Herniated Disks
 A friend once said, "I thought people who complained of chronic back pain were babies, until I injured my back. Now I understand."
Herniated disks are common causes of low back pain. They can cause dull aching pain or severe sharp stabbing pain with muscle weakness and loss of feeling. The pain will often radiate from the back down the leg. The severity of symptoms and the time it takes to heal varies depending on the extent of the herniation.
If our spines were one solid piece of bone we would be stiff and unable to move. Our spines were built with multiple moveable pieces to allow us to bend, twist and rotate. The hard spinal bones, or vertebrae, are separated by disks. The disks have a tough outer covering and a fluid filled inside. The disks serve as shock absorbers between the spinal bones and safely allow the bones to move.
Disks can be thought of as jelly doughnuts. If they become injured or torn, the jelly can be squished out toward the spinal nerves. The "jelly" release will cause inflammation and put pressure on the nerves resulting in pain, muscle weakness, or change of sensation. More severe injuries will cause more "jelly" to be pushed toward the nerve, creating more inflammation and problems.
What are some causes of herniated disks?
 Disk problems are associated with age-related degeneration, or years of wear and tear on the disks. Years of repetitive stress cause small tears on the outside of the disk. Combined with age-related water loss in the disk, repetitive stress causes the disks to become less flexible and more prone to damage. Eventually, a small movement or twist will cause the disk to rupture the "jelly" toward the nerve. The "jelly" will cause inflammation to form and will create pressure around the nerves, and this will result in radiating pain, loss of sensation, decreased muscle strength or decreased reflexes associated with disk problems.
What are the risk factors of herniated disks?
 Disks injuries are a factor of time, force and repetition. Herniated disks are more prone in occupations that involve repetitive lifting, bending, twisting, pushing or pulling. Jobs that are physically demanding obviously place more stress on the disks and lead to greater injuries. Additionally, jobs that involve extended periods of standing or sitting also have greater rates of disk injuries. Sitting actually places more stress on the disks than standing, and sitting for extend periods of time can be just as damaging to the back as lifting activities can be.
Other factors that increase disk injuries are associated with forces placed on disks or factors that affect the disk's health. Extra body weight places more stress on the disks and older disks are less pliable than younger ones. Previous injuries create weakened spots in the disks and increase likelihood of further injury. Smoking and diabetes affect the health of the disks by limiting oxygen and nutrients to the disks.
How are disk injuries diagnosed?
 Disks injuries are different from other low back injuries because of the "jelly" affecting the nerve root. Treatment of the injuries will therefore be different than a simple muscle sprain, so it is important to correctly identify disk injuries.
Disk injuries can be identified through a physical exam, whereby certain tests will identify the type and severity of symptoms. If pain is radiating down the leg, the doctor will probably test muscle strength, reflexes and sensation, as these factors can be affected by disk herniations. Additionally, MRI and X-Ray may be utilized for further information and may also be used to rule out other causes of low back pain.
Are there complications of disk herniations?
Since the symptoms associated with herniated disks are caused by increased pressure around a nerve root, additional pressure can cause severe damage to the nerve. In extreme cases, the pressure can cause equine syndrome whereby the extensive pressure increase will cause loss of bowel or bladder control, significant and increasing pain, and a loss of sensation in the inner thigh and back of legs. This is an emergency medical situation that requires surgery.
How are herniated disks treated?
Most disk herniations can be treated through conservative methods that involve reducing stress to the disk, relieving muscle spasms, and increasing joint motion. Light exercises and stretches prescribed by your healthcare provider will speed recovery and prevent future problems.
Chiropractic therapy will improve the joint motion, will relax the muscles, and will reduce pressure on the disk. Distraction therapy, which involves directly taking pressure off the disk and reducing pressure on the nerve root, can also be employed. These techniques can be safely performed by a licensed professional and will quickly reduce the pain and discomfort. Most people will feel some immediate relief after therapy.
Modification of activity and identifying activities that increase stress to the disk is very important, and this will be addressed by your healthcare professional. Disk injuries commonly take several months to completely heal, so it is important to recognize and reduce risk factors and activities that will cause the injury to reoccur.
Long term goals of therapy are to properly strengthen the core musculature to prevent future injuries to the disks. Establishing better core muscle control will reduce future stress to the disk and spine, thereby reducing future injuries. Research has shown tremendous improvement in strengthening the core muscles and reducing back pain, particularly in patients with chronic low back pain.
Medications are often combined with treatment to reduce inflammation and muscle spasm and to decrease pain. Surgery is performed in cases that fail to improve with proper conservative treatment.
How do I prevent disk injuries?
Several factors will help prevent disk injuries which include proper exercises, maintaining a proper body weight, and improving posture. Poor posture places bad stress on the disk, especially with extended periods of sitting or improper lifting.
Low back injuries are often associated with poor control of the core musculature which leads to re-injury. Specific exercises will improve this performance and improve quality of life. People who properly retrain the core musculature will see a decrease in future occurrences and reduction in low back pain.
See Chiropractic Services (exercise ball) for more information on core strengthening exercises. As every individual has different levels of strength and injury, it is important to seek professional help when trying to rehabilitate core strength after low back injuries. Many people make the mistake of starting exercise programs that are too intense, and eventually lead to injuries instead of preventing them. Call Alpha Chiropractic today to begin your proper disk injury rehabilitation program at (480) 812-1800.
Back to Chiropractic Resources
 Dr. Carson Robertson is in private practice at
Alpha Chiropractic. His clinic services the
chiropractic, massage therapy, and physiotherapy
needs of the Chandler, Ahwatukee, and Gilbert area.
He has a special interest in athletics, running, and
soft tissue injuries. Carson Robertson DC can be
reached at (480) 812-1800. |
|
