrectly loading the discs of the spine, repeatedly flexing the spine and twisting is the most common way to cause a herniation as discs are weakest at the back corners (postero-laterally). Over a long period of repeated movement and with age cracks can begin to form in the disc layers and the toothpaste like substance slowly works it’s way through the layers of cartilage till it reaches one of the outer layers. These outer layers are less reinforced than the inner layers and when put under an unexpected load they can fail and a pocket containing the toothpaste like substance can form. Similar to squeezing a balloon and seeing a pocket of air stretch the balloon out. This pocket is the herniation of the disc, the body reacts to this by initiating a local inflammatory reaction. All that is required to cause this final herniation is something as simple as ‘picking up a pencil’.
Inflammation locally to the herniation results in a decrease in space around the structures in this area such as the nerves and this is what leads to the symptoms many feel when they get a disc Herniation. Symptoms such as lower back, buttock, leg and foot pain, weakness, tingling, pins and needles, numbness. The duration of the problem all depends on the severity of the bulge though the majority are treatable. An untreated disc has been found to take on average 3 months to get better, a Chiropractors aim is to make you better faster than this time. As with a balloon, the area that has herniated does become weaker which means that herniated discs can become a repetative problem if they are not looked after properly, this means receiving strengthening and prevention advice for your back to help support the spine.
I would recommend seeing a Chiropractor to ensure you recover as fast as possible from a disc herniation as chiropractors see these problems all the time and have a great track record of treating and preventing them. One way you can help your own symptoms is by Icing (see “Why I need to Ice?“) before you see the Chiropractor, also remember to avoid heat! as this will make the inflammation and therefore the symptoms worse.
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