The human spine is a complex structure.
The two principle structures that comprise the spine are the spinal column and the spinal cord. The cord attaches to the brain and is housed within the column. Spinal nerves are sent off the cord and exit through the column, carrying information to and from the brain.
The spinal column, also known as the vertebral column, is made up of bones called vertebrae. Each vertebra is separated from another by an intervertebral disc. Our discs are made up of connective tissue and their primary purpose is for shock absorption, as they are able to withstand great amounts of tension and pressure.
Discs are designed to protect the spine against the compressive forces of gravity. Each disc is made up of two parts. The center of the disc is called the nucleus pulposus, and is a spongy material. This spongy material is what accounts for the shock absorption capacity of the disc. The nucleus is surrounded by the annulus fibrosis, which is made up of strong ligamentous rings, and holds the nucleus in place.
While the disc is a resilient structure, it is susceptible to damage and injury. As we age, degenerative changes can cause the nucleus to lose its water content and dry out. The disc becomes less effective as a cushion, and loses its ability to absorb shock, which causes cracks and tearing in the outer annulus, allowing the nuclear material to seep out.
This condition is known as a spinal disc herniation. Though a generalized term, it is the name commonly used when describing this condition. The severity and degree to which the nuclear material migrates out of position determines the disc terminology used to describe the condition. Some additional terms commonly used to describe the different stages of progression of disc herniation include disc bulge, prolapse and rupture.
Though a disc herniation can occur in any spinal region, the most common is the lumbar spine, resulting in low back pain. Generally, these herniations occur at the base of the spine where it meets the sacrum.
Symptoms vary, depending upon the severity of herniation. If a nerve root is irritated by the herniated material, symptoms may include numbness, tingling, burning or weakness. The roots of the sciatic nerve frequently encounter such impingement, resulting in the condition we call “sciatica.”
Disc herniations also occur in the cervical spine. Symptoms occurring here can cause neck and shoulder pain, headache and radiating pain down the arms into the hands.
Our discs dehydrate with age, and the concussive demands we impose on our spines only accelerate these changes. Sudden trauma or gradual micro trauma, such as poor posture, may cause injury. Additionally, stress on the disc as a result of repetitive movements such as twisting or lifting can cause degenerative changes to occur even faster.
A diagnosis of a herniated disc is made by a health care practitioner and is based on a comprehensive history, the patient’s symptoms and a physical exam. Diagnostic imaging such as MRI often accompanies the exam.
Treatment for a herniated disc will vary according to the severity. Alternating ice and heat therapy, in addition to interferential current, are effective modalities for controlling pain and edema, as well as stimulating pain-relieving neuropeptides such as endorphins and enkephalins.
Flexion/distraction and decompression modalities help to relieve annular tension and alleviate spinal nerve irritation. Natural injection therapies such as Platelet Rich Plasma Therapy, Regenerative Injection Therapy and Mesotherapy can help treat and repair the surrounding tissue often inflamed in response to the injured disc.
Surgery may be necessary in severe cases, such as when nerve damage is present, however with the advent of disc replacement surgery, this option is not as “grim” as it once was considered.
Most individuals suffering from disc pain will benefit from conservative treatment. Chiropractic treatment and physical therapy have a long history of successfully treating disc pathology.
Disc injuries are all too common. It is vital to seek medical help if you suspect you have injured or damaged a disc.
Patricia Holl, D.C., is part of the staff at Yellowstone Naturopathic Clinic. She can be reached at 259-5096.