Spinal Disc Problems
Eighty percent of people experience back pain, and at any one point
in time, approximately 20% of the population has back pain. For many
decades, doctors and scientists believed that most back pain was caused
by "slipped" or "torn" discs. We now know this not to be true. Disc
problems constitute only a small portion of the causes of back pain and
rarely require surgery for pain relief.
What are spinal discs?
Spinal discs
are a critically important part of your spinal column. Along with the
vertebrae, also called the spinal bones, they perform many functions.
The discs provide shock absorption, protecting the spinal cord and
ensuring flexibility of the spine. They also perform other functions.
The spinal discs are essentially ligaments (structures connecting bones)
that attach to the top and bottom of each vertebra. They are thick,
ligament-like outer rings, also known as annuli fibrosis.
Because they are arranged in an alternating pattern with the
vertebrae, annuli fibrosis allow flexibility while preventing the
vertebrae from moving too much and causing injury. Inside a single
annulus fibrosis is a jelly-like substance called the nucleus pulposis.
It contains some proteins, but is primarily made up of water. The
nucleus provides more shock absorption than does the annulus, and it
also acts as a fulcrum to direct the type of
movement through which each vertebra travels.
What are the most common disc problems?
•
A disc "bulge" results from slight tears in the outermost fibers of an
annulus fibrosis. These small tears can be painful for a short time.
•
A disc protrusion/extrusion, also called "herniation," is a more
significant injury. It results from a complete or significant tear of
the fibers of an annulus-when some of the nucleus leaks through. A
herniation can also be painful and may even cause nerve compression. In
the most severe cases, the spinal cord can become compressed.
• The
most common disc problem suffered by adults is degenerative disc
disease. This occurs when the nucleus loses water and small tears
develop in it. The body then forms osteophytes (bone spurs), along the
edges of the vertebra and the disc space narrows. We used to believe
that this was a function of "wear and tear" as we aged. The most recent
evidence shows that, most often, there is a hereditary link to the
development of degenerative disc disease. Degenerative disc disease can
also be caused by trauma/injury.
What are the common signs and symptoms of disc problems?
Common signs of disc problems include, but are not limited to:
• Back or neck pain
• Leg or arm pain
• Stiffness
• Tenderness of the spine and spinal muscles
If you experience any of the following, seek immediate medical care for a spine problem:
• Loss of bowel or bladder control
• Inability to urinate and/or defecate
• Acute loss of feeling in both buttocks and/or both arms
• Inability to walk or use your arms (often from severe acute weakness)
• Fever along with your back pain
How are disc problems diagnosed?
Disc
problems are most often diagnosed with the use of a thorough history
and physical examination, including examination of your nervous and
musculoskeletal systems. Your doctor will most likely move your back and
arms and legs into various positions while applying pressure to your
joints. Plain film x-rays are helpful in only some forms of disc
problems. Magnetic resonance imaging (MRI) has become the mainstay for
the diagnosis of disc problems, as it images the discs quite nicely.
Your doctor may order an MRI if he or she feels it would be helpful in
diagnosing a disc problem and determining the proper course of care for
you. Most often, however, this is not necessary.
How are disc problems treated?
Luckily,
in most circumstances, disc problems are easily treated with
conservative interventions. Early in the course of an acute injury, your
doctor of chiropractic will very likely set a goal of pain control,
using several different physical modalities to reach it. Both ice and
heat have shown effectiveness in managing the pain of acute low-back
injury.Your doctor of chiropractic will help you determine which is most
effective for you.
In addition, getting you back on your feet and moving as quickly as is safely possible is critical. Typically, the less time you spend in bed, the better off you are in terms of long-term results. You'll also need to learn not to be afraid to move. If you "baby" your back, in most cases, the long-term results will be worse.
Chiropractic spinal manipulation has also been demonstrated to be a
safe and effective tool in the management of disc problems.
Manipulation is especiallyeffective when combined with therapeutic
exercise. In most circumstances, spine surgery and injections are not
necessary in the management of disc problems- and they often cause more
problems than they're worth. Your doctor of chiropractic will discuss
all available treatment options with you and help you decide on the best
course of action.
Can disc problems be prevented?
While
regular exercise will help strengthen your back, research has
demonstrated that staying fit and using proper body mechanics alone will
not prevent injury. The National Institute for Occupational Safety and
Health (NIOSH) recommends that individuals do not lift more than 50 lbs.
Further, activities that require awkward or prolonged postures and
repetitive acitivities place individuals at high risk for
musculoskeletal disorders and disc problems regardless of body mechanics
and fitness level. Your doctor of chiropractic can conduct an ergonomic
assessment of your work and home activities to help you prevent injury.