How Seeing A Chiropractor Can Help With A Disc Injury
Disc injury or lower back pain the term Degenerative Disc Disease has become more prevalent today than 20 yrs ago due to prolonged life expectancy and more sedentary lifestyle (either due to being inactive or a workplace that requires sitting longer hours). If you are over the age of 40, you probably have some degree of disc degeneration, but experience little to no symptoms.
Degenerative Disc disease - a condition where the disc in between the vertebrae deteriorate or wear out over time.
I typically see patients when they experience a flare up of their lower back, which can oftentimes be contributed to an existing disc issue. It’s not just from a car accident or slip/fall, although people that suffer a car accident will more than likely have lower back pain from an injured disc.
Disc Definitions
Intervertebral discs act as shock absorbers and facilitate movement for our body. They are situated in between the bones that make up our spine. There are 3 parts to a disc
Nucleus Pulposis - the inner part that consists of water, collagen (Type II), and proteins. It absorbs shock and distributes pressure.
Annulus Fibrosis - the tough outer layer made up of collagen (Type I)and provides stability against tensil forces.
Cartilagenous Endplates - these endplates attached the disc to the bones above and below it, which enables smooth movement.
Aside: Skin has Type I and Type III Collagen.
Types of Disc Injuries
Bulge - the gel like fluid inside the disc pushes against the outer wall (annulus fibrosis) but does not rupture.
Herniation - the fluid material inside pushes against the outer wall and ruptures, leading to nerve irritation.
Protrusion - a contained herniation where the fluid inside pushes against the outer wall but does not rupture.
Disc Extrusion - a non-contained herniation where the inner fluid breaks through the outer wall and spreads into the spinal canal.
Disc Sequestration - a disc herniation where the inner fluid separates from the disc altogether and migrates away.
Collapsed Disc - the outer layer (annulus fibrosus) is worn out, reducing the disc height.
Degenerative Disc Disease - the general wearing down of the disc, losing its function, leading to pain.
Symptoms
Classic signs include severe pain along with radiculopathy (pain/numbness/tingling down the arms or legs), and muscle tension. The radiculopathy can sometimes be confused with sciatica; more on that later.
Diagnoses
Diagnosing through examination, orthopedic tests, and comprehensive history intake.
This is especially the case when a patient is involved in a car accident, where the patient may have suffered a whiplash, headache, or a concussion.
I had one patient state during an initial consultation that stated she had been in a total of 10 car accidents during her lifetime. Is there a chance she may have a disc injury? Heck yeah.
To get a definitive diagnosis, I recommend either a CT Scan or an MRI, not X-Ray. MRI continues to be the gold standard because it provides us with a clear view of not only the health of the disc, but also the muscles/tendons/ligaments/bone condition that are oftentimes affected. When you have a history of lower back injuries, the muscles near the joint will become spasmed and become trigger points, or more commonly known as muscle knots. They can sometimes be mistaken for cysts.
Also, muscle spasms can mimic disc injuries. For example, there is a muscle called the Piriformis, which can tighten and irritate the sciatic nerve, and produce sciatic-type pain. MRI helps to clear up any confusion. Some chiropractors require imaging on all patients and I understand the logic behind it. Depending on the severity and presentation of the condition, I don’t require an MRI if I know there is a history of disc issues because the treatment plan may be the same regardless, as long as the patient is aware of the issue and are treating it on their own with stretching exercises, ice/heat therapy, proper posture, etc. Also, an MRI is valid for up to 3 yrs, provided there have been no recent trauma to warrant an updated scan.
Should the patient not respond to consistent chiropractic care, I would refer the patient to a neurologist for a second opinion, preferably with recent MRI reports on hand.
By the way, if a patient were to present to my office with a recent full blown disc herniation, I would not treat that patient same day. If any of you have ever experienced a disc injury, you will know it is very painful, and impossible to move. I will always send the patient out to Urgent Care so they can get the proper medications during the flare up. Remember young chiros, first do no harm. Trust me, its not worth it.
Treatment
When you hear about someone injuring their back or having a disc herniation, they often jump to conclusions and assume surgery is needed. Rest assured, that is not the case. Here are some great treatment options
Consistent chiropractic care has been shown to be an effective treatment for most disc injuries by realigning the vertebrae and alleviating pressure on the disc.
Physical therapy helps protect the disc by strengthening the affected muscles around it.
Massage therapy helps treat injured muscles around the disc (through a technique called myofascial release), as well as promote increased range of motion after a disc injury.
Surgery would be a last resort, some patients report no major benefit post-surgery for a variety of reasons. Through my professional career, I have found that a good surgeon will do everything they can to keep from operating on a patient until all other options have been exhausted.
There is some promising research in the areas of stem cell, regeneration, or gene therapy, but it’s not clear when this will happen and how financially accessible it will be.
In the meantime, I would encourage all of you to be more proactive about the health of your discs as they are extremely important. Besides exercise (ie. Walking 2-3 times per week, 20mins each time), proper posture, consider your diet rich in collagen…
Foods rich in collagen include:
Bone Broth: Type I, III (primarily beef)
Skin-on Chicken or fish
Egg Whites: contain type I, IV
Red Meats: beef, pork, lamb
Fish
Organ Meats: Chicken
Foods that support collagen production:
Oranges, lemons contain Vitamin C which promotes collagen production
Berries
Leafy Greens
Garlic
Nuts/seeds such as pumkin, chia (contain zinc and copper which help collagen production)
Beans (a good source of protein and amino acids which help build collagen)
Nutritional supplements are also another option, as long as you treat them as such. I love taking supplements, but a word of caution: they are there to supplement a healthy diet, but will have no positive effects on a poor one. Consider websites such as Fullscript or any high-quality supplement that provides third-party certification, which guarantees a safer product. Look for a label marked “NSF Certified” on your supplements.
Lastly, on a personal note…I experienced a disc injury about 3 years ago while using the leg press machine at the gym. Yes, chiropractors can also have back pain at times. My body reminded my mind that I was not 20 years old anymore. It was excruciating and debilitating. I was out of the office for 8 weeks, doing all the treatments (chiropractic, massage, and rest). Thankfully, I experienced a complete recovery and am back to running 40- 50 minutes per run and can squat with no issues. If you ever injure your back, please don’t ignore the symptoms. Seek help as soon as possible. Contact my office, I will be glad to help.
