How to deal with a herniated disc

Are you suffering from the following symptoms: Pain that radiates to the buttocks, legs, and feet called sciatica? Tingling or numbness in your legs or feet? Or muscle weakness?

If yes, you could be suffering from a herniated or slipped disc. The spine, or backbone, is made up of a series of individual bones called vertebrae that are stacked to form the spinal column.

Between the vertebrae are flat, round cushioning pads called inter-vertebral discs, which act as shock absorbers.

Each disc has a soft, gel-like centre called the nucleus pulposus surrounded by a tough, fibrous outer layer called the annulus. A herniated or ruptured disc occurs when pressure from the vertebrae above and below force some or all of the nucleus pulposus through a weakened or torn part of the annulus.

The herniated nucleus pulposus can press on the nerves near the disc, resulting in pain.

Herniated discs occur mostly in the lower part of the spine, however they can also occur in the cervical and thoracic spine.

A herniated disc is one of the most common causes of neck, back and leg pain. Several factors contribute to disc weakening including aging and degeneration, excessive weight, and sudden strain from improper lifting or twisting violently.

Symptoms of a herniated disc in the neck include pain near or over the shoulder blade, pain that radiates to the shoulder, arm, and sometimes hand and fingers. Others are neck pain and spasm of the neck muscle. Symptoms of a herniated disc in the mid-back tend to be indefinite. There might be pain in the upper and lower back, abdomen, legs, as well as weakness or numbness in one or both legs.

Herniated discs are very common. They occur more often in people aged 35 to 55 years. They are more common in men than in women. Diagnosis includes a complete physical examination and medical history.

Your physician might perform a neurological exam to test your muscle reflexes and strength as well as sensation.

The healthcare provider might use other tests to confirm the diagnosis and to better evaluate the site and extent of the herniation. The tests might include an X-ray; which uses small doses of radiation to produce images of the body. An MRI (magnetic resonance imaging) and computed tomography (CT) scans can show narrowing of the spinal canal caused by a herniation. How is a herniated disc treated? Most herniated discs resolve on their own or with conservative treatment, which include rest and physical therapy.

Physical therapy often plays a major role in herniated disc recovery. It not only offers immediate pain relief but also teaches one how to condition the body to prevent further injury.

There are a variety of physical therapy techniques. Passive treatments relax your body and include deep tissue massage, hot and cold therapy, electrical stimulation and hydrotherapy.

Your physical therapy programme begins with passive treatment. But once your body heals, you will start active treatment that strengthens your body and prevents further pain. Your physical therapist will work with you to develop a plan that best suits you. On the other hand, chiropractors evaluate the entire spine. The expert wants to see how well your spine is functioning. Remember: What happens in one area of your spine can influence other parts of your body.

If your chiropractor finds that you have advanced loss of strength, sensation, reflexes, and other unusual neurological features then he or she will refer you to a spine surgeon.

To treat a herniated disc, your chiropractor will develop a treatment plan that may include spinal manipulation, also known as adjustment.

Specifics of your treatment plan depend on your pain, level of activity, overall health, and what your chiropractor thinks is best. You want to make sure you understand what will be done and how it can help relieve your pain. Chiropractic treatment is safe and effective for most patients. What complications are associated with a herniated disc?

Chronic (ongoing) back or leg pain and loss of control or sensation in the legs or feet are some complications of an untreated disc herniation.

What is the progress for people with herniated discs? Most back and leg pain will get better gradually if one takes simple measures.

Most people with herniated discs respond to treatment within six weeks and are able to return to their normal activities. Some will continue to have back pain even after treatment.

Can anything be done to prevent a herniated disc?

It is not always possible to prevent a herniated disc, but there are steps you can take to reduce your risk. Use proper lifting techniques. Do not bend at the waist. Bend your knees while keeping your back straight and use your strong leg muscles to help you support the load. Maintain a healthy weight. Excess weight puts pressure on the lower back.

Practice good posture when walking, sitting, standing, and sleeping.

For example, stand up straight with your shoulders back, abdomen in, and the small of your back flat. Sit with your feet flat on the floor or elevated.

Sleep on a firm mattress, and sleep on your side, not your stomach. When sitting for long periods of time, stretch often.

Do not wear high-heeled shoes. Exercise regularly to keep muscles of your back, legs, and stomach strong. Engage in regular aerobic exercise. Try to balance flexibility with strength training in a regular exercise programme. Finally, stop smoking.

Jemimah Kamau, Physical Therapist, Chiropractic & Physiotherapy Health Centre.