While taking new patients medical history, we frequently hear a phrase in our Carol Stream clinic: "I've had a bad back ever since I slipped a disc." This is really an interesting way of communicating a complex system of the body. While providers typically don't always agree with how patients and society word or phrase their pain and discomfort, I believe a stance should be started on the topic.
In short, my answer is: yes, disc material can slip.
The spine does NOT slip in relation to itself (bar any extreme trauma such as a motor vehicle accident). For example, one patient of ours visually showed us, with his hands, a mechanism of action whereby he believed his spine "slipped into two pieces" when he lifted snow with a shovel and experienced his excruciating symptoms. While this mechanism makes ideological sense to patients who currently have low back pain, for example, it is important to note that the spine is not fragile, is quite robust and was design to move, bend, lift, and flex.
One of the definitions of the word slip is "go or move quietly or quickly, without attracting notice". In this sense, we would argue that yes, disc material does slip.
We have seen a plethora of research showing disc material, specifically the nucleus pulposus, migrate outside of the standard disc space. In fact, after small cracks in the annular fibers, which serve as the outer-most layer of disc material, and is quite tough. Compared to the annulus fibrosus, the nucleus pulposus is quite soft and it resonates the same substance as toothpaste.
In the superior view, one can clearly see the space where the anulus fibrosis surrounds the nucleus pulposus.
Since this progression of disc material outside of its original position, and WITHOUT notice of symptoms (especially pain), we would argue the usage of the word "slip" is accurate. The disc material slips through the annular fibers into the nearby joint space. The most shocking bit to patients is when we tell them that this does NOT always produce pain. The disc material must make contact with the nearby nerve root for the sensation of discomfort to be triggered.
Each week at our office in Carol Stream, Illinois, we help men, women and adolescents overcome disc injuries. If you, or someone you know, are suffering with a slipped disc, like I described above, then please know we can help. Most of our patients come to us after going to see a physical therapist, or their primary care physician, only to be discouraged by a lack of progress or the recommendation of pain pills and muscle relaxers. We know, and our patients know, these are NOT effective long-term strategies for spine pain.
Secondly, most of our patients come to us with a specific goal in mind. If you have a health or fitness related goal, and this spine pain is currently preventing you from doing your favorite activities, such as soccer, football, golf, CrossFit, running, etc, then I have good news for you - we are here specifically for you.
If you enjoyed this article, please share it with you friends and family so they too can learn more about this all-to-common topic.
Lastly, if you are currently suffering from spine pain and it is severe enough that it prevents you from being yourself and doing the activities you love, then please call our office TODAY to talk with our amazing AHR Team to see if you would be a good fit for our office. You can call us today at (630) 480-0113
Dr. Alex Earl, DC