No appointments, long waiting times, seemingly superficial examinations: These are often the reasons why people with acute complaints go straight to an osteopath. A slipped disc can be accompanied by highly acute and very severe back pain as well as tingling or numbness.

Of course, it is natural to first think of the doctor when symptoms are intense – and in many cases this is absolutely right. However, in my experience, osteopathic treatment, often accompanying or following acute treatment, can be a sensible option. Even if a herniated disc has already been diagnosed and chronic disc problems are known, alternative medicine can be an option. Here is an attempt at differentiation to show you the best way for your recovery.

First of all, what is an intervertebral disc?

The cartilaginous intervertebral discs (intervertebral discs), each a few millimetres thick, are located between the bones of the spine. Their structure can be visualized as follows: The outer edge, the fibrous ring (annulus fibrosus), consists of firm connective tissue and provides stability. The inner part, the nucleus pulposus, is softer and consists of around 85% water.

The shock absorbers of our backs

The main task of the intervertebral discs is to absorb shocks and pressure on the spine. During movement, the vertebral bodies glide on these buffers, allowing our backs to remain flexible.

The care of the intervertebral disc is fascinating: it works like a sponge. Movement exerts pressure and squeezes out used fluid. When the pressure is relieved (e.g. when lying down), the intervertebral disc soaks up fresh nutrient fluid again. This alternation of load and relief is essential for the health of the tissue.

The intervertebral discs also create space between the vertebrae. This space is important so that the nerves that emerge from the spinal cord are not constricted. Even a slight pinching of a nerve can lead to the familiar symptoms such as tingling or pain that radiates into the arms or legs.

Diagnosis of herniated disc

Typical symptoms such as pain in the spine and discomfort in the arms or legs are used to classify a potential herniated disc. A disc lesion can be detected very reliably by an MRI. Such an examination should therefore be arranged promptly.

However, a positive MRI finding should not prevent the search for other possible causes of the symptoms. It is not uncommon for me to observe in my practice or in rehab that a specific test for a bottleneck is positive despite an MRI finding of a herniated disc. This is because a nerve can become “pinched” not only due to an unstable intervertebral disc; a nerve can also come under pressure in other places. Typical constriction syndromes are thoracic outlet syndrome (shoulder constriction), which is often triggered by poor posture when sitting, or piriformis syndrome, named after the muscle of the same name deep in the pelvis.

Lumbago is a sudden stabbing pain in the lower back caused by severely tense muscles. The symptoms can be similar to those of an intervertebral disc lesion.

Causes of a slipped disc

The causes of disc lesions can rarely be traced back to a single factor. However, there are influences that can significantly affect the development of disc lesions. These include

Lack of exercise. Sitting for long periods of time in particular weakens the back muscles and forces the spine into an unnatural posture. If the lack of exercise is not compensated for by sport, the likelihood of disc lesions increases.
Incorrect loading occurs when muscle groups are heavily loaded on one side. Common types of incorrect strain include standing for long periods, carrying or lifting heavy loads and bent over work.
An unsuitable diet is said to have an influence on the health of the intervertebral discs. However, there are not yet any sound scientific studies on this.
Obesity as a cause of disc lesions is controversial, but can increase the likelihood of back problems given the influencing factors mentioned.
With increasing age, the intervertebral discs lose elasticity and moisture, which makes them more susceptible to cracks.
Accidents such as serious falls can damage intervertebral discs.

These risk factors can be significantly offset by suitable sport. To prevent disc lesions, the focus should be on strengthening the back muscles and improving the mobility of the pelvis, trunk, shoulders and cervical spine.

Paths to recovery: a comparison of treatment methods

There is no one right way to deal with back pain. A combination of different approaches often leads to the best result. Here I compare the common methods.

1. conventional medicine (orthodox medicine)

The first route usually leads to an orthopaedist or Hausarzt. In principle, neurologists are the more appropriate choice.

The approach: focus on diagnostics (MRI, CT, X-ray) and rapid symptom relief.
The methods: painkillers, anti-inflammatory drugs (e.g. ibuprofen, diclofenac), injections (syringes) to the nerve root and, in extreme emergencies, surgical interventions.
Strengths: Indispensable in acute diagnostics and emergencies. Severe pain can be relieved quickly to make movement possible again.
Limitations: Often “only” the symptom is treated, not always the functional cause of the incorrect strain.

2. osteopathy

The osteopath not only looks at the intervertebral disc, but at the whole person.

The approach: We look for tensions in the body that have led to this particular intervertebral disc being overloaded. This can be a misalignment in the pelvis, poor posture, but also internal traction from organs (e.g. due to a dysfunctional bowel).
The methods: Gentle manual techniques to relieve the spine, relaxation of muscles and fascia, decompression of the spine, mobilization of joints and visceral techniques (treatment of the organs).
Strengths: Holistic root cause analysis. Ideal for recurring problems or when patients do not want to take long-term medication.
Limits: A massive, acute prolapse cannot be “massaged away”. Osteopathy can be used here to provide supportive relief, but manual therapy cannot mechanically reverse the herniated disc.

3. traditional Chinese medicine (TCM)

TCM often sees pain as a stagnation of energy (Qi) and blood.

The approach: restoring free flow in the meridians (energy pathways), which often run along the spine and legs (e.g. bladder meridian).
The methods: Acupuncture, cupping, moxibustion and herbal therapy.
Strengths: Possible pain modulation and relaxation of deep muscles without chemical side effects.
Limits: Similar to osteopathy, structural damage cannot be repaired purely by needles, but the symptoms can be managed if necessary.

4. sports rehab and training therapy

“Exercise is the best medicine” – this sentence almost always applies as soon as the acute phase is over.

The approach: stabilizing the spine by building up muscles.
The methods: Targeted exercises for the back and core muscles (core stability), stretching of shortened structures.
Strengths: The only method that can prevent relapses in the long term. Strong muscles stabilize the intervertebral disc.
Limits: Often not yet feasible in the highly acute pain phase.

Conclusion: When do I need to see a doctor immediately? (Red Flags)

While osteopathy and alternative methods are a wonderful help for many back complaints, there are situations that cannot be postponed. If you are experiencing the symptoms described for the first time, medical clarification is mandatory.

Please consult a doctor or an emergency room immediately if the following symptoms (“red flags”) occur:

Loss of bladder or bowel control: If you cannot hold or pass urine or stool (urinary retention).
Numbness in the genital and buttock area: the so-called “saddle anesthesia” (it feels as if the area that touches the saddle is numb).
Symptoms of paralysis: Real reduction in strength, e.g. if you can no longer lift your foot (weak foot lifter) or your knee buckles.
Sudden onset of severe dizziness, nausea or loss of consciousness in combination with neck pain.

My recommendation for your health: In the case of known, recurring problems or chronic back pain, osteopathy and TCM are often strong partners in breaking out of the “pain spiral” and reducing medication. As soon as the acute phase is over, sports rehab is essential to make the back resilient for the future.

I will be happy to advise you on which route – or which combination – is suitable for your current situation.

This article is for information purposes only. For medical advice or diagnosis, you should consult a healthcare professional.