Don’t take it from me. People a lot smarter than I am are saying these things.
It’s a very short video and worth the time to watch.
Lorimer Moseley, who’s a pain science rock star and part of the NOI group in Australia which is a resource group at the helm of pain literacy and education for the general population, has something to say about this unhelpful idea that health professionals spread to patients that our discs slip.
It’s very helpful outcome-wise to challenge and update people’s beliefs on their pain contributors as I mentioned in a previous post (‘Knowledge is therapeutic’ blog post by yours truly). I think we hear stories from close ones about people having disc issues, looking at disc structures in isolation in media and anatomy textbooks, and a pathoanatomical view of the body.
We can make the argument on how strong the spine is:
- the discs are firmly integrated into the bony vertebrae and attach them together;
- they are reinforced by strong ligaments all throughout the complex;
- disc degeneration is completely normal and part of the aging process. It does not necessarily lead to a pain experience. 37% of 20 year olds to 96% of those 88 years old showed no pain but had spinal changes (1);
- if the disc is injured, it’s common there will pain 8-12 hours later, not immediately;
- discs never slip. They may bulge, herniate, get too close to a nerve or irritate the nerve that releases chemicals but this does summate to a pain experience
- the most common kind of injury is a strain of the ligament tissue, and not the disc itself. Interesting eh?
To solely blame our structure and biology is a very biomedicalized, narrow view. To pathologize our anatomy reinforces fragility in our clients. Instead it’s helpful to also deliver the message of our inherent strength, resilience, and robustness.
Our spines are crazy strong! And that’s worth repeating! Just take a look at professionals in sports and marvel at how much force transmits through their spines.
Sources:
1) Brinjikji, W., Luetmer, PH., Comstock, B., Bresnahan, BW., Chen, LE., Deyo, RA., Halabi, S., Turner, JA., Avins, AL, James, K., Wald, JT., Kallmes, DF., Jarvik,JG. (2015). Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 36(4): 811–816. doi:10.3174/ajnr.A4173.
