Herniated Discs Can Now Be Treated Without Surgery 

 

What is a herniated disc?

A spinal disc herniation, which is often misleadingly called a "slipped disc", is a condition affecting the spine secondary to trauma, lifting injuries, or idiopathic (unknown cause), in which a tear in the outer, wall (annulus fibrosus) of an intervertebral disc allows the soft, central portion (nucleus pulposus) to bulge out. Tears are almost always posterior (back) and can also be displaced lateral (right/left). Since the spinal nerves are also located postero-lateral, neurological compression is common. This tear in the disc wall may result in the release of inflammatory cells which may directly cause pain and/or irritation to the spinal nerves, even in the absence of direct nerve root compression.

What are the symptoms of a herniated disc?

The symptoms of a disc herniation can be very varied, but will usually have at least one or more of the following:

• Lower Back Pain/Neck Back Pain – usually worse in the morning and better later in the day
• Radiating Pain – can be in the in the buttock, hip, side of the low back/base of neck, behind or in front of the shoulder
• Thigh/Arm Pain – can be in the back or front and sometimes in the side of the thigh/arm
• Leg/Forearm Pain – below the knee/elbow is usually nerve compression
• Relief Positioning – usually can find a relief position
• Pins/Needles/Numbness – in the leg/arm and/or feet/toes/hand/fingers indicates nerve compression

 

What are the testing procedures to diagnosis a herniated disc?

• History and Examination – this is often the most neglected, yet, by far the most important part of the diagnosis process. Quoting Sir William Osler MD, “Listen to your patients, they are telling you the diagnosis”. It is absolutely crucial to spend the time taking a detailed history.” You cannot find what you do not look for”. It is absolutely crucial to spend the time performing a detailed exam. Based upon the results, a determination will be made as to whether to begin treatment or to order further tests. 
• X-Rays – used to check for bone health, degenerative changes and structural alignment. We will be able to see the space that the disc occupies, but intervertebral discs will not show up on an x-ray.   
• Cat Scan(CT) – can be used to see a disc herniation, however it is better suited to visualize the bone. While less expensive than an MRI, it will expose the patient to high levels of radiation. Generally not the test of choice.   
• MRI – this is the gold standard test to determine a disc herniation. It will clearly show the entire disc and all the sarrounding soft tissue. While this is an excellent test to help differentially diagnosis a disc herniation, there are inherent problems as well. First is the cost, which can be as high $2000. Second, is that the time to perform the test is about 30-45 minutes and you must lie still. This may be very difficult for many patients. Third and most importantly, is that most often, the findings that the MRI shows may have nothing to do with the presenting condition. Studies have shown that 80-90% of asymptomatic people, who have never had any back pain, will have abnormal discal MRI findings. This does pose a diagnostic dilemma and is why you have to “marry the patient to the MRI, not the MRI to the patient”. Again, the history and examination will determine treatment going forward, in spite of the MRI findings.

What treatment can be done to help a herniated disc?

While there are certainly many different types of treatment, that are effective for disc herniation, many of which we readily use in our office, namely spinal manipulation, electric muscle stimulation, ultrasound and spinal exercises, it is not the intent of this article to list all of them but simply to introduce you to a type of treatment that you may not be aware of. SDT is not meant to necessarily replace any of the above therapies. In fact, utilizing them can be very helpful and will often enhance recovery. As a stand alone therapy or as an adjunct to pre-existing therapies, STD can be extremely effective to help you get well.   

Spinal Decompression Therapy

Spinal Decompression Therapy is FDA approved and has a very high success rate for pain associated with herniated discs, degenerative disc disease and spinal stenosis.… even after failed surgery. It is a non-surgical, traction based therapy for the relief of back/ leg pain or neck/arm pain. During this procedure, we have the ability to cycle through distraction and relaxation phases and by proper positioning, a spinal disc can be isolated and placed under negative pressure, causing a vacuum effect within it, drawing it back from its herniated position and away from the nerve. If your condition is not discal and is secondary to arthritis, which can lead to spinal stenosis, we can change the parameters to focus on a more continuous shorter hold/relax phases, creating a “milking of the joints”. This will help to reduce inflammation and allow diffusion (absorption) of nutrients into the arthritic areas to lubricate and heal the irritated structures.