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Back to Basics

The truth about Spinal Discs

THEY DO NOT SLIP! They bulge, they herniate, they sequester or extrude, they degenerate, but they most definitely do not slip no matter how many times people tell me they have a disc out. Patients telling me this is not their fault of course, because at some point either a friend, family member or a misguided yoga website (here) have told them this condition exists; it does not. Patients often attribute low back pain with referral to the back of the leg to a disc problem and this is often known as sciatica.

 

Anatomy of a disk

Intervertebral discs are found in between each unfused vertebrae in the spine with the notable exception of the space between your atlas and axis. The first thing is to realize that your discs are not like poker chips. They are not rigid, solid and immovable. Discs would be more accurately thought of as a really stale jelly donut. The main role of the discs is for shock absorption in the spine, to help dissipate axial forces and to form a fibrocartilagenous joint with its adjacent vertebrae. The individual joints allow a small amount of movement between each vertebra and all these joints combined allow for much greater range of motion.

They have two main distinct anatomical parts. The outside covering of the disc is known as the annulus and the inside portion (or the jelly of the donut) is the nucleus pulposus. The annulus is the tough shell of the disc, which is sort of like rubber. It is somewhat pliable and is thin layers of fibrocartilage that provides the stability and structure to the disc. The annulus itself can degenerate, be damaged and be a pain generator in the back all by itself without anything like a bulge or herniation. This can be acute or what is known as degenerative disc disease. A bulging disc is when the annulus is pushing outward beyond its normal anatomy but the annulus itself has not ruptured. The pulposus is the jelly of the donut and while it is much firmer than jelly its main purpose is to help with the shock absorption functions of the disc and when well hydrated helps to provide the height (or normal disc space) to the disc. When a disc gets damaged and you get a herniation or sequestration, it is the pulposus that gets pushed through the annulus.

 

MRI’s and CT Scans

It is important to keep in mind that while these conditions can certainly be painful, they are not always and that many, many people are out there going about their normal everyday activities with these conditions with no symptoms at all. With findings like these that would be viewable through an MRI or CT-scan, they have to be clinically relevant to what the patient is experiencing. For more on MRI and their limitations with disc injuries, you can view one of my previous columns here. Another informative column is here regarding how these findings on advanced imaging does not necessarily mean a surgical intervention is warranted and that disc herniations can and do resolve with conservative treatment.



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About the Author

Dr. Nimchuk is one of a few full body certified Active Release Technique practitioners in the Okanagan Valley.  It has become known as the gold standard treatment for soft tissue injuries in athletics with almost every professional sports team in North America retaining the services of an ART certified Chiropractor.  Dr. Nimchuk has had the opportunity to work with many professional, Olympic and Ironman athletes.  ART is a patented, state of the art soft tissue system/movement based massage technique that treats problems with muscles, tendons, ligaments, fascia and nerves. Headaches, back pain, carpal tunnel syndrome, shin splints, shoulder pain, sciatica, plantar fasciitis, knee problems, and tennis elbow are just a few of the many conditions that can be resolved quickly and permanently with ART.  Dr. Nimchuk employs many different chiropractic techniques including manual and instrument adjusting along with ART.

In addition to private practice, Dr. Nimchuk is a frequent speaker and consultant to business organizations on topics such as ergonomics and workplace health.  Dr. Nimchuk is also registered as a Certified Exercise Physiologist with the Canadian Society of Exercise Physiology and has worked in many high performance and rehabilitation settings.

As part of his ongoing commitment to health and fitness, Dr. Nimchuk is a clinic instructor for marathon and 1/2 marathon clinics at the Kelowna Running Room and is also the Okanagan evaluator for the RCMP Physical Abilities Requirement Evaluation (PARE test).

To learn more about Dr. Nimchuk's treatments or to schedule a consultation, visit his website at chiropractorkelowna.ca or call 250-860-2212.




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The views expressed are strictly those of the author and not necessarily those of Castanet. Castanet presents its columns "as is" and does not warrant the contents.


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