Myth busting- the TRUTH about lower back pain and ‘slipped discs’
March 22, 2022
The spine is a fragile part of the body that should be kept straight at all times and failing to do so can cause long term injuries, right? Wrong! The spine is an extremely strong structure that is designed to bend and twist and can even tolerate bending to pick objects up from the floor- contrary to what we may have been told over the years. From time to time though, the spine and the structures around it can become a source of pain. At least 60% of all adults experience an episode of low back pain at some point in their lives with around 20% of you going to your GP for help. You may have even been for a scan on your back and been told you have all sorts of worrying conditions from ‘slipped discs’ to wear and tear. Often this information is ill explained, can be confusing and lead to fear about the condition of your spine and make you feel the need to protect it. In this article we look at one particular structure within the spine that we often hear fake news about and look to give you some reassuring information that can allow you to move freely and continue to enjoy the things you love.
Intervertebral discs are rubber like structures between the vertebrae in the spine that spread force evenly through the vertebrae and allow small amounts of movement within the spine. The discs consist of three layers, the ‘jelly like’ inner layer (the Nucleus Pulposus), the super tough outer layer (the annulus fibrosis) and the vertebral end plate; a strong cartilage attaching the disc to the vertebrae above and below. They have no nerve endings so cannot themselves be the source of pain, but can, in certain circumstances, cause other structures to become painful.
There are a number of harmful myths surrounding lower back pain and discs that our patients regularly report to us. We feel that they need to be busted to help you understand your body and allow you to stop fearing those terrifying discs.
I’ve been told I have degeneration of the spine, so I need to be careful!
Discs can become degenerative; this is very common and is a normal process of ageing. It is caused by reduction in fluid content of the disc which reduces the height of the disc and can lead to irritation of the joints with certain movements of the spine. However, the majority of MRIs for people over 30 will show disc degeneration, many of them not reporting any pain at all! In fact, one study has shown that over 80% of all asymptomatic patients above the age of 50 will show signs of disc degeneration, showing that disc degeneration in itself is rarely a problem and is actually completely normal as we age. So, what about the advice to be ‘careful’? Well actually, this advice can do more harm than good as habitual loading of the tissues and the joints in the spine will actually increase hydration of the disc which helps to reduce the rate of degeneration. So, exercise and movement might be just what you need!
I have a slipped disc, do I need an operation?
Firstly, this is an old-fashioned misnomer! Discs cannot slip – they are attached very strongly to the vertebrae by the vertebral end plate which means the disc itself cannot move. What they can do is bulge (often painlessly), and rarely, can herniate. A herniated disc can lead to low back pain and ‘sciatica’ however, many people with confirmed disc herniation on MRI will be completely asymptomatic. Furthermore, even in symptomatic cases, a herniated disc will often reabsorb over time, with less than 10% of herniated discs requiring surgery.
My disc pathology is due to incorrect lifting so I should avoid it.
Although inappropriate loading of the spine can be a precursor to injuries and degeneration of the disc, as stated above habitual loading can help to reduce the risk of degeneration. Additionally, the annulus fibrosus, which can be susceptible to tears, is shown to match the strength of the adjacent vertebral body which itself strengthens with exercise and loading. Therefore, appropriate exercise and loading of the spine through exercises can actually reduce the potential of disc herniation and degeneration.
If I have herniated disc, I should not be moving my back!
Despite a high number of herniated discs causing no symptoms, they can cause low back pain and sciatica through muscle splinting, chemical irritation of nerves, or, less commonly, direct mechanical pressure on the nerve. In most cases, these symptoms are actually eased, and even resolved, with movement and manual therapy and specific exercises can be given to help with the reabsorption of the disc.
There are many false perceptions about disc pathologies that can be worrying to hear. If you have been told you have a disc pathology or are suffering with low back pain and want some help and advice with the best methods to help you manage it, call us on 0333 2200 238 to speak to one of our team or book an assessment with one of our amazing physiotherapists.
We also provide additional services as well as physiotherapy that can be beneficial if you’re suffering with low back pain or if you’re struggling to keep active. Both our Pilates class and our Strength and Conditioning Circuit Class are great ways to maintain and improve strength and stability which can be great for helping to manage your lower back pain.