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  • Piotr Karcinski

Discopathy myths



In the situation of acute lower back pain patients often use to say that their disc is "popping out", and they need somebody who will "crack" their back to "push" the disc on the place and with immediate effect, everything, like in the dream will back to normal, but this is not true.


The disc is not popping in and out. It is a solid structure lying between adjacent vertebrae in the vertebral column. Each disc is made up of two parts: the annulus fibrosus and the nucleus pulposus. The annulus is a sturdy tire-like structure that encases a gel-like centre, which is the nucleus pulposus. What is possible is the damage of the annulus and protrusion of the nucleus pulposus.


Manipulation “crack” of intervertebral joints, does not push the disc inside but can improve movement in the segment of the spine and bring relief in pain.


There is no immediate effect. Pain is caused by inflammation, rather than physical compression of the disc. Inflammation is a natural process for all injuries, and it is necessary to recover happened properly.


I have a pain, so I need MRI –> Majority of disk herniations resorb, and patients usually become asymptomatic within 6-8 weeks after symptom onset. MRI should be considered in patients with radiculopathy symptoms who do not respond to conservative treatment after 4–6 weeks of symptom onset. Alternatively, if motor weakness or muscle atrophy accompanies radiculopathy symptoms, emergent neurosurgical evaluation, and MRI should be obtained.


MRI showed that I have a bulging disc, so I have a severe problem –> Degenerative changes in the spine, same as in entire body, are normal and will increase with age. This that you have degenerative changes is not mean that this is a reason for your problem. Research done by Mauren C. Jensen et al. in the study of MRI scans provided for 98 asymptomatic patients assessed by 2 independent radiologists have pointed that, only 36% have no change in the spine - it’s mean that 64% of the peoples had degenerative changes in the spine including bulging disc and protrusion without having the pain.


I have to stay in bed and not move so as not to worsen my symptoms –> The real disc degeneration will get worse with prolonged immobilization and movement will bring relief in pain. The best is the simplest movements, especially with axial loads like during the walking. Compression and decompression of disc are improving drainage of swelling and providing fresh blood with oxygen and nutrition.


I need to have a strong core –> core is important in general activities but is misinterpreted by patients who are just contracting muscles and avoiding a general movement in their spine. Stiffness will bring more issues with time, as the thoracolumbar fascia, our big ally, will be turned off.

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