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Herniated Discs

What are herniated discs?

The 24 vertebrae of your spine are separated from one another by pads of cartilage called discs. These discs have a fairly tough outer layer with a soft interior to cushion against the shocks and strains experienced as you move and put various stresses on your spine. The discs are subject to injury, disease, and degeneration with use over time. Certain activities and types of work increase the risk of discs being damaged or deteriorating. When the soft interior material of a disc pushes out through a tear or weakening in the outer covering, the disc is said to be herniated.

Herniated discs are also called protruding, bulging, ruptured, prolapsed, slipped, or degenerated discs. There are fine distinctions between these terms, but all really refer to a disc that is no longer in its normal condition and/or position. Herniated discs cause pain by impinging on (intruding upon, irritating, and pinching) and even injuring nerves in the spinal column.

What are some of the typical symptoms of herniated discs?

Most disc herniation takes place in the lower back (lumbar spine). The second most common site of herniation is the neck (cervical spine). A herniated lumbar disc may send pain shooting down through your buttock and thigh into the back of your leg (sciatica). Cervical disc herniation may cause pain in the shoulder, arm, and hand. Herniated discs can cause muscle weakness, make it hard to get up when you've been sitting or lying down, cause pain when you strain to do something, even when you cough or sneeze. They sometimes produce pain in the lower right side of the abdomen. Herniated discs may also affect nerves to the bladder and bowel, causing incontinence. This symptom signals the need for immediate, emergency attention.

What can chiropractic do?

There is broad acceptance among health care professionals and the public of the recommendation that the pain from herniated discs be initially treated conservatively. That is, as long as there are no signs (such as severe pain, numbness, or functional impairment from nerve involvement) of the need for more invasive treatment, two or three months of chiropractic care may be the best choice before considering to spinal surgery or shots of analgesics (painkillers) in your back. And only a minority of disc herniations turn out to require treatment as traumatic and costly as hospitalization and surgery or with as many side effects (especially for older people) as opioid analgesics and muscle relaxants.

A chiropractor will examine and question you carefully, take a complete history, and conduct appropriate diagnostic tests. He or she will focus on exactly what symptoms you've been suffering and determine which parts of your spine are the likely cause of your pain and loss of function. Chiropractic provides the special training, techniques, and experience needed to safely and effectively adjust your spine so that the stress on the discs is minimized, the pain relieved, the damaged or displaced structures given a chance to heal, and your ability to return to normal functioning restored.

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References

• Polkinghorn BS, Colloca CJ. Treatment of symptomatic lumbar disc herniation using activator methods chiropractic technique. Journal of Manipulative and Physiological Therapeutics, Mar.-Apr. 1998; vol 21, no. 3, pp187-96.
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• Humphreys SC, Eck JC. Clinical evaluation and treatment options for herniated lumbar disc. American Family Physician, Feb. 1999; vol. 59, no. 3, pp587-8.
• Guadagnino MR. Flexion/distraction manipulation of a patient with proven disc herniation. Journal of the Neuromusculoskeletal System, Summer 1997; vol. 5, no. 2, pp70-73.
• Milette PC, Fontaine S, Lepanto L, et al. Differentiating disc protrusions, disc bulges, and discs with normal contour but abnormal signal intensity. Magnetic resonance imaging with discographic correlations. Spine, Jan. 1, 1999; vol. 24, no. 1, pp44-53.
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• ten Brinke A, van der Aa H, van der Palen J, Oosterveld F. Is leg length discrepancy associated with the side of radiating pain in patients with a lumbar herniated disc? Spine, Apr. 1, 1999; vol. 24, no. 7, pp684-86.
• Hubka MJ. Chiropractic management of intervertebral disc syndrome. Foundations of Chiropractic Subluxation, Gatterman MI, editor, St. Louis: Mosby Year-Book, 1995; pp428-51.
• Brouillette DL, Gurske DT. Chiropractic treatment of cervical radiculopathy caused by herniated cervical disc. Journal of Manipulative and Physiological Therapeutics, Feb. 1994; vol. 17, no. 2, pp119-23.
• Cassidy, JD, Thiel HW, Kirkaldy-Willis WH. Side posture manipulation for lumbar intervertebral disk herniation. Journal of Manipulative and Physiological Therapeutics, Mar.-Apr. 1992; vol. 21, no. 3, pp187-96.