OMTA
Jun 7, 2018

Intervertebral discs does it slip?

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Edited: Jun 8, 2018

Discs have gained quite a reputation in society today, that everyone seems to “know” a little about discs and have a lot more to say about them.

Let’s discuss how accurate are our common beliefs about the center of spine dysfunction, the first line in the spinal defebce mechanism and the bringer of pain.

 

 

 

Can discs slip out of their place?

Discs can not slip out of place: There is both a bony and cartilaginous end plate that create an exceptionally strong connection to the annulus of the disc making it impossible for the disc to slip.

 

But can discs get injured? 

Sure. Static Postures and repeated movements in one direction especially spinal flexion under load and twisting, would most definitely increase retro-discal pressure in the lumbar spine and surely cause an injury to the disc.

 

Disc Injuries

 

Sequestration

Extrusion

Protrusion

Bulging

 

Disc injury, does it mean that patients must have symptoms?

Actually no, a symptomatic people happened to have discs injuries too, look at the charts below.

 

 

Can discs heal? 

Spontaneous regression of herniated disc tissue can occur, and can completely resolve after conservative treatment.

 

Patients with disc extrusion and sequestration had a significantly higher possibility of having spontaneous regression than did those with bulging or protruding discs.

 

Disc sequestration had a significantly higher rate of complete regression than did disc extrusion.

 

Conservative treatment

  • Early movement / positioning in the direction that decreases the pain, improves the ROM / function or doesn't increase the pain.

  • Use your manual therapy skill to help improving the patient's symptoms: low grade Passive access mobilization, passive movement in form of passive physiological mobilization, neural glide to improve the movement of the nerves.

  • Get the long term result for your management through patient education and encouraging movement and active life styles.

My point is, movement (Passive, Active or combined) is the best therapy with all respect to the patient's symptoms, goals and vision.
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