What’s a Herniated Disc and How Can Chiropractic Care Treat It?
If you have back pain, the cause may be a herniated disc. Learn more about this common condition’s causes and how chiropractic can alleviate the symptoms.
Is a Herniated Disc the Cause of Your Pain?
Herniated disc, ruptured disc, disc herniation, slipped disc—these terms all refer to the same injury. We often hear the term “bulging disc,” which is different from a herniation, usually a less severe injury. These disc injuries are very serious and can have a major impact on the quality of your life.
What Causes a Herniated Disk?
According to Web MD:
“Although a violent injury can damage a disk, problems with disks are often brought on by the normal aging process or by everyday activities, such as lifting heavy objects the wrong way, stretching too hard during a tennis volley, or slipping and falling on an icy sidewalk. Any such event can cause the fibrous outer covering of the disk to break or distort to the point that it presses on a spinal nerve, especially if disk material extrudes. Sometimes, a disk swells, tears, or degenerates without any apparent cause.”
According to Healthline:
“A slipped disk occurs when the outer ring becomes weak or torn and allows the inner portion to slip out. This can happen with age. Certain motions may also cause a slipped disk. A disk 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 disk. If you have a very physically demanding job that requires a lot of lifting, you may be at increased risk for slipped disks.
Overweight individuals are also at increased risk for a slipped disk because their disks must support the additional weight. Weak muscles and a sedentary lifestyle may also contribute to the development of a slipped disk.
As you get older, you are more likely to experience a slipped disk. This is because your disks begin to lose some of their protective water content as you age. As a result, they can slip more easily out of place. They are more common in men than women.”
To summarize, if you have pre-existing conditions in the spine such as arthritis, tropism or stenosis, you are more prone to a disc injury. Trauma, such as a fall or a car accident, can certainly damage a disc. The most common cause I see in my practice is “idiopathic etiology,” or unknown cause! The pain starts either gradually or suddenly and gets worse in the coming days or weeks.
A herniated disc can cause the classic “sciatica” pain when these damaged discs irritate the sensitive spinal nerves. This pain and tingling can radiate all the way down to the feet and toes! In cases with excessive pressure on the spinal nerves, there may be weakness in the involved leg.
Herniated disc and sciatica symptoms are generally worse in the mornings, as the disc absorbs fluid overnight when patients are non-weight bearing. When the disc absorbs fluid, the disc swells and stretches the pain sensitive disc fibers, which causes pain. The sooner patients can get up and move in the morning, releasing fluid from the disc, the sooner they feel better. First thing in the morning – get up and walk.
This may seem strange, but disc pain will increase with sitting. Sitting increases the pressure on the lumbar discs, putting more pressure on damaged tissues, leading to more pain. Disc patients do not like to sit or drive for prolonged periods and would much rather be active because they feel better.
Lower back and leg pain may increase with coughing, sneezing, laughing, and straining at the stool. These activities increase the pressure in the disc and stretch damaged tissues. Many patients have to “brace” themselves before a cough or sneeze.
With that information, if you have allergies that cause you to sneeze and cough, make sure you are taking steps to control them. If you are prone to constipation, make sure you are taking steps to soften your stool.
- Ice – A good guideline is 15-20 minutes on, then off for 1-2 hours
- Avoid bed-rest or prolonged sitting or driving – As discussed above, a herniated disc patient needs to keep moving within their pain tolerance.
- Topical Analgesics – Grandma used Ben-Gay, we all know that smell. We use BioFreeze but all topical analgesics basically do the same thing which is stimulating the cold/hot nerve endings to block pain signals.
- Gentle stretching – This is not a time for high impact exercises. Knee-chest, cat/camel, and figure-4 stretches are usually safe to start with.
- Sleeping – Usually best either on your back with a pillow under your knees or on your side with a pillow between your knees and ankles. Try a recliner if those positions don’t work.
Treating a Herniated Disc
First, what do we want to avoid?
Prolonged use of prescription pain killers – While patients may need meds for the short term, we want to discourage long term use as they can be addictive.
Epidural Steroid Injections – This is not an option we want to start treatment with. Shots don’t heal discs, they just dry up inflammation. In cases that are not responding well, we will have to get a shot and then continue treatment, as our treatments are much more effective after the inflammation is dried up. Shots on their own, however, show a long-term success rate of only 15%.
Surgery – We want to do everything we can to avoid back surgery. People think it is a quick fix. Not true. We know from the British Medical Journal that surgically treated and conservatively treated patients are virtually the same after 1 and 2 years. Why go through the risks, downtime, and expense of surgery if you’re going to be the same?
What do we do?
A complete history, thorough exam, and any necessary imaging are done first to arrive at an accurate diagnosis. If we determine we can help you, we put together an individualized treatment plan specifically for your unique needs.
A treatment plan may consist of:
- The Cox Technique – A gentle, painless, hands-on spinal decompression therapy that boasts a 91% success rate!
- Electrical stimulation – Is used to control pain and decrease inflammation.
- Massage Therapy – The techniques we use break up adhesions, loosens scar tissue, relaxes muscles, improves range of motion, and improves posture.
- Vibration Therapy – Will increase core strength and improve posture 3-4 times faster than traditional rehab.
- Super Pulsed Laser – Accelerates soft tissue healing by increasing cellular energy and improving circulation.
- Custom Orthotics – Correcting foot bio-mechanics puts the feet, knees, hips, pelvis, and lumbar spine in better alignment, which decreases stress on the spinal discs.
- Rehabilitation (Exercise) – We start with gentle stretching and pain-relieving exercises, and progress to core-strengthening and full-body exercises.
- Spinal Bracing – Has been shown to limit the movement of the trunk, provide stability, and increase your tolerance to daily activities.
In disc herniation and sciatica cases, we look for 50% improvement in the first 2-4 weeks. If the patient is improving, we will continue to treat. If not, we will consider an MRI, as well as a consultation with our orthopedic surgeon and our pain management doctor.
If the patient has “red flags,” such as cauda equina syndrome (where patients may lose control of their bowel and bladder), progressive neurologic deficit (patient has weakness that is rapidly getting worse), or any indication of a fracture, tumor, or infection, the patient will be referred out on an emergent basis. The good news is these are relatively rare complications, so if you’re ready to see what chiropractic care can do for you, call the Algonquin Chiropractic Center. We’ve been treating herniated discs in Algonquin and the surrounding Chicago area for years, and will give your condition he attention it needs.