You may have been told you have “slipped a disc” or that you have ruptured a disc, in fact these are lay terms for a herniated disc. This is where you disc has been under pressure and some of the material has leaked away from the disc itself.
The disc is the soft cushion between each vertebra or bones that make up your spine. The spinal cord is housed in the middle of the spine inside the hollow spinal canal. The spinal cord or nerves as they exit the spine can be irritated by a herniated disc.
The disc has a jelly-like substance in the middle (nucleous pulposis) and a more fibrous material on the outer part (annulus fibrosis) of the disc. If the disc has a compression force placed on it, the jelly-like substance is squeezed causing a disc bulge.
If the pressure continues the material make erupt through the outer layers and herniate. In severe cases the material will completely leave the disc and float around the spinal canal. In this situation you will lose bladder and bowel control and should seek help immediately.
Disc herniations are most common in the lower back, they can also occur in the neck. However they are very rare to occur in the upper back region, due to the added protection the ribs provide.
Statistics say that 60-80% of adults suffer with lower back pain, yet only 2% have disc herniations. So they are in fact not very common, a lot of people are wrongly diagnosed with a herniated disc. The symptoms can be the same but he cause completely different.
What are the signs and symptoms?
If you have a herniated disc, the first signs of nerve irritation are tingling and numbness. This is not true numbness as if you pinch the skin you will still feel pain. The outer fibers of the nerve cause an altered sensation – the pins, needles, burning and sensation of numbness.
At first you may or may not have any back pain at all. Your lower back may feel stiff or a burning sensation, but certain movements in your lower back will aggravate the sensations in your buttocks and legs.
But once the nerve becomes more irritated pain will develop.
It will start as local pain in the buttock and then progress to radiate down your leg (sciatica). If the nerve continues to become irritated then pain levels will increase and eventually true numbness, loss of muscle strength will develop. Once this occurs you should seek immediate help.
The final stage is where you lose bladder and bowel control and surgery is your only option.
How are disc herniations diagnosed?
The best way to see if the disc is herniated is through x-rays and MRI’s. Your symptoms may indicate that a herniations is present, however the same symptoms can also be related to spinal imbalances, Piriformis Syndrome and even degeneration of the spine.
X-Rays will show that the disc height has decreased, which can occur with age or due to trauma. It is the MRI that can physically see the disc material and where it lies, so the best method to properly diagnose the herniated disc.
Why do discs herniate?
Because the disc is mainly water, with age and gravity the disc will lose some of this water. Eventually the disc decreases in height – this is a natural effect of time and gravity.
However, if you have had trauma to a specific area in your spine, this degeneration can increase and the height decrease quicker and greater.
These situations will cause the disc to lose its strength and allow for herniations to occur. But the most common cause is the pressures created when the spine is out of balance.
The daily tasks you perform each day (the bending, lifting, twisting, poor postures …) create muscle tension. The muscle tension pulls the spine out of alignment and spinal imbalances develop. These imbalances twist and distort your spine and place uneven pressure on your joints and discs.
With time these compression stresses continue and place the discs under huge stress. Then one day you lift your child, carry an object, cough or sneeze … or even do nothing at all out of your normal daily activities … and suddenly the disc herniates.
What are the best treatment options?
If you have major symptoms then surgery is your only option. This is still rare and studies have shown that conservative treatments will also give you benefit.
For the majority though, you first must reduce and relieve pain. This can be achieved by using ice/heat, ultrasound, electrical stimulation and anti-inflammatories. This will at least offer temporary relief.
But your main focus should be on removing the underlying cause, which is not the disc herniation itself. Even with surgery, you may relieve the pressure on the nerve, but you have not removed why this pressure developed.
If you only remove the nerve pressure, then with time the condition will redevelop and more problems will occur. Statistics point out that once one surgery occurs, there are usually more to follow. Without identifying and addressing the underlying cause of the problem, which is the physical dysfunctions caused by imbalances in muscles and joints, you will likely continue to suffer with this condition and the continuous flare ups for years.
Unfortunately, most doctors, chiropractors and physical therapists don’t spend time or focus on identifying the physical dysfunctions that are responsible for the condition so most people end up jumping from one useless traditional treatment to the next and suffer for months or years unnecessarily.
If you have been diagnosed with a herniated disc, or are wondering if your back pain may be caused by a herniated disc, either way you must identify and address the imbalances that are causing your pain as part of your recovery.
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