Can you push a slipped disc back into place?

Someone felt the slipped disc in my back and pushed it back in! …..REALLY?! What does the science say?

Unfortunately, this is something that I hear from patients all the time at Hawkes Physiotherapy, but it is just so wrong. In fact there has even been research done by Demoulin et al (2018), where they looked into the beliefs of patients about spinal manipulations and cracking, amazingly they found that 33% of people answered yes to the question, ” Can you push a slipped disc back into place or does cracking your back change joint alignment?”

If you want to read more about what cracking your back does then check out our article here:

The myths of Physiotherapy….

Now I don’t know where to start with this because it’s just not possible to push a disc back in based on normal human anatomy. The thing that perpetuates the myth is that whatever technique is used it can bring about symptom improvement, which I don’t dispute at all. However, the statement about what it has done and why it has done it are so far off base it’s crazy!

So answering the first question: Can you feel a disc in the lower back?

I’ll let the pictures illustrate the answer below:

cross-section-of-abdomen

The first problem is the depth. Look below at how deep into the body that disc is! It is not far off half way to your middle. So even if all the stuff in the way was soft and gooey and you could simply push your finger into where the disc is, your finger would be too short!

The next problem is that the ‘stuff’ above it isn’t soft and gooey, it’s tough and hard! You have skin, fascia, muscle, ligament and bone to get though.

Fascia, for example, is made of collagen, which is extremely tough and this makes fascia very tough. This makes it nearly impossible to move, which is supported by Chaudhry et al (2008).

muscles-of-back

If you look below, where the fascia, muscle and ligaments are removed the amount disc that you can see is very small so even if the above issues weren’t there then you would have to be very accurate to feel it.

bones-of-spine

So the fact that you can’t feel it means that you can’t tell if they are ‘out’, calcified or anything else and for the same reason you can’t just push discs back into place.

Even if you could push on them, the problem then would be that they are very hard structures that don’t move easily. This is highlighted by Adams et al (2000) who found that 2 degrees of Lumbar extension (arching the lower back) increased the maximum compressive stress within the posterior anulus of the disc by an average of 16%, compared with a neutral standing posture. It was found that disc force is 404 Newtons on L5 in standing according to Shirazi-Adl et al (2005), which is 41kg.

Disc-pressures

So arching your back to just 2 degrees would place 48kg of force on the L5 disc. Now I’m pretty sure that you would struggle to place this force onto the disc by hand even if you had very long fingers that could pass through skin, fascia, muscle, ligament and bone! Above is a diagram showing disc pressure in kilograms on the discs, as you can see they are huge!

 

Summary:

So, in summary, you can’t touch a disc, tell what state it is in from touch or push a slipped disc back into place by hand. However, we can assess you with a thorough subjective and objective physiotherapy examination, which is exactly what we do at both of our clinics in Stoke-on-Trent. If you want more information of disc prolapses and sciatica then click below:

What is Sciatica really?

Take home message is don’t believe everything that you hear, except from me of course LOL!

If you need any further information or would like to book an appointment then call Hawkes Physiotherapy on 01782 771861 or 07866 195914.

DISCLAIMER:

The content in this blog article is provided for general information purposes only and is not meant to replace a physiotherapy or medical consultation.

  • Adams, Michael A., et al. “Effects of backward bending on lumbar intervertebral discs: relevance to physical therapy treatments for low back pain.” Spine 25.4 (2000): 431-438.
  • Chaudhry, Hans, et al. “Three-dimensional mathematical model for deformation of human fasciae in manual therapy.” The Journal of the American Osteopathic Association 108.8 (2008): 379-390.
  • Demoulin, Christophe, et al. “Beliefs in the population about cracking sounds produced during spinal manipulation.” Joint Bone Spine 85.2 (2018): 239-242.
  • Shirazi-Adl, A., et al. “Spinal muscle forces, internal loads and stability in standing under various postures and loads—application of kinematics-based algorithm.” European spine journal 14.4 (2005): 381-392.

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Online Physiotherapy

Put simply this is Physio done via either telephone or video over the internet. Skype and facetime are examples of this.

Contrary to popular belief online physiotherapy can be very effective and it can help the same injuries that face to face physio can help. I have helped many people with injuries such as disc prolapses, tennis elbow, neck pain and much more).