It’s a gorgeous sunny day, you’re sitting in the car, top-down, minding your business and listening to Justin Bieber whine about the trials and tribulations of being a young, studly, handsome, world-famous millionaire, when you hear some screeching tires and...BOOM! You just got rear-ended, now your neck and back are on fire and your hand feels numb.
You’re doing chores around the house, and as you bend over to pick something...BOOM, you hear a popping sound and are brought to your knees by razor-like back pain.
Sound familiar? If so, you may have just sustained suffered a disc injury. While many of us have had disc injuries, there is much confusion about what they are, how to treat them, or how to prevent them from happening in the first place. In this blog, we will discuss what they are, how they happen, what the different treatment options are, and how to prevent them from happening.
First, a quick crash course in human anatomy and a description of what a disc is. The disc is a spongy cushion that separates the vertebrae. They act as shock absorbers, allow the spine to pivot and move, and also act as “spacers” between the discs. There’s an outer portion called the annulus, and a fluid-filled, jelly-like inner portion called the nucleus pulposus.
So what exactly is a disc herniation? A herniation, sometimes referred to as a “disc bulge”, “disc protrusion”, “blown disc”, or “slipped disc”, is an injury in which the soft center of a spinal disc (the nucleus) pushes through a fissure or “crack” in the outer lining. Two examples to describe them are a “flat tire”, or also a jelly-filled donut that you squish and the “jelly” seeps out. That “jelly” is like battery acid to the nerve, which is why people with herniated discs often times have “burning”, sharp-shooting pain, numbness, and weakness into the arms and hands, if it’s a neck herniation, or into the legs and feet if it’s a low back herniation.
How do they happen? The short answer is trauma. Disc injuries are a result of trauma, in some cases “macro trauma” (massive forces, short time) such as a car accident, a slip and fall, or a sports injury, and in other cases “microtrauma” (low forces, long time), resulting from prolonged sitting, repetitive stress, or postural imbalances.
What are my treatment options? The answer to this depends on several factors:
- size of the disc herniation
- “internal architecture” of your spine
- personal preferences
You are oftentimes presented with a multitude of options, from non-invasive, conservative approaches to more invasive methods such as epidural steroid injections or even surgery. The larger and more severe the injury, the more aggressive the treatment recommendations will be.
First, let’s explore conservative approaches. In some cases, the pain from a disc injury can resolve on its own. Rest and a “wait-and-see” approach can help some people, but more often than not, a menu of options that may include a combination of chiropractic, physical therapy, ice and heat, cold laser therapy, and corrective exercises can provide not only pain relief, but a diminishing risk from further injuries, by improving structure and function, and by protecting and rebuilding the muscles that also act as shock absorbers to the spine.
Chiropractic: can diminish pain and improve function by improving alignment and mobility of the spine and surrounding joints. Can also minimize further disc damage by restoring symmetrical weight distribution from left to right.
Physical Therapy / Corrective Exercises: can improve muscle function by restoring flexibility to tight muscles, increasing strength to weak muscles, and restoring normal muscle firing patterns. If muscles are weak, tight, and not firing properly, the impact and trauma experienced will directly affect the disc, without the first line of defense that the muscles can oftentimes provide if they are functioning properly. Think of well-functioning muscles as “shock absorbers” that can help minimize trauma on the joints.
Ice/Heat: Ice can have an analgesic and anti-inflammatory effect, while heat can reduce stiffness while increasing blood flow to the area.
Cold Laser Therapy: uses the healing properties of light to help diminish pain and inflammation while stimulating healing. It does this by stimulating ATP production within the mitochondria (aka the “powerhouse”) within each cell. It’s painless, safe, and has virtually zero side effects, and can reduce the need for pharmaceuticals.
Aggressive approaches may involve ESIs (epidural steroid injections), and in some cases, different types of surgeries that can go from a microdiscectomy, in which they remove just a small portion of the damaged disc, all the way to full disc removal and replacement, in many cases accompanied by fusion of the vertebrae. While surgical techniques have come a long way over the last several years, the goal should be to exhaust all conservative approaches before taking on the cost/risk of major surgery.
If you are looking for options to deal with your disc injuries, or have any questions, call us at 714 540 6792 for a free virtual or in-person consultation, which is simply a conversation with our doctors to see if we can help!