Issue 15 • July 2013

Spinal Disc Injury, Treatment and Prevention

Symptoms and Solutions

Pain doesn’t indicate a life sentence. People suffering with neck and back pain commonly come to my office believing they have a herniated disc. These patients are usually fearful of needing surgery or of facing the possibility of lifelong discomfort. There’s good news – in most cases, surgery and chronic pain are the exception, not the rule.

Spinal Discs 101

Before beginning to solve neck and back pain, you need basic knowledge of a spinal disc and its function. The disc is composed of two structures, an outer shell called the annulus and an inner, jelly-like substance called the nucleus pulposus. Simply imagine a spinal disc like a jelly donut, the doughy part being the annulus and the jelly being the nucleus pulposus.

What happens to spinal discs during injury? Of the many types of spinal disc injury, the two most common injuries are disc herniation and disc bulge. Disc herniation is typically the more serious of the two injuries and occurs when the jelly substance in the middle of the disc breaks through the dough material. The less severe disc bulge is when the jelly substance is forcefully pushed into the dough material but does not break through. Symptoms of these injuries include:

Herniated Disc

Searing or burning pain radiating down the leg or into the gluteals.
Intense and debilitating discomfort that often disrupts daily activities.

Bulging Disc

Vague, deep and achy pain.
Increased pain with prolonged sitting, bending, coughing or sneezing.

Treatment

Initial treatment for both injuries should be conservative care. Most disc related injuries respond favorably to Chiropractic and/or Physical Therapy along with mild exercise. If there is little to no improvement in pain after six to eight weeks of conservative care then an epidural or corticosteroid injection may be recommended.

Effective chiropractic therapies for spinal injuries would include soft tissue work. Active Release Technique, a gentle tractioning of the back and occasionally manipulation of the spine specifically helps to loosen the tight tissue around the joints. Traction helps to increase fluid in the disc and make the joint more mobile and manipulation helps to make the joint more mobile.

It’s important to understand that all disc injuries are different. After treatment, some patients will return to their normal routines with no interruption while others may have limitations due to the loss of spinal mechanics. Once your disc injury has been diagnosed and cleared by your physician, you can begin exercises to expedite the recovery process.

Exercises

Movement is key. Walking short distances and gradually increasing those distances are an important part of rehabilitation. Slowly return to your gym routine or recreational activities, as long as they do not increase discomfort.

Muscles that matter. Exercises should focus on complex movements that incorporate multiple joints and should engage muscles that strengthen the core. Often, people claim to have good core strength. However, a little known fact is that the core is comprised of the hamstrings, hip flexors, quadriceps, abdominals, obliques, and lower back muscles. In some cases, people overwork their abdominal muscles and neglect the other 5 muscle groups. Excessively worked abdominal muscles lead to core imbalance and often times dysfunction and pain.

Complex movements that incorporate multiple joints and muscles while strengthening the core include:

  • Squats
  • Lunges
  • Dead lifts

If you are intimidated by these exercises, keep in mind, they all mimic activities we perform on a daily basis. Think about a typical trip to the grocery store or yard work where you are repeatedly squatting, bending and lifting. These exercises do not necessarily have to be performed with weight so long as they are performed to increase your strength and range of motion. Working with a trainer or coach, who can help you perform these movements properly, also takes the guesswork out of these exercises.

What to expect

Exercises recommended for core strength don’t in fact heal spinal disc injury. A spinal disc does not have a blood supply. The discs receive leftover nutrients from the vertebrae. Without a vascular supply, tissue cannot heal. So once you damage a spinal disc, the injury is irreversible. Since you cannot reverse or heal the disc, your best option is to strengthen the spine and become more mobile in your back, hips, knees, and ankles. While the exercises may prevent future injury to the spinal discs above and below the injured disc, they provide essential core strength and increased mobility.

Dr. Christopher Land

Dr. Christopher Land

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