There is an unusually wide range of terms used to describe spinal disc problems in the neck, middle and lower back. Some common terms include ruptured disc, slipped disc, disc protrusion, degenerative disc disease, bulging disc and disc herniation. This can often cause our patients confusion and even frustration when different medical people use different terms to describe their problem.
Rather than focussing on which term is used to describe a disc, which often stems from interpreting scan results such as MRI, it is more useful to gain a clear understanding of the precise medical diagnosis. This diagnosis determines the actual cause your back pain, leg pain or other symptoms and is determined after:
- A full medical history
- A thorough physical examination
- Review of one or more scans (if required).
The reason our patients shouldn’t focus on diagnostic imaging terminology is because if every person in Mandurah went off and had a scan of their lower back right now, almost everyone (even those without pain or stiffness) would have something wrong with their discs. By the time you’re in your 50’s, 80% of people without back pain will have disc degeneration. The table below demonstrates the likelihood of different disc diseases in the NORMAL population
Age-specific prevalence estimates of degenerative spine imaging findings
in asymptomatic patients (Brinjikji et al 2004)
| Age (yrs) | |||||||
| Image Finding | 20 | 30 | 40 | 50 | 60 | 70 | 80 |
| Disc Degeneration | 37% | 52% | 68% | 80% | 88% | 93% | 96% |
| Disc Signal Loss | 17% | 33% | 54% | 73% | 86% | 94% | 97% |
| Disc Height Loss | 24% | 34% | 45% | 56% | 67% | 76% | 84% |
| Disc Bulge | 30% | 40% | 50% | 60% | 69% | 77% | 84% |
| Disc Protrusion | 29% | 31% | 33% | 36% | 38% | 40% | 43% |
| Annular Fissure | 19% | 20% | 22% | 23% | 25% | 27% | 29% |
| Facet Degeneration | 4% | 9% | 18% | 32% | 50% | 69% | 83% |
| Spondylolisthesis | 3% | 5% | 8% | 14% | 23% | 35% | 50% |
By the time you’re in your 80’s almost everyone who does not experience back pain will have signs of degeneration of their spine. This is good news for people who are currently experiencing back pain and have one or a combination of the above findings on x-ray. Why? Because 72% of people will resolve their back pain, despite these changes, with conservative treatment such as Physiotherapy.
So if you have had a scan which has identified any of the above conditions, please contact us for an appointment to have a thorough history taken, a full physical examination and a treatment plan to resolve the underlying cause of your pain. Do not think that because you have a degenerative spine that “no-one can help” – quite the contrary!
Sources:
- Brinkikji, W., Luetmer, B., Bresnahan, B., Cornstock, B., Chen, L., Deyo, R., Halabi. S., Turner, J., Avins, A. James, K., Walk, J., Kallmes, D., Jarvik, J. (2014). Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations. Merican Journal of Neuroradiology. Vol36, 811-816
- Wilson, Jordan (2015). Exposing the Truth About Lower Back Scans. https://www.linkedin.com/pulse/exposing-truth-lower-back-scans-jordan-wilson.
- Ullrich, Peter F (2015). What’s a Herniated Disc, Pinched Nerve, Bulging Disc…? http://www.spine-health.com/conditions/herniated-disc/whats-a-herniated-disc-pinched-nerve-bulging-disc.
