Lumbar Disc Bulge and Herniation

Symptoms by body part:

Lumbar Spine (Lower-Middle-Back): Acute Pain

Lumbar Paraspinal (Lower-Side-Back): Dermatomal changes (numbness, tingling or pain along a traceable line); Spasticity

Disc injuries are a common, yet painful occurrence. Patients often complain of shooting pain, numbness/tingling and extreme localized discomfort in the lower back and buttock regions. Many people are driven toward conventional treatments like drugs or surgery to alleviate their pain, but there are other options. Conservative care through Chiropractic Neurology is a great option for many patients that wish to avoid surgery. If that fails, surgery is then warranted.

Chiropractic Neurology care allows us to properly diagnose the cause of your pain and alleviate it, using advanced diagnosis and treatment methods. We are able to rehabilitate the disc injury directly without masking symptoms or causing additional issues, as is a possible complication with surgery. Many surgeons will recommend conservative care before considering surgery, which allows for better results on both ends. However, many situations occur where surgery is appropriate and an excellent method of treatment. For this reason, we always work with your primary care physician, orthopedic and neurosurgeons to provide you the best possible outcome.

The question arises, when is it appropriate? A conservative approach is often recommended as long as you can tolerate your present state of pain. Mayo clinic states that, "Most people who have a herniated disk don't need surgery to correct the problem." Our care is not painful, and patients often notice a dramatic difference within a relatively short period of time. Pharmaceuticals are an excellent short-term option to deal with the inflammation involved with muscle tension and pain during this phase of conservative care.

Common Symptoms

Sciatic Pain (pain down the leg)
Pain in the buttock region
Lower back pain
Tingling/Numbness or weakness in a leg or both legs
Increased pain during sitting
Increased pain going from a sit to stand position
Increased pain when standing for prolonged periods of time
Increased pain in the morning
Pain when sneezing or coughing

How does a disc herniation or bulge occur?

First, it is important to understand the physiology of a disc herniation. A disc can herniate if a tremendous amount of compression, or rotational pressure occurs, literally tearing the outer fibers of the disc, the annulus fibrosus, and allowing the nucleus pulposus, or inner contents, to herniate, or protrude. However, this acute, traumatic injury is less common as discs are incredibly resilient structures. It is more common for a disc herniation to be preceeded by a chronic rotational or linear restriction of the spinal segments. This causes a bulge to form slowly over time, due to the multiple microtraumas that occur causing a weakening of the outer fibers, eventually leading to complete tearing of the disc. This doesn't always happen, and can often maintain itself as a only a slight bulge, often creating pain and discomfort as well. Think of an ice cream sandwich, squeeze down on one side of it and watch as the other side bulges out. The cookie parts are the restricted vertebrae of your spine and the ice cream part is the disc that bulges or may herniate.

How does it heal?

In order for a herniation or bulge to heal, we need to improve disc motion. The inner contents of the disc do not receive blood supply in the same way as other parts of the body do, so it must get its nutrients through diffusion, or motion, as in a vacuum effect, known as imbibition. Through motion, the disc is able to imbibe, or drink in nutrients from the blood vessels, which are located in the outer ring of the disc, by creating a pressurized pumping action. However, as stated earlier, if the vertebrae are restricted, or not moving, the disc is not able acquire nutrients and cannot heal appropriately. A disc herniation is similar to a cut in your skin. It is a fissure that has occurred, leaking contents. The major difference is in how they heal. The cut in your skin has blood flow to carry nutrients, but the disc must have motion to imbibe its healing contents.

What will Chiropractic and Functional Neurology accomplish?

After diagnosing the disc herniation in question, usually through MRI, neurological and physical examination, we can then determine where the affected areas are located. The process initially starts mildly, and is intended to regain motion into the spine and disc. Specialized adjustments that do not create rotation are applied to reduce restrictions in the vertebrae. This allows the disc to begin the motion process. An advanced lumbar spinal decompression machine is used to create the vacuum effect described earlier, providing motion and nutrients into the disc, reducing compression forces of the vertebrae and allowing normal disc function.Muscular and Neurological retraining are achieved through therapies such as Electrical Muscle Stimulation, Chiropractic adjustments, Proprioceptive Neuro-facilitative stretching, cross-cord inhibition and Low Level Laser Therapy. After the patient has shown improvement, strengthening and neurological retraining will be emphasized to reconnect the peripheral and central nervous system control over the tissues in that region.