Disc injuries

A slipped disc, also known as a herniated or bulging disc, is caused by the posterior or posterior-lateral migration of the nucleus pulposus due to a weakened fibrous ring.

Intervertebral discs are essential structures within the spinal structure, providing shock absorption between two vertebrae. Each disc is composed of a central element that is high in water content, called the nucleus pulposus, which is held in place by a fibrous cover. The nucleus pulposus changes its position within the disc as the spine moves, with the extension of the spine pushing it forwards, and an anterior flexion moving it backwards. This process can cause stress on the spinal disc if the body is subject to a sudden, heavy impact or through an extended period of incorrect posture, causing the nucleus pulposus to bulge out from the fibrous ring. When this happens, the fibrous ring, which has a high concentration of nerves, can be compressed causing pain.

In more severe cases, the fibrous ring can be torn, leading to the material inside leaking out and nerve symptoms into the arms or legs. Both the slipped and bulging disc can occur at different points along the spine, and their severity will vary depending on the specific location and the direction of the migration. It is important to establish the location and direction to ensure appropriate treatment, including the type and urgency required.

Cervical and lumbar disc treatment

A clinical examination is required to establish whether nerve compression is a factor, with symptoms including shooting pain, ongoing aching and a loss of muscle strength (myotome) as well as a difference in the cutaneous sensations of the affected area around the compressed nerve (dermatome). This is achieved through a series of orthopaedic, neurological and functional tests performed in-clinic. Further diagnostics may include CT Scans, MRI, or NCS (nerve Conduction Study) to accurately identify any neurological issues – however these are on a case-by-case basis and most patients are able to be accurately diagnosed with in-clinic testing.

For the vast majority of disc injuries, non-invasive treatment can alleviate the problem and reduce future incidence of flare-ups. Treatments commonly applied for disc injuries include myofascial release, dry needling, cupping, high-level laser therapy, joint mobilisation and extensive rehabilitation.