In short, the answer is NO – our discs don’t ‘slip’.
I often get this type of question from patients with back pain and neck pain so I wanted to take some time and explain what our intervertebral discs are, whether or not they ‘slip’ and why they may sometimes contribute to pain in our back or legs.
⦁ What is an intervertebral disc?
Our spine is made up of 33 vertebrae and the majority of them are separated by intervertebral discs. These discs are made up of two components – the outer annulus fibrosis which is composed of strong connective tissue and the inner nucleus pulposis which is a softer, gel-like material. The disc allows for increased motion in our spine and helps connect each segment together.
⦁ Do discs slip?
Nope! The connective tissue attaching those discs to our vertebrae is very strong and much too stable to cause any slippage. Some things that might occur to the discs over time includes dessication (aka dehydration), bulging, herniations, and other forms of degeneration. These are all very common and the majority of adults will have findings of these things in their spine, regardless of whether or not they are experiencing pain. In fact, it has been studied quite often that degenerative findings in the intervertebral discs have little to no correlation with pain.
⦁ Can discs cause pain?
Sometimes. The most likely reason a disc will cause pain is a disc herniation. Over time, with repetitive stresses on our back the outer annulus fibrosis can begin to tear. If it tears enough, some of the inner, gel-like nucleus pulposis can herniate out of the disc and can irritate the nerve root sitting nearby. The pain can be a result of mechanical compression or chemical irritation to the nerve, or both. This can lead to symptoms along the entire course of the nerve. For example, disc herniations in your lumbar spine, or low back, may cause symptoms down your legs.
So what does this mean for the patient with back and/or leg pain?
Majority of cases of back and leg pain due to disc herniations are self-limiting and will get better on their own. Conservative care (e.g. chiropractic, physiotherapy, massage therapy) can often help you get there faster. There are very few cases where disc herniations can lead to a medical emergency – if you are unable to urinate and/or unable to control your bowel movements, go to the emergency room. Additionally, if you have rapidly worsening neurological symptoms (e.g. weakness, loss of sensation), this also needs to be checked out urgently and more invasive approaches to care may be necessary.
Dr. Allie Dennis
**This is not intended to be a replacement for medical advice. If you are suffering from any of these symptoms, please see your healthcare provider for appropriate management**