Herniated & Bulging Discs
The herniated & bulging disc is probably one of the trickiest conditions that we treat, but we treat a lot of them. If you have been diagnosed with one of these conditions, the least invasive course of treatment is the best option. Two of the least invasive types of treatments are chiropractic and physical therapy. Both treatments have their positives in treating disc issues and it’s a shame that the two disciplines can’t seem to work together. I think patients would see faster results under the care of both disciplines.
Anatomy of a Disc Bulge or Herniation
A vertebral disc is basically a cushion between two spinal vertebrae. There is a softer central nucleus that provides some softer structure for the vertebra to move around on. Outside of that is a tense series of concentric collagen fibers and fibrocartilage that keep the nucleus contained and under tension. Because of this system, the nucleus becomes a fulcrum that the vertebra above can tip and move on. The fibers of the anulus, while tough, can be stressed and weakened by repetitive movements. They can become weak and tear if over stressed, allowing the nucleus to bulge outward. A herniation of the disc is there the annular fibers tear through and nucleus material escapes to the outside of the disc. A sequestered herniation is there the nucleus material escapes to the outside of the disc and separates from the disc.
Causes of Tears
Discs bulge and herniate as a result of repetitive stress. Aging plays a significant role as collagen fibers lose elasticity and become more brittle. The most common repetitive stress causing these problems is the process of bending forward, lifting a weight (compressing the disc), and forcefully twisting. Think of shoveling snow or unloading a palate of concrete blocks. This is simplified but a good illustration of how the disc can get damaged.
What can Chiropractic Do?
Chiropractic can work with a disc bulge and even a mild herniation to relieve the stress on the disc from joint fixation. When the joint is allowed to move properly, it receives more nutrients through blood flow and diffusion to help the disc repair itself. With the stress off the joint, the nuclear material can be pulled back in during the repair process. Then the annular fibers can repair the outer part of the disc with scar tissue.
The sequestered herniation is always a surgical case. Some bulging discs can be a surgical case also if the nerve pain is too great and the patient can’t wait for it to repair itself.
Please note that a bulge can happen in any direction around the ring of the disc. If the bulge is forward or lateral to the spine, there is very little nervous tissue to get in the way. The pain problems occur when the disc bulges backwards or back and to the side. These locations are where the spinal cord and nerve roots reside and when the bulge pushes on these structures, it can be severely painful.
Bulging and herniated discs have treatment challenges for any practitioner in healthcare. Doctors spend their entire careers treating just this one condition and see something new almost every day. Anyone who has had a disc issue will tell you it’s not a quick fix type of process. There are usually weeks to months of healing time and you should expect some down time for healing. Please consider the less invasive approach of chiropractic care as your first stop in the care of this condition. We can always transition to a more aggressive approach, but rarely can we go the other direction.