You may have heard the term “slipped disc” used to describe a low
back injury. Discs do not actually “slip”. Rather, they may herniate
or bulge out from between the bones. A herniation is a displaced
fragment of the center part or nucleus of the disc that is pushed
through a tear in the outer layer or annulus of the disc. Pain results
when irritating substances are released from this tear and also if the
fragment touches or compresses a nearby nerve. Disc herniation has
some similarities to degenerative disc disease and discs that herniate
are often in an early stage of degeneration. Herniated discs are
common in the low back or lumbar spine.
Many
factors decrease the strength and resiliency of the disc and increase
the risk of disc herniation. Life style choices such as smoking, lack
of regular exercise, and inadequate nutrition contribute to poor disc
health. Poor posture, daily wear and tear, injury or trauma, and
incorrect lifting or twisting further stress the disc. If the disc is
already weakened, it may herniate with a single movement or strain such
as coughing or bending to pick up a pencil.
Herniated
discs are most likely to affect people between the ages of 30 and 40.
Disc herniations may be present without causing pain. The most common
symptom will be pain in the area of the herniation that may radiate
across the hips or into the buttocks. You may also experience numbness
or pain radiating down your leg to the ankle or foot. If the
herniation is large enough, you may notice weakness with extension of
your big toe and you may be unable to walk on your toes or heels. In
severe cases of lumbar disc herniation, you may experience changes in
your bowel or bladder function and may have difficulty with sexual
function.
Mild to moderate disc herniations can usually be treated conservatively with stretching, exercise therapy and chiropractic care. More advanced cases will often require some form of spinal decompression, such as traction or mechanical decompression, in conjuction with chiropractic care.
Occasionally, a herniation may be severe enough to warrant surgical intervention. These cases are usually reserved as a last resort when other forms of therapy have failed to relieve pain, or if there is significant compression of the spinal cord or nerves.