Slipped Discs

 

In the last month I've seen quite a few cases of sciatica and the equivalent problem in the neck and arm, namely brachial plexus irritation.  Both of these problems stem from an irritation or damage of the inter-vertebral discs.  In old money this is a "slipped disc".  Truth is, the discs don't slip out of position, but they do bulge, become inflamed, tear and even burst.

 

The discs themselves are constructed of rings of fibrous cartilage running in opposite directions with a soft gel like centre called the nucleus palposa.  Think jam filled donut.  Ironically the centre gel is one of the most active nerve irritants known.  If the disc bursts or even leaks the resulting nerve pain is excruciating.  Patients will describe the pain that shoots down the leg to the foot as if they were connected to the mains.  The pain often rates above child birth, but below that caused by kidney stones.  This and the fact the discs are mostly water is a very good reason to keep fully hydrated.

 

 If you ever wonder why you are taller in the morning, it's partly because gravity squashes the water out of the discs during the day.  Often most noticeable to drivers as they need to adjust the rear view mirror in the morning as they are taller than the evening before! 

 

By around the age of 35 the soft core thickens to become all cartilage. Beyond this age it's a small tear or bulge and swelling that pushes onto the sciatic nerve resulting in the pain.  The cause to avoid is lifting a weight away from the body with a rotation to one side. Add in a sudden unexpected load, "they dropped their end", and the shearing force can tear the disc. Lifting a baby carrier into the back of a car is another good example. 

 

Usually it is one of the two discs between the lowest lumbar vertebrae that cause the problem (L4/L5 or L5/S1).  Key diagnostic indicators are; the leg pain is worse than the back pain, there is little relief lying down or at night, bending forwards shoots the pain down the leg, the foot can become numb or weak and the idea of coughing or sneezing is terrifying!

 

A course Chiropractic care will usually resolve the problem. In a recent study the course averaged at 13.2 treatments, personally I find it's about 8 treatments.  Those that don't resolve, about 4%, may require surgery.  The traditional method is a discectomy possibly with fusion of the vertebrae.  Disc replacements are increasingly available, but at £15,000 and with no certainty of result, often the last choice.

 

Julien Barker

Chiropractor at South Street Chiropractic