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Disc Pathology

Disc Pathology

So, what exactly is a disc?

A disc is a softer piece of cartilage (a very short cylindrical shape) that sits between each vertebra (spine bone) in your body. That’s right, they go right the way from your low back to the top of your neck. Their job is mainly to shock absorb all those strong forces that go through your body as you go about your day to day life, but they also give your spine a bit more space to move so that your back can be lovely and flexi-ble. Each disc has a very strong, fibrous, outer layer called the annulus, and inside is a thick, sticky gel (image a water bal-loon filled with jelly!). Deep inside the gel is the centre part called the nucleus (I imagine it a bit like a bean).

What are the most common injuries?

Well, the main one is a disc bulge/prolapse/herniated disc, commonly known as a ‘slipped disc’. This is where those outer fibres have been over stretched causing a bulge in the disc. The disc is no longer a perfect cylindrical shape because it has a bump on the outside. Sometimes this bump can hit a nerve root. If this happens, it wont cause paralysis, but can be very painful and you may experience nerve pain running down your leg or even tingling or numbness in your limbs.

Common Myths

The most common myth is the misconception that a healthcare professional can ‘put the disc back’. Unfortunately, be-cause discs aren’t hard like bone they can’t just be pushed back into place. However, the good news is that naturally, over time, that bulging of the disc will shrink and the over-stretched outer fibres will become hard and strong again as they scar over. Because discs, like most cartilage in the body, don’t have an amazing blood supply, they do take longer to heal than say, a torn muscle. Texts books suggest on average 3-6months. But remember, everyone is different! Your injury might take longer, but it may also be faster too!

The second myth is the idea that ‘disc bulges mean I’ll have back pain forever’. No, this is not likely at all, and certainly isn’t in the case in the majority of people! Discs will heal given time and the right advice. The secret to preventing an ongoing problem is….exercise! It’s certainly important not to over do it in the early stages of recovery (acute/subacute phases…roughly 6 months). That being said, long-gone are the days that doctors prescribed extended periods of bed rest for these sorts of issues (exceptions apply, naturally). I see a great number of patients who have had a previous disc injury and were told to take it easy, then never went back to exercise to regain the strength that they inevitably lost in their back post-injury. You’d be surprised at how much trouble weak back muscles can cause, even after the disc has scarred over and healed.

If you’re nervous about how to implement a gradual return to exercise, I would highly recommend seeking some professional advice! Clinical Pilates, and in particular, Private or Semi-Private Pilates sessions, is a great place to start. Being nervous about returning to exercise after you’ve been in pain is very normal and that mental barrier can be a big hurdle. Many people can get frightened by a back pain flare up after returning to exercise for the first time. This is normal too. Remember, your back is made up of lots of muscles and think of it this way – if you hadn’t used your arms in several months and then carried some heavy groceries you’d expect them to be sore the next day or so but you’d be confident in your knowledge that it would right itself soon. Well, the same applies to your back. What you should find is that as the months go by, if you’re giving yourself enough time in between your workouts, that your back doesn’t feel as sore after or for as long after each exercise session. This is the sign that your back is getting stronger, and a stronger back is ultimately a happier back!

Steven Sparavec, Osteopath


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