The most common reason to visit a Chiropractor is a problem with the spine and the most common reason for spinal pain is related to problems with the disc. I would like to take some time to explain the basics about these intervertebral discs. Please keep in mind that this information has been simplified to make it easier to understand.
The disc is basically a shock absorber. It is very much like one of those gel inserts you put in your shoe. The outside is a rubbery material and the inside is a gelatinous liquid. The design provides for mobility and reduction of stress on the joints. Let’s take a look.
There is a disc between each vertebral bone in the spine. The disc connects to the spine at the endplate. The outside of the disc is made up of layers of tough material called annulus fibrosus. The Inside of the disc consists of a gel called the nucleus pulposus.
If enough stress occurs to the disc, it can start to cause damage. The first thing that happens is usually a tear in the annulus fibrosus (the fibrous rings that hold the nucleus in place). There are several patterns of disc tears. Tears can occur through the annulus or between the fibers of the annulus.
If the tear is bad enough, the nucleus can begin to migrate from the center position into the tear which causes an abnormal shape of the disc. This abnormal shape interferes with the movement of the spine. You may notice painful restricted motion. You may notice spasm or a shifting or leaning of your spine.
When the shape of the disc is distorted in this way but the nucleus has not yet migrated outside of the confines of the disc we call it a Disc Bulge.
This Problem can continue to worsen to the point where the nucleus travels further outside of the layers of the annulus fibers. At this point we call the abnormality a herniation.
There are a variety of other terms used to describe differing shapes and phenomenon that can occur with herniations including: protrusions, prolapses, and sequestrations, but we won’t get into those here.
So, the take home point is that damage to the disc over time will create these disc bulges and herniations that result in a change in shape and position of the disc. This in and of itself is painful enough, but there is an even more significant problem that can occur. It can lead to pinching of the nerves in the spine!
The spinal cord goes from the brain down through the center of the vertebra and exits the spine in fibers called spinal nerves or nerve roots. Those spinal nerves travel to different parts of the body to control sensation, muscle function, and some other things. This system allows your brain to communicate with your body. For example, the nerves that control your legs come from the brain. The nerve begins in the brain, travels down your spine, exits out of your low back, then goes to your legs. If a disc herniation is compressing one or more of these nerves it interferes with the signal. This can create pain, numbness/tingling, and even spasm or weakness in your legs.
There are two basic types of herniations that can put pressure on the nerves. The herniation can poke out to the side contacting the nerve root AKA spinal nerve, or it can herniate centrally putting pressure on the cord (shown left).
Pressure on the cord is by far the worst scenario. This can even be life threatening if it occurs in the right place. It could also cause paralysis, loss of bowl or bladder control, and a variety of other terrible issues. This is a surgical emergency. Thankfully, this is not the most common form.
The more common thing to happen is for the spinal nerve to be affected from a herniation that goes out to the side. This can happen in the neck causing pain to shoot out into the shoulder, arms, or hands along with weakness and numbness or spasm of the muscles. It can happen in the low back as well causing the same sort of thing to happen in the legs. This is actually the cause of most cases of sciatica.
As the process of disc injury continues, the disc begins to whither and desiccate causing loss of disc space. This creates another situation that we call degenerative disc disease. This can also lead to narrowing of the space that the nerve needs to exit the spine. If this space is narrowed to the point that it compresses the nerve, we call this stenosis, and it can cause the same sort of nerve problems that a herniation can create.
So, what can a Chiropractor do to help you with your disc issue?
A Chiropractor’s job first and foremost is to identify which type of disc issue is occurring, then correct the position of your spine. This will take the stress off of the disc and stop the process of the disc herniation from continuing. Once the position is corrected, the disc can have a chance to heal especially with the right nutrition.
A Chiropractor will usually use manipulation to correct the position and movement in your spine. This typically brings a lot of relief. I like to use electro-muscle stimulation to calm down the muscles and reduce pain either locally or down the affected limb. Additionally, traction or decompression can be used to take the pressure off of the disc and centralize the nucleus to reduce the herniation. Once the pain is under control, I use progressive rehab techniques to train the muscles of the body to hold the spine in the correct position. This step is important to stabilize the joint so the problem doesn’t just come back the next time you bend over to pick up a pencil.
If you think that you might have a disc problem, please give us a call today at 918-600-2969. Don’t wait for it to get worse. By that time, you may be looking at surgery.