What is the spinal disc?
The disc is the small cushion between the spinal bones (vertebra). It is made of 2 parts, an outer & inner layer. The outer layer is a firm, rubber band like, fibro-elastic ring called the anulus fibrosus. The thick gelatinous inner layer is the nucleus pulposus.
The disc acts as a shock absorber for the spine. It constantly combats the gravitational and compressive forces that are required by daily activity.
What is a disc herniation?
As we age, the disc tissue undergoes regressive changes. The water content of the disc decreases and the disc begins to thin. Furthermore, the strength & elasticity of the outer sheath of the disc declines providing less effective containment of the inner gel substance. As a result, the nucleus pulposus may protrude through weak spots or breaks in the fibrous ring.
If the nucleus protrudes through the outer layer it is termed a disc herniation. Most herniated discs occur in the low back because they undergo the most compression & bear the most weight. Disc herniations, however, may also occur in the neck and mid-back.
The herniated material can compress the nearby nerve root, which may result in radiating symptoms in either the arms or the legs. Common manifestations of such nerve involvement include shooting pain, burning, tingling, numbness, and weakness. Inflammation occurs in response to the herniated disc and can further contribute to the nerve pressure and radiating symptoms.
Disc herniation causes:
The most common predisposing factors influencing disc herniations include age, sex, occupation, lifestyle, and history of past back injuries. According to the Mayo Clinic, middle age men between 35 – 45 y/o are the most at risk for this type of injury. Occupation is also a contributing factor to injury, especially, if the job entails prolonged sitting or physically demanding tasks such as repetitive lifting, pulling, pushing, bending, and twisting.
Lifestyle issues can increase the risk for disc herniation injuries as well. Excess body weight amplifies the stress and pressure on the discs in the lower back, and not exercising diminishes the muscular support needed for core stabilization. Smoking reduces the ability of the spinal disc to absorb necessary nutrients & thus contributes to degenerative processes that make the disc vulnerable to injury and herniation.
Weakening in the outer layer of the disc naturally occurs over time with age. However, a sudden increase in a compressing force may also damage the disc for example during a vehicle accident, slip & fall, and sports or work injury. Any significant force that extends beyond what the disc can withstand may lead to a portion of the disc to bulge.
Diagnosis & Treatment
Regardless of the mechanism of injury, conservative care is recommended most of the time for a trial period before surgery is ever considered. MRI is used to confirm the location of the herniated disc and to view which nerves are affected. A thorough neurological and orthopedic exam will also help to reveal the problem area. Chiropractic care has been shown to successfully decrease the pain following a disc herniation. Zindt Chiropractic Center doctors utilize a gentle, non-invasive, and manual decompressive traction treatment to assist in the healing process following intervertebral disc injuries.
Disc injuries can be extremely painful and scary but they do not have to be a permanent problem. Receiving a proper diagnosis and treatment in a timely manner may make a difference in the healing process.