Disc Herniations and Related Conditions
If you are one of 31 million Americans experiencing back pain, neck pain, or low back pain, a “slipped” disc or herniated disc may be the cause.
But what exactly is a herniated disc, and how does it become injured?
The spine consists of 24 blocky bones (vertebra) stacked on top of each other in a flexible column that allows our body to move. Between each vertebra sits a soft, rubbery cushion made of cartilaginous fibers and hydrated proteins known as an intervertebral disc.
Intervertebral discs act as shock absorbers for our spine, much like brake pads in a vehicle. Discs absorb the impact of numerous physical activities: running, bending over, sitting, jumping on a trampoline, and more. Intervertebral discs also absorb physical forces sustained in stationary positions like sitting at a football game or in front of a computer for long periods.
Intervertebral discs are located along the spine in our neck, mid back, and lower back. They also bend and twist with movements of the spine, allowing our bodies to be flexible.
How do they accomplish this? Intervertebral discs are shaped like jelly donuts with a tough, fibrous outer portion known as the annulus fibrosis and a soft, gel-like inner portion called the nucleus pulposus. This combination of a more rigid exterior and softer interior allows it to distribute the forces we encounter with our everyday activities and physical exertion – all because this bendable disc absorbs the forces of physics.
Here’s a quick link on Spine Universe about disc anatomy:
How does an injury occur to an intervertebral disc?
Imagine dropping a jelly doughnut onto the sidewalk and stepping on it.
The term “slipped disc,” more accurately known as a bulging or herniated disc, refers to some damage that has occurred to either the annulus fibrosis, the nucleus pulposus, or both.
The damage can be minor – think of a small papercut that heals just fine on its own. Sometimes, the outer portion of the intervertebral disc tears, resulting in large bulges in the annulus fibrosis. If the tearing and damage to the annulus fibrosis are extensive, the nucleus pulposus may leak out.
Damage to this tough exterior of the intervertebral disc can also irritate the nerves on the outer third of the annulus fibrosis, causing pain and other sequelae to occur.
Compromise to the disc structure is commonly thought to occur from accidents or traumas, but this isn’t always the case. Although injuries from traumatic accidents like sporting injuries, vehicle collisions, or slips and falls can cause damage to the disc, degeneration, or accumulated wear and tear on the body, can also cause discs to become more susceptible to injury and damage! Sometimes degeneration occurs from age, but it also can occur naturally.
Thankfully, the rubbery discs in our spine are a lot stronger than a jelly doughnut!
Although intervertebral discs can be injured, there may not be any symptoms. Having a disc injury may not always be painful or even result in pain or a loss of function.
If there is a disc bulge or herniation, surgery is not always necessary to relieve the problem, either. Why is this?
Disc bulges can occur naturally in the body without producing any signs or symptoms that they exist.
It’s when signs and symptoms, such as pain and a decreased ability to perform regular activities, may indicate the need for some intervention.
The mechanism of a disc herniation
The vertebrae and intervertebral discs of the spine surround and protect the spinal cord: the information highway connecting the brain to the nerves in the body. The nerves exiting the spinal cord travel outward, innervating both the left and right sides of our bodies.
Injury to a disc can create a bulge that pinches one of the nerves exiting the spinal cord. This is known as nerve impingement. Signs and symptoms depend on where the disc is located and whether the disc bulge or injury is pressing on a nerve.
If this is the case, depending on where the pinched nerve is in the spine, it can result in pain, weakness, or odd sensations called paresthesia in an arm or leg!
Signs of a disc herniation causing nerve impingement include:
- Arm or leg pain. If pain is left in the upper or lower extremities, it is usually only on one side.
- A disc herniation in the neck may cause pain and discomfort in the shoulder and arm.
- If the disc herniation is in the lower back, it may cause pain and discomfort along the beltline, thigh, and even into the foot.
- This pain can feel sharp or shooting when you cough, sneeze or move into certain positions.
- Weakness. A disc herniation may pinch the nerve, resulting in muscles controlled by the nerve becoming weaker.
- Paresthesia. This may feel like tingling, numbness, strange sensations, or even ants crawling on the skin. The areas of the body that experience these symptoms are often supplied by the nerve being impinged.
Increasing the chances of disc herniations
Certain conditions increase the risk of developing disc herniations and disc injury. These are:
- Weight. Obesity and excess body weight places additional stress on the discs, primarily in the lower back.
- Occupation. People with labor-intensive jobs have a greater risk of developing back problems. This includes repetitive lifting, pulling, pushing, twisting, bending at the waist, and leaning from side to side.
- Genetics. Some people inherit a predisposition to developing a disc herniation.
- Smoking. Smoking decreases the oxygen supply to the disc, causing the cartilaginous fibers to break down more quickly.
What should you do if you suspect a disc herniation?
Because the nature of this injury is mechanical, which means it occurs in relation to the muscles, joints, and bones of the body, addressing the musculoskeletal components and making changes to overall bodily movement becomes an imperative part of an effective treatment plan.
This isn’t to say a person with a disc herniation needs to stop all activities and engage in bedrest. This could be an undesirable course of action.
Management of a disc herniation will depend on whether the condition is acute (sudden onset) or chronic (repeatedly occurring over time). It will also depend on the severity of symptoms and the size of the injury to the disc.
Thankfully, with the right interventions and tools, intervertebral discs have the ability to heal –although it can be slow.
How we treat Disc Herniations
In our Boca Raton Sports Chiropractic practice, we take a detailed history of your injury, followed by a functional movement assessment and examination.
A chiropractor is a trained doctor with the necessary educational background to analyze the body's physical movements and can be an asset in directing the course of care best for recovery. Chiropractors are well-equipped to assess, diagnose, and treat mechanical conditions — like disc herniations and pinched nerves — through gentle, conservative interventions that don’t include injections or surgery.
Treatment approaches may include isometric exercises, specific stretches and exercises for muscles and tendons of the affected spinal region, ice and rest, myofascial release (targeted soft tissue work into the muscles and fascia), peripheral nerve flossing, making ergonomic changes at work or home, and more.
Treating disc herniations and related conditions is right up our alley, and we have many methods to manage your care safely, effectively, and compassionately.
We may analyze your daily ergonomics and habits to determine if lifestyle or activity modifications are necessary and what those may include. We also prescribe sports rehab exercises and have other therapeutic modalities to safely and compassionately treat your elbow pain.
Your treatment plan is unique to you and your condition. We may use some approaches to help your disc herniation consist of sports rehabilitation exercises, Active Release Techniques (Muscle Work), chiropractic, Graston Technique®, and deep tissue laser therapy.
Frequently Asked Questions (FAQ)
How do I know if a chiropractor is right for me? Do I need surgery?
At our chiropractic office, we take the time to get to know you and your symptoms. We find the cause of your pain and develop an individually tailored treatment plan to suit your care.
Suppose your symptoms are severely affecting your abilities to function and engage in daily living. In that case, we may co-manage your care with another specialist, such as an orthopedist or sports medicine doctor, or refer you for a surgical consult once a thorough exam has been performed.
Many times, surgery for a disc herniation is not the best course of care. We will find the best options for you with our team of healthcare professionals.
A conservative approach often has fewer side effects than medications or injections and a faster return to normalcy than the extensive rehabilitation required after surgery. Conservative management allows a person to continue doing what they love, help slow or prevent injuries before they occur, and return to their daily living activities more quickly.
How long will it take to recover from a disc herniation?
Unfortunately, this depends. Many factors are considered, such as what level the disc herniation is located, nerve impingement present, the severity of your symptoms, and more.
Recovery can also depend on your lifestyle, including activity levels, ergonomics at work or home, and your body’s response to treatment. Depending on your condition, you may also need collaboration with other healthcare providers to help restore function as quickly and effectively as possible.
That’s why no two treatment plans must be exactly alike. Everyone’s body is different and will heal at different rates.
It is essential to have the right team monitoring your condition and supporting you with a comprehensive approach to conservative care.
Helping you understand your body and how it moves is an important piece to preventing future injury. Here are some other articles to read regarding treating disc herniations in the spine:
When should I see a chiropractor for my pain? If you are dealing with pain and suspect you may have a disc herniation, we are here for you. If you want a same-day examination and treatment for your sports injury, call our Boca Raton or Miami chiropractic and sports injury office at 561-997-8898 or schedule online.