Q: I was helping to lift furniture last week and hurt my lower back. My brother said I probably slipped a disc. It still hurts. Could I have slipped a disc and what should I do about it?
A: When the conversation turns to back pain, you’ll often hear mention of a “slipped disc.” You may wonder just what a disc is and how it “slips.”
The human spine is made up of 24 individual bones, each called a vertebra. Between each vertebra is an oval-shaped cushion of cartilage that is called a disc. Each disc is firmly attached to the vertebra above and below it so they don’t actually “slip.” But they can be damaged and could make you feel like one has “slipped” out of place. Inside the disc is a jelly-like substance called nucleus pulposus. The outer ring is a tough assemblage of fibrocartilage called the annulus fibrosis, which holds in the nucleus.
Injury, commonly a bending and lifting mechanism, can tear the exterior fiber and let the nucleus leak through cracks and pinch nerves in the area. If the nucleus pushes against the annulus, the condition is referred to as a disc bulge. If the nucleus breaks through, the condition is called a herniation. Sciatica pain, sometimes referred to as a pinched nerve, occurs when a herniated disc compresses nerves in the lower back, also called the lumbar spine.
It is likely that you have sprained some of the ligaments that make up the disc and they are swollen, causing pressure around the nerves. You need to have an evaluation to see the severity and if treatment is required. Not commonly is surgery necessary but it is possible that without treatment and instruction on avoiding further injury you could make it worse to the point that surgery will be needed.
Usually, treatment consists of 3 phases. Pain relief phase to remove swelling, corrective phase to rehab tight and weak muscles, and stabilization phase to return to optimal function and strength. Talk with your chiropractor about the nature and role of the disc and about ways you can avoid damaging them.
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