Disc injuries

How common it is

Disc findings on imaging are ordinary. A review of imaging in 3,110 people without symptoms found that the prevalence of disc degeneration rose from 37 per cent of 20 year olds to 96 per cent of 80 year olds, and concluded that many imaging based degenerative features are likely part of normal ageing and unassociated with pain. ^[1]

Australian consumer guidance says the same thing more plainly: disc protrusions, often called herniated, bulging or prolapsed discs, are often found in people without back pain, and disc bulges, disc space narrowing and disc dehydration are normal, common age related changes. ^[2]

What can be behind it

A disc is a spongy cushion between two vertebrae, with a firm outer ring and a softer centre. It does not slip. Discs are held firmly in place by ligaments, and the term slipped disc is an inaccurate one that suggests a movement that does not happen. ^[2]

What can happen is that the outer ring is irritated or gives way at one point, so the disc protrudes. For some people a protruded disc can irritate a nearby nerve and result in sciatica, nerve pain spreading into the lower limbs. ^[2] That is the version that produces leg or arm symptoms rather than back pain alone.

• Irritation of the outer ring of the disc itself
• A protrusion crowding a nerve root nearby
• Age related change that may be incidental
• Guarding in the muscles around the level involved

How we assess it

We read your scan alongside you rather than instead of examining you, and we are careful to say which findings match your symptoms and which are background. A report is a photograph of your anatomy, not a description of your pain.

The examination is the same disciplined Gonstead sequence: how you move, heat readings down the spine, palpation at rest and in motion, and a neurological screen if anything travels past the shoulder or the hip. Weakness that is getting worse, or the red flags below, means medical referral first.

What care looks like

A disc finding does not by itself determine which care is appropriate. We consider your symptoms, examination and any existing scans before discussing options, risks and whether medical referral is needed.

We explain the scan report alongside the examination findings and leave time for questions. You can discuss the proposed plan and alternatives before deciding what to do.

When to seek urgent care

We are not an emergency service. If you have loss of bladder or bowel control, numbness in the saddle area, weakness in both legs, or pain after a serious accident, call 000 or go to an emergency department.