What is a Disc Herniation?
Chances are, if you have a disc herniation, you may not even know it. As much as 15% of the population in the United States has undiagnosed disc herniations that don’t produce any symptoms and produce very few problems. Now, if you are suffering through intense pain in your buttock, lower back and legs, you probably aren’t all that concerned about those who have symptom-free disc herniations.
Disc herniations, also referred to as slipped disks, prolapsed disks, disk bulges or ruptured disks, are most commonly found (approximately 90% of the time) in the lower back, or what is known as the lumbar spine. They affect men much more commonly then women and especially those between the ages of 30 and 70. A disk herniation may also occur in the neck (8% of disk herniations occur here) and is even less likely in the upper or mid back (only 1-2% of disc herniations).
Your disks are soft, gelatinous pads that are found between the bones of your spine (vertebrae) and are designed to cushion the spine and provide shock absorption. Your disks are made up of two parts; the outer ring or annulus is the stronger, firmer portion of the disk, while the central portion or nucleus pulposus is the softer, more gelatinous portion. The outer annulus is what connects the neighboring vertebrae to each other while the inner nucleus provides shock absorption for the spine.
A disk herniation occurs when the annulus becomes weak or torn and allows the nucleus to squeeze through it out into the area of the area of the spinal column where the spinal cord and nerve roots are found. If a nerve root becomes compressed or strained as a result of the disc herniation it will typically produce pain, numbness and weakness in the areas supplied by the nerve.
Disc Herniation Symptoms
Symptoms of a low back or lumbar disk herniation may include intense pain in the low back, buttocks, legs and/or feet with increased pain while coughing, sneezing, straining or laughing. Pain will typically also increase when you bend forward at the waist or lean side to side. You may also experience muscle spasm as well as numbness and tingling in the legs or feet. In later stages of disc herniation weakness may occur in the muscles of the legs and/or hips.
Neck disc herniation symptoms will typically include pain in the back and sides of your neck and shoulder/upper back area on the side of the disc herniation. Many times this pain will travel out to the shoulder and down to the upper arm and forearm. Infrequently you may experience pain in the hands or fingers.
Your pain will greatly increase when you cough, sneeze, strain or laugh and also when you bend your neck down or turn your head side to side. You may also experience muscle spasm in the neck and weakness in the arm muscles. A thoracic or mid back disc herniation will produce a variety of different symptoms or no symptoms at all.
Pain is the most common symptom with any disc herniation. In the case of thoracic disc herniations, pain can be present at the level of the herniation on one side of the back or the both, and many times you will feel a band of pain that goes around the torso to the front of the chest. Over time you may begin to feel pins and needles type sensations or even numbness.
Occasionally you may feel weakness in the muscles of the leg or arm. Extreme cases where the disc pushes into the spinal cord itself can produce problems with bowel and bladder function.
If the thoracic disc herniation is in the upper part of the thoracic spine, you can experience pain and other symptoms in one or both arms. Disc herniations affecting the middle part of the thoracic spine may imitate a heart problem due to pain radiating into the chest or the abdomen. Lower thoracic disc herniations may cause pain in the groin or inner thighs and may sometimes feel similar to kidney problems, with pain in the flank.
Disc Herniation Treatments
As with any health condition, it is important to evaluate all the different treatments available to determine which option is the best for you. In the case of disc herniation, several treatment options exist and all options have advantages and disadvantages.
Medical intervention typically involves utilizing medication that is meant to decrease swelling and mask pain, whether taken orally or injected into the area of the disc herniation. If this does not provide adequate pain relief within the desired length of time, surgery will usually be recommended to either remove the offending portion of the disc or to remove a portion of the vertebra to allow the nerve and disc more space.
The greatest advantage to medical intervention is generally quick relief of pain and symptoms. The disadvantages to this treatment option are that the problems which produced the disc herniation in the first place are not addressed and as a result many times these problems will either not resolve or will return later, and the fact that the risk of side effects are relatively high. Also, especially in the case of disc herniation surgery, you are significantly limited in pursuing other treatment methods once you have undergone surgery.
Physical therapy may be recommended to improve movement in the low back and assist in stretching and strengthening of the muscles in the lower back and pelvis. The advantage of physical therapy is in its ability to train you in proper care of your back and spine, encouraging you to develop habits that will not only provide you benefit in the short term, but also for years to come. Also, it carries with it few side effects and is can be utilized along with other treatment options without many problems. The disadvantage to physical therapy treatment is that by itself it may not be effective in getting to the root of the problem, so recovery may be slow or incomplete.
Acupuncture is an alternative treatment method that can help alleviate the pain associated with the herniated disc. The advantage to this treatment option is that acupuncture is quite safe. There are few if any side effects to treatment so you are not limited in pursuing other options if this method is ineffective. Acupuncture’s main disadvantage is that it may not effectively deal with the damage within the joint, allowing symptoms to persist or return.
Disc herniation may respond well to chiropractic care designed to restore alignment of the spine and alleviate pressure on the nervous system. The main advantage to this treatment method is that it is also quite safe and effective in providing not only short term but also long-term relief of disc herniation pain and symptoms. A chiropractor can also make stretching, strengthening and postural recommendations which can help improve your overall health. The disadvantage to this option is that it may take time for your symptoms to go away.
Nutritional therapy may be beneficial as well. Supplements which have been shown to strengthen and improve joint function, such as Glucosamine, Chondroitin Sulfate, MSM and GLA, to name a few, can help strengthen the outer portion of the disc. Over time this may help your body restore the herniated portion of the disc and keep the disc healthy if used regularly.
For reasons yet unknown, you may respond better to one or a combination of treatments then to others. It is important to set your expectations at a reasonable level. It will take time for your body to heal from any injury or health problem. In the case of disc herniations, regardless of what area of the spine is involved it may take several weeks to up to a couple of months to effectively resolve the problem.
It is wise to use the more conservative methods of treatment first, including chiropractic care, nutritional therapy, physical therapy and acupuncture. If these options don’t provide you the benefit that you are looking for in a reasonable time frame, you can still use more aggressive forms of treatment including medical intervention. When you go to aggressive forms of care first, many times you are no longer able to get benefit from less invasive measures, so your options become limited. It is never wise to put all of your eggs in one basket.