Chiropractic Care for Disc Injuries
A Disc Injury isn’t just a pain in the back
what is a slipped disc?
You may not be familiar with the term spinal disc injury, although an injury of this type can often be referred to by other names, such as a pinched nerve or a slipped disc. It can cause low back pain, sciatica and even weakness or numbness if a nerve is being compressed.
The spine is primarily made up of a series of blocks called vertebrae interspersed with discs which, along with the spinal joints, give you the movement you need to move about the day comfortably.
These discs are a flat circular capsule-like structure, made up of solid fibrous rings on the outside (annulus fibrosis) with a soft, almost jelly-like centre (nucleus pulposus).
The spinal discs act as shock absorbing cushions, similar to those in a car.
What is a Disc Herniation?
A normal, healthy disc is
very strong. However, it can wear over time due to cumulative strain from repeated bending, twisting, lifting or prolonged sitting.
The tough outer fibres can eventually tear allowing the nucleus to move and essentially ‘leak’ out, pushing into the spinal canal causing excruciating pain. This is known as a disc herniation.
The phrase ‘slipped disc’ is an interesting one when it is used to describe lower back or neck pain because discs cannot actually slip out. They can certainly wear out, tear or herniate, but they cannot slip!
What are the Symptoms of Disc Injuries?
A disc herniation can put pressure on both the spinal cord and the nerves causing symptoms such as:
- intense stabbing spinal pain
- pain or numbness in the limbs
- weak muscles
- bowel or bladder issues
Spinal disc pain can be excruciating and even a small movement can cause it to flare up.
If any of these symptoms (especially change in bowel or bladder function) develop suddenly, without explanation, visit your GP or local hospital.
What is The Cause of a Bulging or Herniated Disc?
Disc bulging or herniation can occur suddenly due to a single injury or accident, but it is more likely to occur after years of degenerative change happening gradually. Often a patient will perform a relatively simple task such as bending or lifting which suddenly produces pain and symptoms; however, the damage started long before.
Disc injuries can be linked to many different causes including trauma, repetitive lifting of large or heavy objects, repetitive movements and abnormal spinal function .
How do you Treat It?
Regardless of whether you consult your doctor, chiropractor, physiotherapist or exercise physiologist, the aims of the treatment are essentially the same.
- reduce the inflammatory response in the region (Ice, NSAIDS etc)
- rest whilst keeping mobile
- pain relieving drugs
- improving spinal movement in the region (spinal manipulation, mobilisation, targeted exercises)
- stopping any activities that place stress on or aggravate the disc
It is important to note that before any treatment is started, a thorough examination should be performed to confirm the disc is actually the cause of your symptoms as there are many other issues that can result in the same symptoms.
One recent review of the scientific literature found that in asymptomatic patients “Disk degeneration prevalence ranged from 37% of asymptomatic individuals 20 years of age to 96% of those 80 years of age, with a large increase in the prevalence through 50 years.” and that “over 50% of asymptomatic individuals 30–39 years of age have disk degeneration, height loss, or bulging suggests that even in young adults, degenerative changes may be incidental and not causally related to presenting symptoms.” (1) What this means is that when changes to a disc are present on MRI and scans it is possible that this is incidental to the patients current symptoms and not the cause. This is why an accurate diagnosis is so important.
how do our chiropractors approach a Disc Injury
When you come in for your first appointment we will perform a thorough examination, including functional, neurological and orthopedic testing where necessary, to attempt to diagnose exactly what is causing your symptoms. If necessary, an X-ray, CT scan or MRI will be arranged to help accurately assess any damage to your vertebra and discs.
Once we have a working diagnosis we will design a specific treatment program for you aimed at improving your spinal function and reducing your symptoms.
We will also give you specific exercises and other advice about what you can do at home to potentially speed up your recovery and prevent further injury.
If we believe chiropractic care will not help you we will refer you to another health care professional for further assessment.
References
1. Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations W. Brinjikji, P.H. Luetmer, B. Comstock, B.W. Bresnahan, L.E. Chen, R.A. Deyo, S. Halabi, J.A. Turner, A.L. Avins, K. James, J.T. Wald, D.F. Kallmes, and J.G. Jarvik
2. Spine. APRIL 21, 2015 Disc bulging most prevalent abnormal finding on MRI in asymptomatic patients Nakashima H, et al.
