Disc Herniations: What Are They, And How Are They Best Treated?

by Dr. Brett L. Lukert, DC

Frequently, I am asked what the difference is between a disc herniation, a disc bulge, a slipped disc, and a ruptured disc. The answer is there is no difference; these are all terms that refer to the same thing. We have 23 discs in our cervical (neck), thoracic (mid-back) and lumbar (low-back) spine. Their purpose is to provide cushioned support and shock absorption between each of the vertebra. Each disc is composed of an inner gel-like substance called the nucleus pulposus, which is surrounded by fibrous material called the annulus fibrosus. Sometimes, when a disc is damaged or is undergoing degenerative changes, the gel-like material in the middle of the disc can rupture through the outer fibrous material of the disc, causing what we will refer to as a disc herniation.

Once a disc is herniated, it can extrude into the spinal canal causing nerve irritation. This is what can elicit severe symptoms such as sharp pain, weakness, numbness, and tingling in the arms and legs. Interestingly, in most cases, disc herniations are asymptomatic. Research has shown that a large percentage of people with disc herniations detected on MR imaging have no specific symptoms or back pain at all. People in their 30s and 40s are the most commonly affected age group, and approximately 90 percent of all disc herniations occur in the lower lumbar spine between the last two lumbar vertebra (L4 and L5) and the first sacral segment (S1).

Risk factors for disc herniations include extensive driving of motor vehicles, sedentary occupations, smoking, physical inactivity, obesity, and tall stature. Improper lifting also makes discs vulnerable to injury. Most disc herniations will respond well to conservative care, and 95 percent of people will return to work within three months. Conservative treatment options include chiropractic care, physical therapy, non-steroidal anti-inflammatory drugs (NSAIDS), and epidural (cortisone) injections.

Prevention of disc herniations is sometimes unavoidable but a few wellness tips that will reduce the chances of injury include:

•  Practicing good posture
•  Maintaining healthy weight
•  Keeping the back straight when lifting
•  Exercising regularly
•  Stretching exercises to strengthen the back and stomach

It is estimated that 60-80 percent of the population will have low back pain at some point in our lives. These are a few easy suggestions that will reduce this probability and will help us be healthy, live healthy and stay healthy!