Herniated discs are a common problem, and can cause a variety of unpleasant symptoms. Fortunately, most patients can be treated without surgery. What is a herniated disc? How can a chiropractor help someone who has this problem?

What are the discs of the spine?

The spine is made up of many small bones (called vertebrae). Between each pair of vertebrae, there is a disc. The center of the disc contains a jelly-like substance, which has many layers of collagen fibers wrapped around it. The inner part of the disc acts like a cushion, while the outer layers help to maintain its structural integrity.

The disc is stuck down to the bones on either side, so the spine can move at these points only to the extent that it can be compressed, stretched, or twisted. This prevents the disc from slipping out of place and pressing on the spinal cord or other structures. (There are also movements between the vertebrae at other smaller joints, which gives the spine its mobility.)

Because of its structure, the spine is flexible enough to perform a variety of movements, while still being strong enough to protect the delicate spinal cord (which carries nearly all of the communication between the brain and the body). The discs help the spine to absorb shock during movements like walking, running, and jumping, so that it won’t be damaged. However, the structure of the discs does leave them vulnerable to a problem called herniation.

What is a bulging or herniated disc?

When a disc is herniated, the gelatinous material in the center of the disc is pressing outward, either expanding the outer layer of the disc or breaking through it. A herniated disc can cause pain and dysfunction in the spine itself, and can also cause more serious problems if the disc presses on other structures (such as nerves). Herniated discs are most common in the lower back, but may also occur in the neck and, less commonly, in the mid-back.

There are two main types of herniated disc: a contained herniation, often referred to as a “bulging disc,” and a non-contained herniation, which is commonly referred to as a “ruptured disc” or a “herniated disc.”

Bulging disc (contained herniation)

With a contained herniation, the inner gelatinous substance has pressed outward on the outer layers of the disc and has caused the disc to expand, but hasn’t broken all the way through. There may be just one part of the disc that is bulging, or the entire disc may have been squished flatter and be bulging all the way around. (Imagine pressing down on a jelly donut, but not very hard. Part of the donut may bulge outward, or the whole donut may become a little larger around as well as less tall.)

A bulging disc may occur as a result of the aging process, which causes a slow breakdown of the collagen in the disc. With less of the strong and supportive collagen, the pressure on the disc caused by gravity and bodily movement can be enough to stretch the collagen and cause a bulge. Wear and tear on the discs may be increased by certain chronic postural habits, repetitive movements, or by lifting heavy objects without proper form and conditioning.

A bulging disc may cause symptoms in itself. It can also be a precursor to a non-contained herniation.

Ruptured or herniated disc (non-contained herniation)

With a non-contained herniation, the gelatinous material inside has broken through the “shell” of the disc. (Imagine squishing the jelly donut a little harder, until the jelly starts to leak out. The jelly will tend to break through the donut at its weakest point.) At this point, this material may begin to press on surrounding structures.

A herniated disc may occur at a defined moment in time (for example, when lifting a heavy box). However, it’s often the case that years of chronic damage to the disc precede the herniation itself, by weakening the disc and making it easier for the inner material to break through. As with contained herniations, aging and certain postural or movement habits contribute to chronic disc damage and increase the likelihood of a non-contained herniation. A bulging disc indicates the breakdown of collagen in the disc, and it indicates that a non-contained herniation is more likely to occur at some point.

What are the symptoms of a herniated disc?

A herniated or bulging disc often leads to inflammation around the area. This may cause a dull or throbbing pain, along with stiffness, in the area of the spine where the herniated disc is located. However, herniated discs don’t always cause these symptoms; the area around the herniated disc may be completely pain-free.

Other symptoms of a herniated disc result from the disc pressing on a spinal nerve. These are the nerves that allow the brain and spinal cord to communicate with the body; they exit the spinal cord very close to where the discs are located, so that a herniated disc can easily press on one of these nerves. A herniation in the lower back leads to nerve symptoms in the leg, while a herniation in the neck causes such symptoms in the arm. Some of the symptoms may include:

• Numbness
• Tingling (a “pins and needles” feeling)
• Pain, often described as a “burning” sensation
• Muscle weakness

It’s also possible for a bulging or herniated disc to cause no symptoms at all. Sometimes, a herniated disc may be found on an MRI, but is not the actual cause of the patient’s symptoms. It’s important to have a careful and thorough evaluation, rather than simply assuming that a damaged disc is the only cause of a patient’s symptoms.

How can chiropractic help?

While the old advice to people with herniated discs was that they should immediately have surgery, this is no longer recommended. In fact, surgery tends to create more problems than it solves for many people. It’s strongly recommended by professionals in this field that patients with a herniated disc try non-surgical options first. Chiropractic can be an excellent drug-free method of treating the symptoms of a herniated disc.

A variety of studies have shown that patients with herniated discs can benefit from spinal manipulation by a chiropractor, with reduced pain and improved function for many people. Spinal manipulation will not directly repair a bulging or herniated disc. Rather, it can help to take pressure off of the disc, so that the body has the opportunity to repair itself.

Sometimes, patients may worry that the pressure on the disc during spinal manipulation will cause the disc to get even worse. Rest assured that this is not the case. The force applied during chiropractic adjustment is high frequency and low amplitude (meaning that it’s small but quick), and this force is not enough to cause any extra damage to the disc. Research has shown that chiropractic care doesn’t present any greater risk to a patient with a herniated disc than do other forms of care (such as taking medication).

Patients with bulging or herniated discs who are looking for an effective, drug-free treatment method should consider including chiropractic in their treatment plan. If you’d like to learn more about chiropractic in the Chester, NJ, area, please contact our office to schedule your appointment with Dr. Barnes.