Herniated Disc

What is a Spinal Disc, and What Does it Do?

The vertebrae in the spine have discs that act as a cushion, or shock absorber, between the bones. These discs serve multiple purposes. They allow the spine to move while cushioning the spinal bones as the body twists and bends. They also provide the space between the vertebrae, known as the intervertebral foramen, for the nerves to exit the spine. These discs, which act as a ligament holding the vertebrae in place, contain a gel-like inner part known as the nucleus pulposus, surrounded by an outer more fibrous material known as the annulus fibrosus disci intervertebralis. When the disc starts to degenerate, herniate out, or bulge, it can put pressure on the nerves exiting the intervertebral foramen causing pain and other problems.

Causes of Disc Problems

Your body is meant to move, and the proper movement of the spinal bones (vertebrae) allows the discs to get nutrition and remain healthy. A misalignment in the spine or a lack of movement can lead to degenerative disc disease. Here are some of the causes of disc problems.

1. Trauma or traumatic injuries. Injuries from lifting, falls, accidents, sports, poor posture, and more can cause direct damage to the discs or weaken them causing disc problems.
2. Subluxations (misalignments) to the spine. When the spine is out of alignment, the vertebrae puts pressure on the discs and the nerves exiting the spine. A subluxation can cause the vertebrae to move incorrectly or to have restricted movement. Either can lead to disc damage or a lack of nutrients to the disc.
3. Inactivity or lack of movement. We have all heard the phrase, “use it or lose it.” This also applies to the health of your spinal discs. Long periods of inactivity or lack of movement in the spine can block the flow of nutrients to the disc. Over time this will lead to degeneration in the discs.When someone is inactive, typically they are sitting for long periods of time, the disc doesn’t stay healthy. This is because the disc stays healthy in response to motion and movement. As you move around and your discs are moving around, there is fluid coming in or imbibing in and out of the disc, and as a result, the disc gets nutrition and remains healthy.

   Sitting puts three times the amount of pressure on the disc as opposed to standing. If you sit for long periods at work, or just sit because you are not very active, the spinal discs start to go through a degenerative process.

4. Poor diet. Over time, poor diets will lead to increased inflammation in the body, which leads to degenerative changes in the spinal discs.

Symptoms of Disc Problems

The two most common areas of disc herniations are in the cervical spine (neck) and the lumbar spine (lower back). Disc herniations can cause pain and symptoms such as tingling, numbness, burning, or aching sensations that radiate down the arms and legs all the way to the fingers and toes.

• Lower Back Pain (lumbar spine) with radiation into the legs. There is a series of nerves that exits out from the lower back and runs down into the legs known as the lumbosacral plexus. These nerves exit out between the spinal bones and turn into one of two nerves, one is the sciatic nerve, which is the nerve that runs down the back of the leg to the feet, the other one is the femoral nerve, that goes into the front of the leg.
• Neck Pain (cervical spine) with radiation into the arms. There is a series of nerves that exits out from your neck, called the brachioplexus, and runs down your arms to your fingers. Disc problems in the neck can also cause symptoms such as frequent headaches, problems with sleep, and a weakened immune system. Cervical disc problems can also cause pain between the shoulder blades. Nerves in the cervical spine affect the rhomboid muscles. Since the rhomboid muscles start at the base of the neck and run down, attaching to the scapula (shoulder blade), disc problems in the neck can be a source of pain.

Diagnosing a Disc Problem

When patients come into our office we always do a full and thorough examination, which includes discussing your health history, current complaints, a full exam with orthopedic, neurological, physical exam tests, and thermograph nerve scans. We will take digital X-Rays in our office to view the spine and see if you have any disc degeneration, misalignments, or osteoarthritis that can be contributing to your condition. If we see the disc is getting smaller than it should be, this indicates that the disc is degenerating and most degenerative discs have a herniation or bulging associated with it.

Here are some of the common findings the exams can reveal:

1. Diminished deep tendon reflexes in the arms or legs. This could indicate that there is pressure on the nerves that exit out of the spine and shoot down into the arms and into the legs.
2. Decreased sensations. By checking sensations using a picky wheel, or pinprick, we can tell if a patient senses a decreased sharp sensation that means that the sensory nerves, that come out and shoot down into the arms and the legs, are being affected.
3. During orthopedic testing, we will put the spine in different positions, and if it re-creates the radiation of pain in the legs and arms this could suggest a disc problem going on.

The best way to see a herniated disc is with an MRI. An MRI allows us to see the disc and the water content of the disc, and whether the disc is bulging or herniating out, and to see if the disc is occluding (obstructing) the hole (intervertebral foramen) where the nerve comes out.

Chiropractic Care to Treat Herniated Disc Problems

Chiropractic care is very effective in treating disc problems. For 95% of our patients with degenerating disc problems, such as herniated discs, bulging discs, slipped discs, sequestered discs, and extruded discs, we can locate the cause of their problem and correct it. 95% of our patients do not need surgery.

Once we have reviewed the results of our exams, we will plan a course of treatment to correct their problems. The course of treatment may include some or all of the following:

1. Flexion Distraction:
   Effective at increasing the intervertebral disc height, creating more room for the nerves while improving circulation. This also allows the center of your disc (nucleus pulpous) to move back into its proper position in the spine. It is also effective at increasing spinal movement and resolving disc bulges and herniations.
2. Specific Chiropractic Adjustments:
   Chiropractic adjustments remove subluxations (misalignments) and restore proper movement and range of motion to the spine.
3. Electronic Muscle Stimulation:
   We use electronic muscle stimulation (EMS), to help decrease pain, decrease inflammation, and help speed up the healing process.
4. Rehabilitative Exercises:
   We recommend rehabilitative exercises to strengthen and stabilize the muscles around the spine. This allows the spine to move properly, and this, in combination with chiropractic adjustments, helps the disc and spine to become healthier.

Chiropractic care includes gentle adjustments to the spine, correcting any subluxation (misalignment), and increasing your flexibility and range of motion. When the spine is correctly aligned, the pressure is removed from the nerves alleviating pain and other symptoms. This, in turn, helps the spinal discs become healthier and prevents further disc degeneration.

Three Phases to Treating Disc Problems

Phase 1:
The first phase, and the first goal, is to get the pressure off the nerves to decrease the pain. Only 10% of your nervous system feels pain, so once you start feeling better we have only treated part of your problem.

Phase 2:
Phase two is the corrective phase. During the corrective phase, chiropractic adjustments and rehabilitative exercises work together to stabilize and strengthen the spine. The goal is to keep the pressure off the nerves and correct your problem.

Phase 3:
The third phase is wellness and preventative care. Once your problem is corrected, wellness and preventative care keep your spine properly aligned, prevent further disc degeneration, and keeps your spine healthy.

Set a Chiropractic Appointment

Dr. Mike Berardis treats patients with herniated discs and other degenerative disc problems. To set an appointment, call (914) 962-1234 or use our appointment form. If you have friends and family that can benefit from this article, please share and recommend it.