Vertebral Discs: What are they, and why can they be problematic?
What exactly are “discs” in your spine? Chances are, you’ve heard someone mention this term before when referring to their neck or back. You may have heard someone say, “I slipped a disc in my back”, or “My doctor said that I have a bulging disc” and maybe not have given much thought past that. But did you ever actually wonder what the discs are?
A typical human spine consists of 7 cervical, 12 thoracic, and 5 lumbar bones, known as vertebrae. Between each vertebrae are what are called intervertebral discs. The discs primarily function as “shock” absorbers; they provide cushion to the spine and absorb everyday stresses that are placed upon it. The disc is composed of a tough outer covering known as the annulus fibrosis. The annulus fibrosis is formed into concentric layers that sit around the inner part of the disc, known as the nucleus pulposis. The nucleus pulposis is a jelly-like substance that is mostly comprised of water, which is super important for the cushioning of stresses placed on the spine.
Complications with the disc:
The disc is primarily composed of water. The entire spine contains a complex venous network that helps to keep the discs hydrated. Under proper hydration, the discs are effective in absorption of forces placed upon the spine.
Over the course of your life, the discs can undergo “wear and tear” from various activities (i.e. lifting heavy objects, carrying heavy objects, repetitive motions such as twisting, etc). Over time, these discs start to lose their water content. This causes the discs to lose turgor or firmness and as a result, the disc starts to shrink in height. As this starts to happen, the vertebrae start to get closer together in proximity. This is known as degenerative disc disease and can lead to pain in the lower back, or even into the legs.
Wear and tear can also produce bulging or herniated discs. As previously mentioned, the tough outer annulus fibrosis is organized into layers. Certain strenuous activities, such as improper lifting, can lead to tearing in some of these layers. When this happens, the inner jelly-like substance can migrate away from the center of the disc, essentially “bulging” or protruding outward. In some cases, continued trauma to the disc can actually cause a full-thickness tear in which case the inner substance can extrude out of the disc, causing what is known as a herniation. Bulges and Herniations can be particularly problematic because they can irritate nerves around the spinal cord. This causes pain in both the low back and often times into the lower extremities.
How chiropractic can help with disc issues:
Research shows that chiropractic care is effective in managing issues with the disc. A 2010 study published by the Journal of Manipulative and Physiological Therapeutics found that 60% of patients who presented with disc symptoms and that failed other medical management benefitted from spinal manipulation to the same degree as if they underwent surgical intervention1. Another study published by the same journal in 2014 showed that spinal manipulation produced clinically significant outcomes in regards to patients with both acute and chronic disc herniations2.
Research has shown that regular intersegmental movement within the vertebrae can help keep fluid pumping to your discs via the venous system previously mentioned above. As chiropractors, we
always encourage our patients to stay moving and to participate in an active lifestyle. Additionally, as chiropractors, it is our job to assess your spine for lack of movement, and to restore motion where it is needed. Adjustments ensure that your spine is moving properly and that your discs are staying hydrated, which can prevent injury.
Rehabilitation exercises are often beneficial to the patient who is experiencing disc issues. The most common trauma occurs at the posterior portion of the disc. This is usually due to a bending/twisting mechanism (ie picking something up and putting it somewhere else). When a disc herniates, the inner material can push outward, which can irritate spinal nerves. In this scenario, patients typically respond well to particular types of exercises. Chiropractors are trained to assess if these exercises can be beneficial, and can help in implementing a home exercise program so that you heal more quickly.
Clinical trials show that the treatment of the disc tissue with low-frequency electronic pulse current through the acupuncture needle or pads applied to affected area can not only effectively play sedative and analgesic effects to adjust the muscular tension of human body, but also promote the blood circulation system in the body. Blood flow is important allowing delivery of oxygenated blood, and inflammatory agents which help speed the rate of tissue healing. ROS is a series of reactive oxygen species produced by aerobic cells during the metabolic process. Experimental studies have shown that ROS is essential in initiating and maintaining the regeneration reaction in human body, because ROS is critical for activating the WNT signal of the body, the latter of which plays a key role in the regeneration process. Results of this study showed that the total cure-remarkable-effectiveness rate of patients in research group (84.0%) was higher than that in control group (62.0%), and the difference was statistically significant (p<0.05), suggesting that the electrical stimulation therapy has a significant effect in the treatment of lumbar disc herniation-induced sciatica and can effectively improve the healing effect.
Dry needling is the use of solid filament needles inserted through the skin and into the muscle to release painful myofascial trigger points. Dry needling results in the deepest tissue release allowing for improvements in movement and pain. It is called “Dry” Needling because there is no solution injected as with a hypodermic needle during a flu shot. A small, solid filament needle which is inserted in a contracted painful knotted muscle to create a local twitch reflex which is both diagnostic and therapeutic as it is the first step in breaking the pain cycle as research shows will decrease muscle contraction, reduce chemical irritation, improve flexibility and decrease pain. When a needle is inserted into muscle it will also produce a controlled lesion and will cut between three to fifteen thousand individual muscle fibers. The body considers the needle as a foreign invader and will activate the immune system as a response. The cut muscle fibers also produce an inflammatory reaction that your body will respond to not just locally but all over the body to reduce inflammation systemically. By promoting blood flow to the affected tissue, decreasing muscular spasm, and removing stress off the subsequent joints, dry needling is an effective treatment when used in conjunction with other conservative therapies in treating low back pain as a result of disc herniation.
Disc issues are very common in today’s society. It should also be noted that just because you have a disc issue, does not necessarily mean that you will have pain. Regardless, chiropractors are well-equipped to assess, detect, and treat difficulties arising with the disc. If you are experiencing any symptoms mentioned above, feel free to reach out to our office so that we can help you determine the best possible course of action.
1. McMorland, Gordon, et al. “Manipulation or Microdiskectomy for Sciatica? A Prospective Randomized Clinical Study.” Journal of Manipulative and Physiological Therapeutics, U.S. National Library of Medicine, Oct. 2010, www.ncbi.nlm.nih.gov/pubmed/21036279.
2. Leemann, Serafin, et al. “Outcomes of Acute and Chronic Patients With Magnetic Resonance Imaging–Confirmed Symptomatic Lumbar Disc Herniations Receiving High-Velocity, Low-Amplitude, Spinal Manipulative Therapy: A Prospective Observational Cohort Study With One-Year Follow-Up.” Journal of Manipulative and Physiological Therapeutics, vol. 37, no. 3, 2014, pp. 155–163., doi:10.1016/j.jmpt.2013.12.011.