Herniated Disc and Back Pain

Herniated Disc and Back Pain

For 26 years Barton Chiropractic has consistently been one of the top chiropractic offices in Concord. We have helped hundreds of patients suffering from bulging disc and back pain. Our gentle chiropractic care is designed to get you out of pain and keep you out of pain as fast as possible and as gently as possible.
Chiropractic can have great sucsess in removing back pain if done correctly. We start with a thorough consultation then an examination utilizing chiropractic, orthopedic and neurological testing. If at that point we believe that your back pain or neck pain is caused by a chiropractic problem, we will take x-rays.

X-Rays
I realize that there are chiropractors that do not take x-rays. In believe that they are absolutely necessary. Last month we found two fractures and one case of cancer. Adjusting a spine with a fracture could have devastating results, and we would not have known without x-rays. Secondly, when vertebrea misalign, they do not just go “out.”  The first move toward the back of the spine then rotate right or left then they can wedge on the right or left side. In order correct this with the utmost accuracy you must know exactly how that vertebrea is misaligned. Without all the information, one can only hope for so so results. You get what you pay for.

Disc Herniation
Herniation describes an abnormality of the intervertebral disc that is also known as a "slipped disc," "ruptured disc," or "torn disc. This process occurs when the inner core (nucleus pulposus) of the intervertebral disc bulges out through the outer layer of ligaments that surround the disc (annulus fibrosis). This tear in the annulus fibrosis causes pain in the back at the point of herniation. If the protruding disc presses on a spinal nerve, the pain may spread to the area of the body that is served by that nerve. Between each vertebra in the spine are a pair of spinal nerves, which branch off from the spinal cord to a specific area in the body. Any part of the skin that can experience hot and cold, pain or touch refers that sensation to the brain through one of these nerves. In turn, pressure on a spinal nerve from a herniated disc will cause pain in the part of the body that is served by that nerve.

 

Four Degrees of Disc Herniation:
Nuclear Herniation, Disc Protrusion, Nuclear Extrusion, and Sequestered Nucleus

Most disc ruptures will occur when a person is in their thirties or forties when the nucleus pulposus is still a gelatin-like substance. Oddly enough, most disc herniations will occur in the morning. The causes of this phenomenon are not entirely known, but are probably due to the physiology of the spine and the changes in the water content of the disc that occur throughout the day. The two most common locations for a herniated disc in the lower back are at the disc between fourth and fifth lumbar vertebra (L4-5) and at disc between the fifth lumbar vertebra and the first sacral vertebra (L5-S1). These two discs account for 98 percent of all painful disc herniations. A herniated disc can occur elsewhere along the spine, but low lumbar herniations are by far the most common.

Symptoms
Usually a patient's main complaint is a sharp, cutting pain. In some cases there may be a previous history of episodes of localized low back pain, which is present in the back and continues down the leg that is served by the affected nerve. This pain is usually described as a deep and sharp pain, which gets worse as it moves down the affected leg. The onset of pain with a herniated disc may occur out of the blue or it may be announced by a tearing or snapping sensation in the spine that is thought to be the result of a sudden tear of part of the annulus fibrosis.

Diagnosis
A patient with a herniated disc will usually complain of low back pain that may or may not radiate into different parts of the body. They will often demonstrate a limitation in range of motion when asked to bend forward or lean backwards, and they may lean to one side as they try to bend forward. Patients will sometimes walk with an "antalgic" or painful gait, flexing the affected leg so as not to put too much weight on the side of the body that hurts. Straight leg raising may be positive indicating tension on the nerve root.
Abnormalities in the strength and sensation of particular parts of the body that are found with a neurological examination performed by a chiropractic doctor provide the most objective evidence of nerve root compression. There are no laboratory tests that can detect the presence or absence of a herniated disc, but they may be helpful in the diagnosis of unusual causes of nerve root pain and irritation. An MRI is the test of choice for diagnosis of a herniated disc, but a CT scan (CAT scan) may often be helpful because it provides better visualization of the bony anatomy of the spinal column, indicating where the source of pressure on the nerve root is located.

Treatment
The treatment for vast majority of patients with a herniated disc rarely requires surgery. Eighty percent of patients will respond to conservative Chiropractic care. The primary elements of conservative treatment are Specific Chiropractic adjustments and controlled physical activity. Usually treatment will begin with very short period of bed rest followed by a gradual return to normal activities. Sitting is bad for this condition because the sitting posture puts a large amount of stress and pressure on the lumbar spine, which may increase the pressure on the affected nerve root.