Understanding a Herniated Disc

If you’ve ever been minding your own business quietly resting or relaxing watching TV and felt a sudden, unexpected sharp pain in your back when you stood to get more popcorn, you might be wondering where on earth the pain came from and what could possibly be wrong with your back.  You may even be afraid you have a herniated disc, and frankly, it isn’t out of the question.

What is a herniated disc?  First, let’s explain what a disc actually is.

Your spine is made of 33 individual bony vertebral segments.  Between each segment is a cushion that has a somewhat firm outer covering surrounding a soft gel type of substance, sort of like a jelly filled donut from your favorite bake shop.  Because these cushions of gel are somewhat delicate, they can rip or rupture, allowing some of the gel to be forced through the tear.  This can result in the disc itself beginning to slip from between the vertebrae in a condition called a herniated, ruptured or slipped disc.  Without these discs, you can not bend your spine but if the discs themselves are a problem, nerves can be irritated.  A person who has a slipped disc will often feel weakness, numbness or pain in an extremity, but occasionally the injury isn’t apparent and no symptoms will show at all.

The good news is that, most of the time, a herniated disc will not require surgery to repair.

Causes of Disc Herniation

Many times, disc herniation is not the result of a single, easily identified incident.  It is usually more of a gradual wear and tear on the discs, a process called disc degeneration.  Disc Degeneration is quite common as you get older.  With age comes a decrease in the water inside the discs, which makes them far less flexible and much more brittle.  These changes mean that your discs will be easier to tear or rupture with very little strain or stress, sometimes even just by twisting.

Injury can happen by improper lifting techniques, such as lifting with the back instead of the legs when picking up heavy, awkward objects.  Turning or twisting the wrong way is also a cause of disc herniation, especially when combined with improper lifting.

It is far less likely, though not impossible, that disc herniation can be traced to a single event like an accident, direct hit on the spine, or a fall.

Signs and Symptoms of a Herniated Disc

While most disc herniations will occur in the lumbar spine, or lower back, they can also happen higher up on the neck, along the cervical spine.

Obvious signs of disc herniation will include pain that isn’t always at the origin of the injured disc.  In fact, depending on where the herniated disc is, you may feel the worst of the pain along your thigh, calf, buttocks and even the foot, common spots for pain when the herniation is in the lower back.  For a herniated disc in the neck, the pain may be focused along the arm or shoulder, and the simple act of sneezing, coughing or just moving can cause the pain in your extremities.

People with herniated discs will frequently come to the doctor with complaints of weakness in the muscles.  This happens because of damage to the nerves servicing the muscles, and may cause falls, stumbles, and even disability.  It may be difficult for you to hold objects, or to lift them.

Numbness and tingling are commonly reported by people who are suffering a herniated disc.  The pins and needles sensations are most common in the areas serviced by the irritated nerves.

Some people have disc herniation without any symptoms at all.  In these cases, the discovery of the herniation is usually almost an accident, only noted when an image is taken for other reasons.

Seeing a Doctor for your Herniated Disc

Anytime you have a pain in your back or neck that radiates to an extremity, you should consult a doctor.  Likewise, make an appointment if the pain also has weakness, tingling or numbness associated with it.

Your doctor has many ways to diagnose a herniated disc.  The first thing he will do, obviously, is to examine you and see if he can pinpoint your pain.  His findings may be enough to support the diagnosis of a herniated disc, but many times, your doctor may want to go a step further to find out exactly what nerves are affected and to rule out any other causes for your discomfort.

Common tests your doctor may order to help him conclude you have a disc herniation may include:

CT Scan:

A CAT scan is a very thorough X Ray that takes multiple pictures at once, then puts them together to help your doctor visualize the spinal cord and surrounding vertebrae.

Standard X-Ray:

An X-ray is the doctor’s first line of diagnosis.  While it can’t show the disc itself, it can help your provider rule out other causes of your pain, like a tumor or a fracture.

MRI:

The MRI is a very advanced test that uses a magnetic field, radio waves, and a specialized computer to show your spine in full 3-D view for the doctor to get a very detailed look at your spine.  MRIs can show your doctor the exact location of your disc herniation as well as showing him which nerves are affected by the condition.

Myelogram:

A myelogram is a dye enhanced X Ray.  With the injection of a dye directly into your spinal fluid, the soft tissues and any injuries will be very apparent.

EMG/NCS:

These tests are run together.  The first, the Electromyogram, is used to trace the electricity that your muscles use when they expand or contract.  An electrode is placed directly into the musculature itself and tracks all electrical activity within it.

The Nerve Conduction Study will trace the amount of time it takes a nerve impulse to travel from one point to another in your body.  This involves using electrical impulses to stimulate nerves in one area while another area is monitored for reactions to the impulses.  If there is a significant lapse in time from the moment the impulse is introduced to the moment it is recognized by the other electrode, the doctor will know there may be other complications to your herniated disc, such as damage to the surrounding nerves.

Your Chiropractor and Your Herniated Disc

Your chiropractor is uniquely qualified to help you safely and naturally manage your herniated disc.  He will devise a treatment plan to get you back on track quickly, without pain medications or surgery.  Your treatment plan may include gentle manipulation to free the compressed disc and the irritated nerves as well as other therapy options.  If you think your back pain may be from a herniated disc, it is better to seek treatment quickly before any lasting damage to nerves or other spinal structures can occur.

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