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SPINAL PAIN

Spinal pain is one of the most common causes of pain and disability and it is estimated that approximately 80% of the population will suffer an episode of spinal pain at some stage in their lives. The spine is the central point from which movement occurs. Spinal injury is both painful and debilitating and can truly affect your function.

It is important to note if you take people without back pain and perform a CT scan or MRI, you would see 30% of 20 years olds, 60% of 50 year olds and 84% of 80 year olds have disc bulging and similar incidences are shown for disc degeneration. Brinjikji,et al. Am J Neuroradiol.2014 Nov

It therefore seems that these charges are just a normal part of the aging process. If your MRI shows something like this, it doesn’t necessarily mean it is the cause of your pain and the finding may be incidental. Don’t panic, these are simply normal changes that happen from 20 onwards.

Many people view discs as fragile structures that are easily injured but in fact an accurate picture of what these structures do in relation to anatomy function and pain, still isn’t clear. The disc lies between the vertebrae at every segment of the spine. It is a joint between two vertebrae that allows a slight movement of the vertebrae. It also acts like a ligament holding the two vertebrae together. It is extremely strong as it is made of fibrocartilage. The other function of the disc is to allow absorption of forces and it is designed specifically to do this. It is therefore incredibly strong and it is also attached to the vertebra at a point called the end plate. It is impossible for the disc to “SLIP”. The end plates attach to the disc, holding it in place and making it impossible for it to “slip”.

Discs can get injured and they can also heal. We do know that shearing forces are most likely to injure discs just like they do to ligaments. This is why if you lift something heavy in full spinal flexion, twisting at the same time, you can injure the disc. Interestingly, discs can be injured but you may not even feel it – hence the large number of pain free people who have bulging discs on imaging, with no pain. BUT even an injured disc can heal.

It is important to always remember that our spines are robust and pain and structure are not well correlated. What this means is that pain doesn’t necessarily equate to the level of “damage” and findings on imaging may not necessarily be relevant to your pain.

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