Are you looking for a chiropractor for slipped disc? Today we want to talk about slipped disc treatment and how your MRI scan may not be as scary as you think.

The Flawed “Slipped Disc” Approach To Back Pain No One Is Talking About

Quite often people ask what we can do about disc herniation and if we can put it back into place. From a structural viewpoint? Nothing. Zilch.

Science tells us that there is no way a chiropractic adjustment can move your spine back into alignment or move your disc back in place. This is the truth. There are Singapore chiropractors who claim otherwise but current research does not support this. For more details, check out our blog post: The Chiropractic Adjustment – Seven Hard Truths You Need To Know.

What chiropractors can do for you, however, is change your pain experience. It may seem like a shock to you but your back pain is probably not coming from your disc. (For the purpose of this blog entry, we use the terms slipped disc and disc herniation interchangeably.) Truth is, most of us have herniated discs and do not have pain. Research has been telling us that slipped disc is more likely a natural progression of ageing – no different from wrinkles and white hair. Will you dye your hair black just because your head hurts? No, you are not likely to.

As a society, we are obsessed with perfection, symmetry, and alignment. When our magnetic resonance imaging, MRI, scan shows that we have a slipped disc, we tunnel-vision into looking at how we can get rid of it. What if that is the wrong way to look at your back pain? Wait, we know that is the wrong way to look at back pain. We have hard data to support this.

It’s normal for us to have disc degeneration. You do not need degenerative disc disease treatment. You want a lower back pain treatment.

A massive study from 2015 looking at 3110 asymptomatic individuals found that spinal degeneration progressively increases with age (American Journal of Neuroradiology). What was previously thought of as “wear and tear” is now – by best evidence – archaic, pejorative, and inaccurate (yes, those exact words were used in Rheumatology, 2018).

This is what best evidence says.

You might have a disc herniation from today or ten years ago. So what? If you want, you can read the specifics to why an entirely structural approach to pain doesn’t work. What we want to address today is that spinal degeneration or even “slipped disc” – as scary as they sound – both have a weak correlation with back pain. That is a sciencey way of saying you have slipped disc and you have back pain but that doesn’t mean your back pain is caused by your herniated disc. In fact, we know they are unrelated. Like mentioned earlier, they are more likely natural age-associated changes.

Why is no one talking about this? Why healthcare providers consistently lying to patients by telling them their back pain is coming from their disc herniations?

Let’s say I’ll let you have it that disc herniations cause back pain. So what? We know slipped disc resorbs itself over time (Clinical Rehabilitation, 2015). Wow, right? I don’t think it can get any more perfect than this:

  1. Slipped disc and pain is poorly correlated (i.e. your back pain is not coming from your slipped disc)
  2. Your slipped disc will go away by itself even if you do nothing to it, quite often within months
1 in 3 people WITHOUT back pain has a “slipped disc”! Most of you will attribute your symptoms to your disc herniation but they actually do not cause pain.

MRI To Diagnose Back Pain

MRI referral for back pain is an epidemic. They do not help with recovery most of the time but yet doctors are still referring back pain patients for MRI. You are probably one of them.

Do you know imaging findings have such poor correlation with back pain that medical organisations around the world are frantically pushing for doctors to dramatically reduce MRI studies referrals since as early as 2011 (Annals of Internal Medicine)? Maybe you think this is a financial decision. Less MRI referrals = less insurance payouts and less strain on the public health system right?

No, you are wrong. A study in 2019 found that patients who chose to undergo imaging spend more money on healthcare and are absent from work more than those who did not choose to undergo imaging. We like to think if we can see exactly what is wrong, we will be able to better fix the problem. Unfortunately, in this case, that doesn’t apply.

There are other studies who publish similar findings. Patients with back pain who have had imaging experienced a worse sense of well-being (Radiology, 2005) and were eight times more likely to opt for surgery (Journal of Occupational and Environmental Medicine, 2010). The difference is REAL. It is a lose-lose situation. Even for you.

p.s. MRI studies are useful when clinically indicated. It is invaluable for diagnosing life-threatening conditions such as cauda equina syndrome. You can read more about when MRI is appropriate here.

How do I know my disc herniation is a problem?

While disc herniations poorly correlate with back pain, they might cause leg pain or “sciatica”. Common slipped disc symptoms also include pain, numbness, or weakness in your lower limb. These symptoms result from a compression of the spinal nerve or nerve roots coming out of your lumbar spine.

While the most obvious treatment may be surgery, there are also conservative treatment options available. Neurodynamic mobilisation is a type of herniated disc exercises that can help. There are slipped disc treatment without surgery.

If you start to changes in your bladder or bowel movements or significantly muscle weakness, seek medical care immediately.

What causes lower back pain?

There are many reasons why your back may be hurting. It could be from the soft tissues in your low back, a muscle spasm, nerve pain, or other conditions such as ankylosing spondylitis.As such, there are different types of lower back pain.

Do not try diagnosing back pain symptoms yourself.

The best thing you can do to find out where your pain is coming from is to seek professional advice. A good chiropractor will go through your medical history and perform a thorough examination. After which, they work with you to get to the root of your back pain to provide treatment to relieve pain.

Slipped Disc Treatment

Now that you know your back pain is unlikely to be coming from your disc, allow me to take you through on how your recovery may look like. The first thing to do is to not think of me as your pain terminator. Think of me as someone who works with you to increase your body’s resilience and your body’s tolerance for the activities you love enough so that you don’t get pain. Even if all you want to do is “just” read on your ottoman pain-free, we want to help.

The difference between a good chiropractor and a mediocre one is his or her intention to help you live your life the way you want it. It is what you deserve and we want to work with you to achieve just that.

Research has been telling us exercise is the best approach to treating back pain. Most Singapore chiropractic clinics, however, still offer only chiropractic adjustments. Even physical therapists or physiotherapists in Singapore are slow to pick up exercise as a primary modality – physical therapy, IASTM, dry needling are still common treatments offered in Singapore even though all of them are at best adjunctive therapy.

I know exercise rehabilitation is probably not what you are after. You must think I am crazy to suggest you exercise even though you are in pain. Remember, back pain exercise is what works best.

Even if you have a pinched nerve in your lower back, we have exercises that can help with just that.

Research has also shown painful rehabilitative exercises have better outcomes than non-painful ones. Of course we will work within your limits to help you achieve full recovery. Don’t worry, we are good at what we do.

The worst thing you can do for yourself is avoid physical activity.

While muscle relaxants and anti inflammatories may be good for short-term relief, they are extremely unlikely to be your long term pain solution.

The Doctor-Patient Dialogue

At Square One, we treat you (patients and prospective patients alike) holistically. We put your values and preferences alongside our clinical expertise and the best research evidence. (Not coincidentally, the three pillars of evidence-based practice.) In the rush and hurry of living in the 21st century, healthcare providers stopped listening to what you desire (as a patient). This is unacceptable. It caused misconceptions and misunderstanding of what your symptoms are and your can do about it. Tell me, when was the last time a health professional you offered you advice AND the research papers to support their recommendations? 

To illustrate the severity of the problem, do you know the average doctor interrupts you just after 23 seconds (Journal of American Medical Association, 1999)? The amount of time it will take for you to complete your opening statement is only 32 seconds. Yet most health professionals can’t let you speak for 32 seconds uninterrupted. 

jesse cai, best chiropractor singapore, chiropractic first
Singapore’s #1 exercise chiropractor Jesse Cai believes movement is medicine. He helps lower back pain patients achieve pain free living in just 4 to 7 visits.

 

You First, Always

Research guides us as healthcare providers to administer best-evidence care. This not limited to just the best techniques and modalities. It also includes the relationship we build with you, and how we can – in intangible ways – help you get more than pain relief.

Don’t settle for less. Let us help you with what really matters to you.

Today, we want you to know that MRIs are not good for your back pain. In fact, MRI itself is a risk factor for chronic back pain!

If you already had your MRI done and found that you have a couple of slipped discs, don’t worry. Research tells us it’s okay. Just breathe, relax, and find yourself a good chiropractor Singapore that will help with your back pain treatment. We know you probably came to this page because you were looking for advice on slipped disc recovery. The good news? You don’t have to worry about them any more! Let us help you achieve pain-free living with the best evidence care. We promise we will help.

Looking to visit us? We are two minutes away from Outram Park MRT (Dorsett Hotel exit). If you are coming from Tanjong Pagar, we are a five minute walk from 100 AM Mall.

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