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Low Back Pain From Disc Herniation
Disc herniations can cause disproportionate fear in the patient's mind when they receive this diagnosis. Often, patients fear that their only resolution to disc related back pain is surgery. Fortunately, there are effective treatment options for patients suffering from disc related back pain. Proper chiropractic care is a surprisingly effective alternative.
Anatomically, the discs are located between the spinal bones. The disc functions to absorb compression due to body weight and position, and maintain proper spacing between the spinal bones. Each disc is composed of two parts. The inner part is made up of a soft jelly material. The outer part consists of concentric fibrous layers that control the position of the inner gel. When healthy, the gel remains centrally located. When a disc is injured, the outer wall is weakened. Then, under pressure, the disc gel migrates outward. As the disc wall thins, it weakens and bulges and a “disc bulge” results. When the tear is through the outer disc wall and the disc gel protrudes through this tear, a herniation results. A herniation is more severe than a bulge.
Disc problems occur due to degenerative changes, arthritis, sudden or cumulative trauma. The most common disc injury involves bending with rotation or twisting at the waist. These movements tear the outer disc wall, leading to bulging or herniation. Disc related back pain is most common among the 30-50 year old age group, equally affecting both sexes. Signs of disc related back pain often include a history of low back pain episodes with or without leg pain over months or years.
Proper diagnosis is essential for effective treatment. While x-ray findings may be negative, MRI is very reliable at showing the location and size of bulging and herniated discs. Treatment decisions may be influenced based on MRI results.
Initial treatment goals are to relieve pain and spasm by reducing inflammation and swelling around the disc and nerve roots. This can be accomplished with frequent applications of moist ice packs, short and frequent periods of recumbency and limiting activities. Gentle traction and appropriate stretching can also alleviate pain.
It is also important to restore range of motion and trunk strength. This is accomplished through structured exercises, beginning with the simple and graduating to more advanced. Long-term management of disc-related back pain should be focused on building core strength and minimizing risk factors.
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