At the Osteopathic Health Centre Chester we can help you recover from a host of conditions including; low back pain, neck pain, sports injuries, arthritis and muscle spasms.

We are conveniently placed for visitors coming to us from all parts of; Cheshire, Wirral, Deeside, Flintshire, North Wales, Chester, Christleton, Tattenhall, Tarporley, Malpas, Kelsall, Helsby, Frodsham, Hawarden, Great Sutton, Ellesmere Port, Queensferry, Hawarden, Flint, Wrexham.

Disc Problems

 

You have probably heard the terms “slipped disc”, “ruptured disc”, “herniated disc” and “prolapsed disc” but what do these terms really mean? Perhaps you have come across someone who has told you that they visited an osteopath who “cracked their disc back in"? This is not strictly accurate, but we will address this later! Let's first look at the anatomy...

 

What is a disc?

The correct term is an intervertebral disc and, as its name suggests, the disc is a structure located between the spinal bones (vertebrae). The disc is made up of two parts: a tough fibrous outer ring (anulus fibrosus) and the gel-like centre (nucleus pulposus).

 

Functions

The intervertebral disc has many functions; it separates the vertebrae and acts like a shock absorber between the bones, it helps give the spine its curves and also joins the vertebrae together. There are 23 discs in our spinal column.We are actually about a quarter to half an inch taller in the mornings than we are in the evenings because overnight the discs absorb fluid and during the day fluid is squeezed out of the discs by the pressure exerted by being upright causing some loss of height.

The disc, back and neck pain

Problems with the discs in the spine are a common cause of back pain. Most of us are familiar with the fact that disc problems can cause low back ache. However, as the discs are between every vertebrae in the spine it is possible to have pain as a result of a disc problem anywhere throughout the spine e.g. in the neck or between the shoulder blades. What does a disc problem mean?

 

 

Disc protrusion and prolapse?

The disc, like any shock absorber, can start to wear with time. Over the years the disc loses a little fluid (this can be picked up on an MRI scan) and  small cracks begin to appear in the outer walls. If the disc is placed under undue strain the nucleus pulposus (nucleus) can begin to push the anulus fibrosus (anulus) out of shape. This is called a protrusion. The bulge may push out so much that it strains the anulus and eventually a small part of the nucleus escapes through the anulus fibrosus  and becomes separated. This is called a disc prolapse.

 

The anulus is pain sensitive so any problem with the disc can cause pain. A prolapse can exude and compress the nerves of the spine as they exit through small foramen (tunnels) to supply the arms, legs and body. This can cause symptoms of nerve root compression such as pain, numbness, tingling or power loss. In severe cases the disc can prolapse into the spinal canal causing signs of spinal cord compression. Osteopaths are trained to recognize “red flag signs” which necessitate an urgent medical/surgical referral.

 

Whether mild or severe, a protrusion/prolapse can be painful and can make sitting, standing, walking, lifting, moving, urinating, defaecating or sneezing difficult.

 

 

Slipped disc

The term “slipped disc” is really a misnomer as the disc, by virtue of its anatomy, cannot slip as it is attached to the vertebrae both above and below. The terms ‘disc prolapse’ and ‘disc protrusion’ are much more accurate. As such, the old tale of a patient having their “disc cracked back into place” by an osteopath is really a myth.

Osteopaths sometimes manipulate the facet joints in the spine which, when gapped, can cause an audible sound due to a suction pop as the joint surfaces separate.  In uncomplicated cases this technique may be used to help alleviate some of the mechanical strain which is placed on the disc but is not actually the disc “being put back in”.

 

The medical approach to treating disc problems

The medical approach to treating a disc problem is often a combination of pain killers, muscle relaxants and physical therapy.  In this area (i.e. Chester) if the problem persists or there are any worrying symptoms you will be referred into the back care system where you will be triaged and then may be sent on for further investigations. MRI scans are an extremely useful procedure to gather more information. If all else fails and you fulfill certain criteria a spinal operation such as a microdiscectomy may be an option.

 

 

The Osteopathic Health Centre approach to disc problems

Having a disc problem, whether it is a protrusion, a prolapse or a minor strain of the annulus, indicates that the disc has sustained some physical damage. Bearing this in mind, disc problems take time to resolve as there is a certain amount of repairing which has to take place. Osteopathy can be used to try and speed this process up and to ensure that the spine is in the right condition to allow the healing process to happen.

 

These days it is well recognized that the best advice is to try and stay as mobile as possible while suffering from a disc problem. However everybody’s reaction to disc injuries is slightly different and having individually tailored advice from an Osteopath can be invaluable in the early stages.

 

The osteopathic approach involves assessing the spine as a whole and trying to establish the reason why that particular disc has become symptomatic. It may be that the disc has sustained trauma, it could be degenerative or there may be a quirk in that particular individual’s anatomy or posture which has placed undue strain on one particular disc.

 

In the acute phase osteopathic treatment can ease the protective spasm around a symptomatic disc and improve the mechanical function of the spine. Help and advice on the management is invaluable. Painkillers and anti inflammatory tablets can be useful. In the long run understanding how the problem developed in the first place is the key to knowing how to treat the condition and how to prevent it from reoccurring in the future.At the Osteopathic Health Centre we place great emphasis on educating patients on appropriate exercise, how to look after themselves and prevention.