Disc Herniation

Herniated-Disc

Herniated Disc

The intervertebral discs are located between each vertebrae in the spinal column. Of the vertebrae, there are 7 cervical (neck), 12 thoracic (mid-back) and 5 lumbar (low back) discs. The discs make up approximately 1/3 of the spinal column. They have three main functions: (1) “Absorb shock” from everyday wear and tear. (2) Allow movement of our spinal column. (3) Separate the vertebrae.

The intervertebral disc is actually a type of cartilaginous joint. Discs consist of an outer layer, annulus fibrosis, and an inner nucleus pulposus, which is a soft, jelly-like, substance. The disc is made up of proteins called collagen and proteoglycans that attract water. Normally, discs compress when pressure is put on them and decompress when the pressure is relieved. These discs do not have a blood supply; therefore, they exchange nutrients by a process called “imbibition”. Imagine a sponge filled with water; when that sponge is compressed, the water is forced out of the sponge. When the compressive force is removed, the water is “sucked” back into the sponge. This is precisely how discs stay healthy and functional. Diseased discs can lead to degenerative disc disease that can then lead to: arthritis, herniated discs, bulging discs, facet syndromes, sciatica and spinal stenosis.

A herniation describes an abnormal condition of an intervertebral disc. Some refer to this condition as a “slipped”, “ruptured”, or “blown” disc. Most of the time it is not known what caused the disc to herniate, but it is thought to occur from repetitive stress due to occupation, poor spinal posture, and/or natural processes of aging and/or trauma.

A herniation begins when the inner nucleus pulposus bulges through the annulus fibrosis, causing a bulging or protruding disc. This bulge may push on a spinal nerve. This interferes with the natural blood supply to the nerve roots and sets up a condition known as intraneural edema. Basically, the nerve root microcirculation is compressed and can progress to the point where the nucleus begins to leak out of the disc. At this point the body begins to fight back by launching an autoimmune response to the disc material (nucleus pulposus). The reaction of this defense mechanism causes severe inflammation and progressive deterioration of the nerve root. If the herniation is located in the cervical spine (neck), the symptoms can range from neck pain, with or without arm pain, to numbness and tingling. Muscle weakness can be common as well. If the herniated disc is located in the lumbar spine (low back), the symptoms can range from low back pain, with or without leg pain, to numbness and tingling. Muscle weakness is also common. This type of pain and/or numbness in the legs or arms is referred to as a “radiculopathy”. This happens because the nerves that exit your spinal cord innervate (“attach to”) the skin in your arms and legs. They are responsible for sensation and for movement of the muscles in your arms and legs. They are also responsible for the reflexive movements as well. This is the reason some individuals with these conditions experience extremity (leg/arm) pain / numbness / tingling and/or weakness when they have a herniated or bulging disc. Be aware that, some individuals with herniated discs may report arm or leg pain only, with minimal neck or low back pain.

Diagnosis

Diagnosis of a herniated disc (either neck or low back) can be made from a thorough physical examination including a detailed history, orthopedic and/or neurological evaluation.

Some disc patients will present with an antalgic gait (lean away from the side of the disc lesion), extremity pain/numbness/tingling (abnormal sensation) in addition to neck or low back pain. Muscle weakness may be present in the more chronic cases as well as areflexia (“loss of reflex”). X-rays can be helpful in identifying degenerative changes of the vertebra, but MRI’s are the “gold standard” to identify the exact nature of the lesion. When the disc is herniated in the lumbar spine (low back), and it is compressing the spinal nerve roots causing pain and numbness down the buttocks, thigh and leg, it is often referred to as sciatica.

Treatment

Non-Surgical Spinal Decompression offers to treat the root cause of the diseased or pathological disc based on the anatomical and physiological principles of Non-Surgical Spinal Decompression.

Non-Surgical Spinal Decompression relieves pressure from the disc, which, in turn, relieves pressure from the nerve. Research has shown that Non-Surgical Spinal Decompression can create a negative pressure within the disc causing a “vacuum effect”. This vacuum effect can “suck” the disc material back inside, thus relieving the pressure from the nerve.

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