A ruptured disc can occur following a lift, fall, slip or other injury. However, many ruptures that I see in my practice occur with simple maneuvers like picking up a pencil or turning to speak to someone. This causes significant confusion in the minds of patients. How could this happen?
First, normal healthy discs do not rupture. In fact, when healthy patients fall hard, they often will break their back before the discs are injured. However, due to the natural aging process, discs begin to degenerate based on a patient’s family tendency (genetics) and exposure to repetitive trauma (football?). A weakened disc may tear inside allowing the center of the disc to herniate. This tear is painful, and if the disc protrusion hits a nerve the nerve will hurt as well.
Chiropractic physicians are experts in evaluating the neck and back to find out exactly what structures are causing pain. If your chiropractor believes that you have a ruptured disc, the first thing they will do is to assess your nerves in your arms or legs to make sure that they are OK.
Mild disc injuries usually need bracing and time. Some treatments may be helpful to manage the spasms. Many of these disc problems will heal without much assistance. After a few weeks and with some home rehabilitative exercises the patient is usually back in the game.
A more complicated ruptured disc will require special manual techniques to decompress the disc. These decompression techniques are designed to reduce internal disc pressure to help reduce the herniation. Also, decompression stretches tight muscles and improves circulation around inflamed joints and nerves. You can know you are on the right track with decompression because most patients feel relief during the decompression process.
Sometimes the ruptured disc is not severe, but the patient is in a lot of pain. In those situations, we often work with medical physicians who specialize in nerve cortisone injections to reduce nerve inflammation. Once the inflamed nerve calms down, we have a window of opportunity to decompress the disc to help it heal.
Another excellent way to manage nerve pain from a ruptured disc is with acupuncture. Acupuncture is a common sense alternative for many patients since it is much less invasive, does not involve cortisone with its side effects, and can be much less expensive.
Managing the pain and dysfunction of the ruptured disc is a preferred approach since the body will remove the offending disc tissue naturally if it is given enough time. Our job for these patients is to manage the pain and dysfunction of the disc injury and return the patients to their normal lifestyle. Statistics report that 80% of ruptured discs are removed by the body within two years.
Some disc herniations are surgical. These are usually identified on examination. What makes a disc lesion surgical is when a disc leans on a nerve hard enough that it causes damage to the nerve. Damaged nerves lead to weakness and numbness. I am much more concerned with a patient who has a weak non-painful disc lesion than I am the patient who has good strength but who may be in a lot of pain.
When patients present with an apparent surgical disc, we quickly obtain an MRI and get the patient in for a surgical consult. There are several excellent spine surgeons in Memphis who can remove the bad disc, but I mainly refer to Dr. Maurice Smith and Dr. Kevin Foley at Semmes-Murphy. As neurosurgeons, these doctors were trained to use microscopes to place a clip on a small blood vessel deep in the brain (among other things). They use the same talent when they do spine surgery. They make a small hole in the back, use their microscopes and remove only the offending disc. Small holes cause less tissue damage resulting in faster recovery and better outcomes. A great concept!
So, when you know of someone who has back pain with leg or arm involvement, get them into a highly trained chiropractic physician for an evaluation and recommendation. With care, compassion and expertise, they will help you through the challenges of dealing with a ruptured disc.