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Herniated discs are a significant problem. They can obviously create a great deal of pain, like sciatica; however, they can cause other substantial problems. If you have a herniated disc or even a “bulging disc” in your low back you can lose the ability to walk normally. Our chiropractors have had patients that report that they feel clumsier and trip over stairs or their own feet. The herniation can put pressure on nerves that help the gut to function. The pressure on these nerves can cause loose stools, constipation, bloating and stomach pain. Our chiropractors have even seen herniated discs decrease sexual function with symptoms like erectile dysfunction, premature ejaculation issues, loss of sensation and pain with intercourse. A herniation, for the most part, can cause issues in function with everything from the belly button down. Whereas a herniated disc in the neck can lead to weakness in the arms, pain in the shoulders and arms, even head aches and sinus infections. Herniated discs are always accompanied by muscle spasms and loss of normal function in the surrounding joint complex. This decrease in function will increase pressure on the surrounding bones joints ligaments and muscles which will cause other problems if not properly addressed. These problems are typically degeneration, desiccation, arthritis, and secondary disc herniation. These secondary symptoms can be irreversible and require substantial work and often surgery to reduce. It is critical that anyone facing a herniated disc get the proper treatment immediately and not allow further damage to occur.
Treating herniated discs is problematic due to the complexity of the situation and often times severity of the pain associated with these issues. The other major factor to remember when someone has a herniated disc is that the spine is now forever structurally damaged. Even with the best treatment the spine will not ever function the way it did before the herniation. With that said, in most cases pain can be eliminated and normal life can be resumed. The reason it is important to recognize that the structure has now been changed is that the need for exercise and maintenance on the spine and the muscles of the spine is going to be even more critical. This is best illustrated by the actual reason, and the only reason, that a disc will herniate or bulge is that the spine is weak. When the spine, which consists of the muscles around the bones, the bones themselves, the ligaments that attach to the bones as well as the tendons that make up the spine fail as a group and thus the disc herniates. If we understand that the failure was due to lack of function for example the joints were not moving properly or the muscles were weak then it is easy to properly fix the issue long term, which can only be done with chiropractic and exercise.
There are many options that are used to treat the problems, symptoms, most often associated with herniated discs the most common are: oral steroids, steroid injections, rhizotomy, chiropractic, spinal decompression, discectomy surgery, laminectomy surgery, and fusion surgery.
Oral steroids and steroid injections strive to serve the same purpose of decreasing pain by decreasing inflammation. The major difference in the two is how they are delivered. Any medication that you take orally, by mouth, has to go through the stomach, intestines, and then into the blood where it hits the liver, kidney, heart, brain and all other tissues and organs until it eventually also hits the area that you want to help. While this process has many side effects it is the least invasive medical remedy and can help.
Steroid injections come in a variety of fashions. The most common for herniated discs is a facet injection where the medication is deposited directly into the area of inflammation and muscular spasm. This delivery system is the most invasive as you often times need to be sedated for it however, it is the most effective. This method also spares the organs that are damaged by the oral pathway of pills.
All surgeries are going to require specific changes and that makes them specific to the individual surgeon and the individual patient however, all will require cutting of the spine and or spinal complex.
Rhizotomy surgeries are preformed where the primary goal is to destroy the nerve that is causing pain or problems. This technique is most often used for spastic issues like in spastic diplegia or in spastic cerebral palsy, however, is also used for pain.
Laminectomy surgeries is a technique that allows more room for nerves to pass off the spinal cord and out into the body by way of cutting a piece of the bone off of the spinal vertebrae, the lamina, and leaving a larger hole for the nerve. This process is often times referred to as “surgical decompression”.
Discectomy is where the disc itself is cut off and removed to allow more room for the nerve or spinal cord.
Vertebral fusion surgery is where 2 or more discs are completely removed and the bones are either bolted together or they are glued together. If the bones are “glued together” bone chips and bone cement is used to grow the 2 bones together.
Chiropractic treatments focus on the entire joint complex, the ligaments, tendons, muscles, bones and joints. The concept is to activate the joint and get everything moving. This increase in normal function decreases muscle spasm and thus pressure on nerves and allows disc function to return to normal. The reduction in spasm and the return to normal function will also allow for the inflammation to start reducing which will lead to a further decrease in pain and help restore function.
Non-Surgical Spinal decompression is a process of using intermentant traction to fluff the disc back up and brake down muscle spasms. Spinal decompression can also help restore normal joint complex function by slowly moving the joints through a range of motion.
These treatments can often times be combined to achieve faster results or even better results.
For instance combining steroid injections with chiropractic and spinal decompression can substantially reduce total treatment time and the need for surgery.
The best long term solution to this issue is to correct the actual problem that lead to the herniation of the disc. A disc will only herniate for one reason. If a force is put into the spine that the muscles and joints cannot handle then the spine will fail. For this reason chiropractic care to ensure that the joints are moving properly and exercise is the only way to prevent future disc herniation.
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