|
Herniated Disc /
Sciatica
written by, Dr. John
A. Harris
There
are 23 discs in the spine, starting between the 2nd and 3rd cervical
(neck) vertebrae and ending between the 5th lumbar vertebrae and the
sacrum (a pelvic bone). Herniated disc is one of the more serious
conditions we chiropractors routinely treat.
A herniated disc is
also known by several other names. Terms such as bulge, prolapsed,
protrusion, tear, rupture, and slipped all refer to various degrees
of the same thing. However, the term "slipped disc" should not be
used as the disc never slips out of place - it is firmly attached to
the vertebrae above and below it.
To understand
what happens when a disc herniates it is important to first know a
few things about its structure and function. Discs are small
cartilage pads between vertebrae and are structured similar to a
jelly donut. There is a tough, fibrous outside ring called the
annulus and a soft, gel-like center called the nucleus pulposus.
Discs make up approximately 25% of the spine's total length and
their function is to act as a connector, spacer, and shock absorber
for the spine. They have a poor blood supply and get their
nutrition and expel waste via the pumping action that occurs when
the spine is in motion. Therefore, someone with an active lifestyle
will have healthier discs than a "Couch Potato." Discs are considered
"soft tissue" and do NOT show up on an x-ray. Only an MRI or a CT
scan will show the disc. However, there are a number of orthopedic
and neurologic tests we can do right in our office that tells us if
your pain is due to an injured disc.
Herniation occurs
when the annulus tears or weakens. This allows fluid in the
disc to leak out, often onto the nearby nerve root. This fluid
is highly irritating to the nerve-causing local spinal pain and
radiating nerve pain down the arm (cervical radiculitis) or leg
(sciatica). This tear or weakness can also allow the gel-like
nucleus to bulge out and put pressure on the nerve. Symptoms of a
herniated disc include back or neck pain, spinal muscle spasms, a radiating numbness,
"tingling," or pain down the arm or leg, muscle weakness in the arm
or leg, and a dragging of the foot when walking. (A rare, extreme
situation is when someone may actually loose control of their bowel or
bladder function. This is known as cauda equina syndrome and
requires immediate surgery - as the disc is actually
compressing the spinal cord).
There are a
number of things that can be done to treat a herniated disc. Surgery
should always be the last resort (unless cauda equina syndrome)
after all other treatments have failed, as there is a high rate of
"failed back surgery" with herniated discs. Therapies like
ultrasound, shortwave diathermy, and interferential stimulation to
decrease painful muscle spasms and increase circulation to flush out
the disc fluid on the nerve help considerably. Traction, either
manual or mechanical, helps "pull" the bulge back off the nerve.
Finally, chiropractic adjustments restore normal motion to the spine
and reestablish the pumping action needed to provide nutrition and
waste removal to heal the disc. I have saved many patients from
having to get spinal surgery using these methods.
Chiropractic
adjustments can also help prevent disc injuries. Periodic,
maintenance adjustments keep the spine aligned, allowing proper
motion between the vertebrae keeping the discs healthy.
Health and Fitness Articles by John A.
Harris, D.C. |
