“Oh no! Not a herniated disc!” This phrase is probably uttered every day in doctor’s offices across the country.
You should know that with proper treatment a herniated disc does not mean a lifetime sentence of unbearable pain.
Are herniated disc serious? Yes. However with proper care and monitoring many herniated discs can be managed successfully.
Seek immediate medical attention if you present with any of the following symptoms:
- Loss of balance
- Loss of bladder control
- Loss of sensation especially in the inner part of the thighs
- Loss of consciousness
- Symptoms are rapidly getting worse
A disc herniation falls into a broader category of disc derangement.
Disc derangement is when the disc positioned between your vertebrae has damage to its structure. This damage can be minor or major depending on age and type of trauma. The disc is a made up of a gelatinous center called the nucleus pulposus surrounded by fibrocartilaginous material (annulus fibrosis). When the annulus fibrosus is torn due to stress the gelatinous nucleus pulposus can ooze out creating disc derangement. How far that gelatinous nucleus pulposus oozes out is what determines what kind of disc derangement you have.
There are four stages of disc derangement:
- and sequestration.
Degeneration is where the nucleus pulposus is no longer in a nice contained area but rather is oozing into the layers of annulus fibrosis. The oozing hasn’t gone far but the nucleus pulposus is no longer contained.
Prolapse is when the nucleus pulposus is pushing all the way out to the last layers of the annulus fibrosis. It hasn’t left the confinement of the disc but its close.
Extrusion is when nucleus pulposus has left the confinement of the annulus fibrosis. This is the state where nucleus pulposus can physically start interfering with surrounding structures.
Finally sequestration is when the nucleus pulposus has left the confinement of the annular fibrosis and has broken off into little pieces. These pieces can travel and cause interference with the surrounding structures.
Any stage of disc derangement can cause pain. How much pain depends upon the individual and the location of the derangement. However extrusion and sequestration can pose the most serious risk of the four. Anytime nucleus pulposus has left its confinement, it can cause impingement and pain.
When a disc undergoes derangement it was believed that it actually pinched a nerve causing pain. Although that can be the case with some types of derangement in general the pain associated with disc derangement comes from the inflammatory response of the body to the change in structure. The inflammation occurs around the deranged disc and then the nerve and other pain sensitive structures become irritated, causing pain.
Herniated discs are diagnosis with MRI imaging which can tell the doctor where and what type of disc derangement is present. MRI imaging can also show the doctor if any other structures are being physically intruded by the disc derangement.
What are the symptoms of a herniated disc?
Disc derangement can have many presentations and should always be check by a qualified medical professional such as a medical doctor or chiropractor.
Some people have herniated discs and do not demonstrate any symptoms. However when symptoms do arise they are different depending on location.
Cervical disc herniation symptoms:
- Pain in the arm or hand, this pain often feels like it is traveling down the arm or radiating
- Numbness and tingling
- Weakness in the arms
- In severe cases reduced reflexes in the upper limbs with increased reflexes in the lower limbs
Lumbar disc herniation symptoms:
- Low back pain that travels down the buttocks, legs and feet
- Numbness and tingling
- Weakness in the legs
- Decreased reflexes
Risk factors for herniated disc:
- Overweight: excess weight puts extra stress and different weight loading on discs
- Physically demanding jobs
- Genetics: a family history of disc herniation
- Age: most likely to occur between 30-50
What causes a herniated disc?
Herniated discs happen gradually with repeat stress. A person can’t often pinpoint when they herniated a disc. If they do say that picking up a piece of paper caused their herniated disc it was not the simple act of bending over but rather the repeated stress to the disc that caused the herniation. When that person bent over to pick up the paper that was the straw that broke the camel’s back.
How do you treat a herniated disc?
Treatments for a herniated disc include:
- Chiropractic treatment with adjustments
- Cervical traction
- Physical therapy
- At home exercises and stretches
- Postural correction
- Weight reduction
- OTC, muscle relaxers and other narcotics
Chiropractic care with flexion distraction has been shown to be helpful in disc herniation treatment.
An important thing to remember is to avoid too much bed rest. Taking it easy and not lifting heavy things is fine but lying in bed for the pain to go away is one of the worst things you can do for your spine. Retaining motion is crucial when there is a herniation of a disc.
If you are experiencing herniated disc symptoms and wish to discuss your treatments options please schedule your appointment today.