Herniated Disc(s) – Causes and Treatment
A herniated disc is also known as a bulging disc, slipped disc, prolapsed disc or even ruptured disc. These terms are all synonymous with the same symptom(s) however – pain and discomfort in the spinal region, particularly in the lower back. Herniation is not exclusive to the lower back as they can occur in the smaller discs of the neck region however they tend to be more common in the lower back, especially given the amount of load and leverage the bones there have to deal with. More on that as we go on.
It is not entirely necessary that pain or discomfort will accompany a herniated disc. In fact, it is more common than you may think to HAVE a herniated disc and not even know, because there is no pain. Many individuals have reported having had MRI’s that showed disc herniation but they had no complaint of pain.
The image above illustrates the general anatomy of your spine vertebrae. Between the odd shaped bones (bluish region) you will find the discs. You can think of them as your spine’s shock absorbers, cushioning the bones from daily activities like walking, running, twisting, climbing, jumping etc.
Each disc has two parts: a soft, gelatinous inner portion and a tough outer ring. When the inner portion of the disc protrudes through the outer ring you have a herniated disc.
Imagine you had a jam doughnut and squeezed it from top to bottom to the point the jam began to ooze out. That is in a sense what is happening to a disc when it herniates.
If the herniation is bad enough and begins to press upon or irritate a nerve you can develop pain, tingling, numbness or weakness. As herniation is usually found in the lower back and neck the associated symptoms therefore usually occur in the arms and/or legs. Essentially it is a precursor for sciatica and carpal tunnel syndrome.
The symptoms usually affect one side of the body. With lower back herniation you’ll typically feel the most pain in the buttocks, thigh and calf. There may also be pain in part of the foot. If, however the herniation is around the neck you’ll typically feel the most pain in the shoulder and arm. You may find sometimes your pain shoots into your arm or leg as you cough, sneeze or move into certain positions. The pain is often sharp or burning.
Atlantic Spine Center have a helpful animation that demonstrates the sequence a little better.
Causes & Risk Factors
In general, physical trauma and injury would be the main cause of disc herniation. Examples would include but not limited to falling down a flight of stairs, falling off a ladder, slipping as you get out of a bathtub, falling off a horse or bike even car crashes. In other words, almost anything.
Most doctors will tell you a disc can slip out of place while you are twisting or turning to lift an object. Lifting a very large, heavy object can place great strain on the lower back, resulting in a slipped disc. If you have a very physically demanding job that requires a lot of lifting, you may be at increased risk for slipped discs. We explain a little further down why this is not entirely accurate.
Overweight individuals are also at increased risk for a slipped disc because their discs must support the additional weight. Weak muscles and a sedentary lifestyle may also contribute to the development of a slipped disc.
In children and young adults, discs have high water content. As people age, the water content in the disks decreases and the discs become less flexible. The discs begin to shrink and the spaces between the vertebrae get narrower.
Conditions that can weaken the disc include:
- Improper lifting
- Smoking
- Excessive body weight that places added stress on the discs (in the lower back)
- Sudden pressure (which may be slight)
- Repetitive strenuous activities
An untreated, severe slipped disc can lead to permanent nerve damage. In very rare cases, a slipped disc can cut off nerve impulses to the cauda equina nerves in your lower back and legs. If this occurs, you may lose bowel or bladder control.
Another long-term complication is known as saddle anaesthesia. In this case, the slipped disc compresses nerves and causes you to lose sensation in your inner thighs, the back of your legs, and around your rectum.
While the symptoms of a slipped disc may improve, they also can worsen. If you cannot perform the activities you once could, it’s time to see your doctor.
Diagnosis Methods
The first port of call as usual in determining if you do indeed have a disc herniation is to seek the advice of your GP. Your GP or hospital doctor will first perform a physical exam. They will be looking for the source of your pain and discomfort.
This will involve checking your nerve function and muscle strength, and whether you feel pain when moving or touching the affected area. Your doctor will also ask you about your medical history and your symptoms. They will be interested in when you first felt symptoms and what activities cause your pain to worsen.
Imaging tests can help your doctor view the bones and muscles of your spine and identify any damaged areas. Examples of imaging scans include:
- X-rays
- CT scans
- MRI scans
- Discograms
Your doctor can combine all these pieces of information to determine what is causing your pain, weakness, or discomfort.
What Are the Regular Treatment Methods?
While a lumbar herniated disc can be extremely painful, for most people the symptoms are not long-lasting. About 90% of people who experience a lumbar herniated disc will have no symptoms six weeks later, even if they have had no medical treatment.1
Traditional medical “experts” believe the symptoms from a lumbar herniated disc may resolve themselves for three reasons:
- The body attacks the herniation as a foreign material, shrinking the size of the herniated material and reducing the amount of inflammatory proteins near the nerve root.
- Over time, some of the water from inside the disc is absorbed into the body, causing the disc to shrink. The smaller disc is less likely to extend into nerve roots, causing irritation.
- Lumbar extension exercises may move the herniated area away from the spinal discs. Whether exercise can accomplish this is a matter of debate in the medical community. (key point(s) to remember here)
In general, it is thought that the symptoms get better because the smaller size of the herniated material reduces the likelihood it will irritate the nerve root.
Although a lumbar herniated disc usually triggers attention when it becomes painful, medical research has found it is common for people to have a lumbar disc herniation in their lumbar spine, but no associated pain or other symptoms.2 (The study that has been referenced merely reiterates what we spoke about earlier.)
It is for this reason that care must be taken in the diagnosis to be sure a herniated lumbar disc is causing the problem.
The above is actually an excerpt from https://www.spine-health.com/conditions/herniated-disc/lumbar-herniated-disc. Here they outline what conventional medicine would have you believe. However, we ABC™ providers understand the body’s mechanics a little better.
Whilst traditional medicine is correct for the most part in its understanding of what is happening they do not understand why it is happening. You do not suddenly wake up one day and acquire a herniated disc. Most doctors would even have you believe that that heavy object you tried picking up was the cause of the disc herniation. This is not entirely true.
Although lifting the heavy object may have been the trigger for the pain, it was actually the final injury in a catalogue of injuries you built up over the years before said incident that was the final straw for you.
Over time as you acquire more and more injuries it causes your spine to twist and stiffen up. You don’t really perceive this as it happens very slowly. However, when you have a big injury such as lifting a heavy object with a twisted/stiff spine or falling from a height you will notice the changes quickly. After such injuries you may lose the ability or strength to hold your body up as you did before and start to appear twisted and contorted.
This new further twisted spine configuration that becomes more difficult for you to hold straight will be painful and tiring. More often than not your doctor will offer various anti-inflammatory drugs, muscle relaxers, narcotics for the pain or even nerve pain medication such as gabapentin or duloxetine. Such medications will NEVER fix the issue as chemicals CANNOT fix a mechanical problem.
In some cases, you may be offered surgery if your symptoms do not subside in six weeks or if your slipped disc is affecting your muscle function. Your surgeon may remove the damaged or protruding portion of the disc without removing the entire disc. This is called a microdiskectomy.
In more severe cases, your doctor may replace the disc with an artificial one or remove the disc and fuse your vertebrae together. This procedure, along with a laminectomy and spinal fusion, adds stability to your spinal column, apparently. In fact, it merely further stiffens and reduces mobility in an already stiff and immobile spine. This is a risky option to take and could cause permanent nerve damage, resulting in possible paralysis if not performed well.
How Do YOU Fix It Then?
It’s actually pretty simple in the end. We correct those bones in the body that need to be corrected and return your body to its optimum configuration, therefore returning its bone leverage and systems function.
The herniation actually occurs when the disc(s) become compressed by the vertebrae through pressure from the spine twisting and compressing in order to stiffen up so that it may keep you somewhat more upright. You cannot actually “slip” a disc. If this twisting and stiffening, in other words compensating, did not occur you would not be able to stand, move or function very well.
This compensating is as a result of bones moving in a direction where the body could not self-correct them i.e. directly forward in the spine. Although there are others it is here in the spine that has the largest effect on the body. The more injuries you suffer the more compensations your body will need, causing a loss of mobility and proper function. This is why that last heavy lift or fall would have felt like it had such seemingly significant affects to your health.
When we return said bones to their proper positions your body reduces the number of compensations it needs, therefore reducing pressure and stretch on the nerves, easing load on the muscles and slowly restoring function to the body.
We achieve all this without the need for invasive surgery, damaging drugs, stretches or exercises. Our goal is to help you get back to health and be the best you can be. Let us get to the root cause of your ailment(s). We offer a FREE consultation including a demo of the ‘First Rib Manoeuver’ before you decide on proceeding with any treatment. You will feel the difference to your pain and movement right from the off.
References
1.Slipped Disk: Overview, National Library of Medicine, PubMed Health. Oct. 9, 2014. www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072656/
2.Brinjikji W, Luetmer PH, Comstock B, et al. Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations. AJNR American journal of neuroradiology. 2015;36(4):811-816. doi:10.3174/ajnr.A4173.