In most cases, absolutely yes. The twenty-four moveable bones of the spine are each separated by discs composed of an inner jelly-like substance called the nucleus pulposus, surrounded by a tough outer fibrous ring called the annulus fibrosis. These discs allow one bone to move on the other, as well as creating a gap for nerves to exit from the spinal cord. The discs absorb 90% of the wight that goes through the spine and provide a degree of shock absorption. The remaining 10% of the weight rests on the small joints at the back of the spine called facet joints.
A disc injury typically involves a tear in the outer annulus that allows the nucleus to bulge out. When the nucleus breaks right through the annulus, it is called a disk herniation or disc prolapse. These injuries happen most commonly at the base of the low back, and sometimes at the base of the low back, and sometimes at the base of the neck. Symptoms of a herniated disc may include dull or sharp pain, muscle spasm or cramping, weakness, tingling, or ‘referred pain’. Referred pain means that you have pain in another part of your body as a result of the disc problem. For example, a bulging or herniated disc in your low back (lumbar spine), may cause referred pain in your leg. This is known as sciatica – a shooting pain that can extend from the buttock into the leg and sometimes into the foot. A herniated disc in your neck (cervical spine), may cause referred pain down your arm and into your hand. Leg and arm pain caused by a herniated disc is also called radiculopathy. Very rarely, herniated discs can cause a spinal nerve compression known as cauda eqina syndrome, in which there is a loss of bowel or bladder control. Such a presentation requires urgent medical attention.
While a herniated disc may come on suddenly, it is usually the result of wear and tear over a long period. For example, a middle-aged accountant who sits for long periods, suffers from disc dehydration, and has poor mechanics from weak abdominal muscles. He then lifts a heavy piece of furniture and experiences acute low back and leg pain. Or perhaps many months after lifting the piece of furniture, he experiences no pain at all until he sneezes. Bingo – a herniated disc.
A disc injury is often identified by case history and careful physical and neurological examination. Plain film x-rays can indicate disc degeneration, although CT scans and MRI (magnetic resonance imaging) are the best tests to confirm disc herniation. While some disc injuries may require surgery, a conservative chiropractic approach is usually best. Traction, gentle spinal adjustments (often to sites other than the level of the herniated disc) and soft tissue techniques are often used. A graduated exercise program and a close look at lifestyle factors and agronomics will also be essential in the long term management of a disc injury.
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