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Disc pain is the single most common cause of chronic low back pain accounting for around 40% of cases . However, chiropractic for slipped disc pain, incorporating treatments including spinal mobilisation, traction and stabilsiation exercise has been found to be an extremely effective treatment approach – with an approximately 95% success rate.
What are spinal discs?
The spinal discs sit between and separate each segment (or vertebra) of the spine (see image). They act as spacers, allowing the vertebrae of the spine to move freely.
You can think of the disc a little like a jam donut – they have a strong fibrous outer layer, the annulus, which surrounds a jelly-like centre, the nucleus (see below).
What is a slipped disc?
Although it is a commonly used expression, discs don’t actually ‘slip’. If the outer portion of the disc, (the annulus) is weakened the centre of the disc can begin to migrate through the outer portion and begin to bulge or herniate. This bulging can irritate pain receptors in the outer portion of the disc or surrounding tissues causing back pain. If the herniation worsens and begins to irritate the nerve it can also cause shooting pains, numbness or tingling into the arms or legs. (Nerve compression in the neck will cause symptoms into the arms, whilst nerve compression in the lower back will cause symptoms into the legs).
Chiropractic for slipped disc
In the large majority of cases, disc herniation (in both the neck and lower back) can be successfully treated with conservative care, such as chiropractic, without the need for injections or surgery. Chiropractic for slipped disc involves various forms of treatment such as repeated movements, traction, spinal manipulation, and exercise rehabilitation, which are described in more detail below:
Spinal traction acts to separate the vertebrae to decompress the spinal discs and reduce pressure on entrapped nerves. Spinal traction can be very effective in acute cases and is usually very well tolerated even in patients with severe pain. Traction manoeuvres can be performed in a variety of ways either manually or mechanically.
The position of the spine changes the pressure on the disc and the position of the nucleus. Generally, extending the spine (arching the back) will draw the nucleus forward, whilst bending forwards will push the nucleus backwards. This principle can be helpful in treating many (but not all) patients with disc pain. Since the spinal disc is thinnest and weakness at the back, if it herniates it usually does so backwards towards the spinals nerves. Extended positions can therefore often reduce disc pain and aid in recovery in these cases by drawing the herniated portion of the disc forwards away from of the spinal nerve roots. Read more about extension based exercsies here.
Manipulation / mobilisation
Manipulation is a controlled, specific force applied to a restricted spinal or extremity joint. It is often associated with a ‘clicking’ or ‘popping’ noise, similar to what you might hear when a wet glass is lifted from a table. It is a very quick and effective approach to restore proper movement to restricted joints to improve movement and reduce pain.
In the case of disc problems it is often used in restricted areas above or below the disc injury itself. For example, with a lower back disc herniation we often find restriction in the hips or middle back. If these areas are restricted more load is placed the lower back disc when moving which can predispose to injury:
Below you can see a tennis player with good movement through middle back and hips allowing the lower back to maintain a neutral position, sparing the spine (green line).
In contrast the tennis player below has a much more extended (or arched) position of the lower spine (orange line) which is often driven by restriction in the hips or middle back.
Restoring proper movement to these areas with manipualtion of mobilisation will help reduce the load on the discs of the lower back with movement which will aid healing and help prevent future recurrence.
Specific exercises such as the cat camel or cobra can be used in the early stages of treatment to desensitise the spine and reduce pain. Spine sparing activities like microbreaks and walking can also be introduced to promote proper healing. Later, strength and mobility deficits can be addressed with spine safe strengthening exercises such as side bridges.
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‘Chiropractic for Slipped Disc Pain’ was written by Steffen Toates. Steffen is a chiropractor at Dynamic Health Chiropractic in Jersey, Channel Islands. For more information about Steffen click here.