The human spine is made up of individual bones known as vertebrae.
Between each vertebra lies a natural cushion, the intervertebral disc.
The main function of these discs is to absorb shock and compression and permit easy spinal movement.
With age or disease the structural integrity of the intevertebral disc can be compromised, resulting in disc bulging or herniation.
Let's look at exactly what happens with a herniated disc, why it causes symptoms, and how it can be treated.
Most often disc herniation can be attributed to degenerative changes that occur within the intervertebral disc due to aging.
The intervertebral disc is made up of outer and inner layers.
The outer layer, known as the annulus, is basically a tough fibrous ring.
The inner layer, or nucleus, is a core of gelatinous like material.
With age intervertebral discs become less hydrated and lose their elasticity and flexibility.
Disc degeneration also causes small tears in the fibers of the outer annulus.
These small ruptures are actually thought to first appear around the age of 25.
These perforations allow the inner nucleus to leak, or herniate, out of the disc.
What's the difference between a bulged and herniated disc? Although many people mistakenly use the two terms interchangeably, there is a difference.
When an unhealthy disc loses its structural integrity due to fractures in the outer annulus, the disc can lose normal shape and bulge out beyond the confines of the space it normally occupies.
This is often referred to as a bulging disc and is generally more common than a herniated disc.
A herniated disc occurs when the inner nucleus escapes the disc through those small tears in the outer annulus we previously discussed.
Although a bulged disc is generally more common, disc herniation is actually more likely to cause symptoms and complications.
A bulged disc often eventually progresses into a true disc herniation and this probably explains why many people think of them as one and the same.
Herniated discs are most common in the low back, most likely because this area of the spine is subjected to the greatest amount of stress and strain over time.
Although most common in the lumbar spine, herniated discs can also occur in the neck and mid-back.
Although disc herniation and bulging don't always cause symptoms, let's look at how, and why, they often do.
The spinal nerves branch off of the spinal cord between the bones of the spine and near the intervertebral disc.
When a disc bulges or herniates into the space surrounding a spinal nerve it puts pressure on the nerve root.
In addition, natural biochemical byproducts of disc degeneration chemically irritate the adjacent spinal nerve root.
These occurrences can lead to pain and other symptoms.
Symptoms often associated with a herniated or bulging disc include: numbness, tingling, pain in the legs or arms, muscle weakness, and pain that worsens when you cough, sit, strain, or sneeze.
If the herniated disc occurs in the neck, symptoms will primarily affect the neck, arms, hands, fingers, and upper body.
A herniated disc in the low back will generally affect the patient with symptoms from the waist down.
Advanced disc herniation in the low back can cause a condition known as cauda equina syndrome.
Cauda equina syndrome is characterized by progressive loss of feeling in the areas that would touch a saddle: for example the back of your thighs, inner thighs, and around the genital area and rectum.
Bowel and bladder dysfunction, including incontinence and difficulty urinating even if the bladder is full, are additional warning signs of this condition.
Although rare, cauda equina syndrome is a serious medical condition that signifies dangerous compression of the spinal nerve roots.
It is a medical emergency that necessitates prompt surgical intervention.
You may be wondering what factors contribute to developing intervertebral disc disorders.
There are several factors that increase a person's risk of experiencing disc herniation.
Some research has indicated there is a genetic component.
Age is another risk factor, with disc herniation being most common in middle age; around 35 to 50 years of age.
Increased height and weight are also associated with an increased risk of disc herniation.
Smoking increases the risk of developing disc herniation as well, since it decreases oxygen and nutrients available to the intervertebral disc.
How is a disc herniation diagnosed? A healthcare provider diagnoses disc herniation primarily through taking a history and performing a physical examination.
Specific signs, symptoms, and orthopedic test results can tell your physician whether you might be suffering with a herniated disc.
Since invertebral discs do not appear on a standard x-ray, the diagnosis is often confirmed via specialized imaging such as an MRI.
Treatment for a herniated intervertebral disc depends on a variety of factors including age, persistence and severity of symptoms, and a variety of other factors.
Standard medical treatment can include medications for pain and inflammation, injections, and surgery.
Many times a disc condition can resolve on its own over time, thus conservative treatment is generally recommended before surgery and more invasive options.
Chiropractors can be a valuable asset to patients with herniated or bulging discs.
Doctors of Chiropractic are trained to diagnose and treat misalignment and dysfunction in the spine.
There are also many chiropractic techniques, nutritional supplements, and treatment protocols that can help relieve pain and muscle hypertonicity associated with intervertebral disc disorders.
A Doctor of Chiropractic may also be able to help patients reduce their likelihood of experiencing a herniated disc.
This can be done by providing lifestyle modification advice, nutritional and ergonomic advice, and by prescribing core strengthening and lumbar stabilization exercises to help strengthen the muscles that stabilize the back.
Many people panic when they are diagnosed with a herniated disc, fearing the diagnosis means surgery is inevitable.
Many cases do respond well over time with conservative treatment.
In fact, research shows only about 10% of patients with herniated discs causing noticeable symptoms eventually end up undergoing surgery.
Contact a Doctor of Chiropractic or other qualified healthcare provider to discuss your specific case and the variety of conservative treatment options available.