“My uncle had a slipped disc 10 years ago and never recovered from it.”
“My doctor says I have herniated discs at L4-L5 and L5-S1.”
Herniated discs can be some of the scariest conditions out there both for clients and for health professionals. Unfortunately there is a lot of outdated and incorrect information out there about discs which I will address in this article.
What are herniated discs?
Discs are shock absorbers that sit between the vertebrae, the individual bones, in your back.
In a herniated disc part of the fluid in the inside of the disc (the nucleus) starts to work its way out through the outer layers of the disc (the annulus).
Contrary to popular belief – discs don’t actually slip (1). Part of the vertebrae actually anchors the discs to the vertebrae.
What causes them?
Doing too much sitting or bending relative to what the discs can tolerate can contribute to herniations (2,3). This isn’t to say that bending or sitting are bad – but can be a problem if they’re done too much too soon.
It is important to know (4) that many painfree people have disc herniations and don’t know that they have them. Inflammation can be the difference in some cases between a painful and a non-painful disc herniation (5). Being overweight and smoking can be risk factors for herniated discs as well (3).
If I have a herniated disc do I need surgery?
Research has shown that many disc herniations can heal without surgery (6). The trick is to have the right amount and the right type of movement and exercise to stimulate healing without pushing it too far. This is where a physiotherapist or chiropractor who understands disc injuries, back pain, and pain science can help a lot with giving you the proper guidance.
In addition – managing lifestyle factors such as nutrition and smoking may also help as well.
Am I just going to wear out over time as I get older?
For a long time we thought that discs were just like car parts that have worn out over time – but more recent research over the last 10 years has shown that they can get stronger in response to appropriately dosed exercise (7).
Disc herniations are scary and can be misunderstood, but in many cases they can be managed well with proper guidance without the need for surgery.
References
- Physio Network – https://www.physio-network.com/blog/discs-dont-slip-dammit/
- Wilder DG, Pope MH, Frymoyer JW. The biomechanics of lumbar disc herniation and the effect of overload and instability. J Spinal Disord. 1988;1(1):16-32.
- Qi, L., Luo, L., Meng, X., Zhang, J., Yu, T., Nie, X., Liu, Q. (2023). Risk factors for lumbar disc herniation in adolescents and young adults: A case-control study. Front Surg, 9, 1009568.
- Brinjikji, W., Luetmer, P.H., Comstock, B., Bresnahan, B.W., Chen, L.E., Deyo, R.A., et al. (2015). Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol, 36(4), 811-6.
- Shin, D,A,, Chang, M.C. (2023). Five Reasons Why Some Herniated Intervertebral Discs are Painless. J Pain Res, 16, 2993-2995.
- Chiu, C.C., Chuang, T.Y., Chang, K.H., Wu, C.H., Lin, P.W., Hsu, W.Y. (2015). The probability of spontaneous regression of lumbar herniated disc: a systematic review. Clin Rehabil, 29(2), 184-95.
- Bowden, J.A., Bowden, A.E., Wang, H., Hager, R.L., LeCheminant, J.D., Mitchell, U.H. (2018). In vivo correlates between daily physical activity and intervertebral disc health. J Orthop Res, 36(5), 1313-1323.
If you have any questions or would like to explore further, please book a free, no-charge online appointment. Eric Bowman is a physiotherapist in Waterloo.
