The term “disc herniation” often causes a disproportionate level of fear in the patient’s mind when they are confronted with this diagnosis. Often, patients fear that their only resolution to disc related back pain is through surgery. Fortunately, there are effective treatment options for patients suffering from disc related back pain. Proper chiropractic care is a surprisingly effective alternative.
Anatomically, the discs are located between the spinal bones. The disc functions to absorb compression due to body weight and position, and maintain proper spacing between the spinal bones. Each disc is composed of two parts. The inner part is made up of a soft jelly material. The outer part consists of concentric fibrous layers that control the position of the inner part. When healthy, the gel remains centrally located. When a disc is injured, the outer wall is weakened. Under pressure, the disc gel migrates outward toward the outer aspect of the disc wall. As the disc wall thins, it weakens and bulges. A “disc bulge” is the result. When there is a tear through the outer disc wall and the disc gel protrudes through this tear, a herniation results. A herniation is more severe than a bulge.
Disc problems occur due to degenerative changes, arthritis, sudden or cumulative trauma. The most common disc injury involves rotation or twisting at the waist in combination with bending. These movements tear the outer disc wall, leading to bulging or herniation. Disc related back pain is most common among the 30 to 50 year old age group, equally affecting both sexes. Signs and symptoms of disc related back pain often include a history of low back pain episodes with or without leg pain over months or years.
Proper diagnosis is essential for effective treatment. While x-ray findings may be negative, MRI is very reliable at showing the location and size of bulging and herniated discs in good detail. Decisions regarding treatment may be influenced based on MRI results.
Initial treatment goals are to relieve pain and spasm by reducing inflammation and swelling around the disc and nerve roots. This can be accomplished with frequent applications of moist ice packs, short and frequent periods of recumbence, limiting activities and lying on the back with the knees bent. Gentle traction and stretching can also alleviate pain.
It is important to restore range of motion and trunk strength. This is accomplished through structured exercises, beginning with simple, easy ones and graduating to more advanced exercises. Long term management of disc-related back pain should be geared toward building ideal function and fitness, while minimizing risks.