For many being told they have a slipped disc or disc bulge can be quite daunting. In society there seems to be this perception that if one receives this diagnosis the back is cactus so to speak. Not to mention if you are told that you have spinal degeneration or spondylolisthesis! It seems for many this maybe as troubling as seeing the four horseman of the apocalypse.
Before I go on please be aware I am not and I do not want to take away from those who are experiencing pain or disability as a result of some form of spinal degenerative change. It’s not a pleasant experience can be quite debilitating but can be managed very well in most cases.
Let’s clear up this myth once and for all!
This table below from the British Journal of Sports Medicine is probably one of the most important pieces of research that was put together in 2014 and clears up a lot of the myths I speak of. What we can see is the percentages of people who have a particular diagnosis without any symptoms at all. For example 60% of people in their 50’s will have a disc bulge and when you’re 80, its 84%. This does not mean that 60% of 50 year olds have disc pain nor does it mean that 60% of all 50 year olds need some form of treatment either.
What is becoming more and more apparent is that some form of ‘degenerative’ change for want of a better term will likely happen to us all and is likely just a normal part of being human. It also means that just because there is something there it does not mean is a) it is causing your pain; b) has to be causing you any issue at all.
Accurate diagnosis comes from a combination of the patient history, physical examination, special tests or images (if clinically required) and the clinician’s experience. There at times seems to be a tendency to put too much emphasis on what can be seen on an image or on a specific degeneration of anatomy rather than a focus on what you can do to live a healthy, happy and normal life.
So what’s the take home message here?
There are pretty much two!
- Just because you have it doesn’t mean it has to be a big deal
- There is a lot more to back pain than a specific pathology. Focus on what moves well and how you can make it move better!