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Herniated or Bulged Discs

PART III: CONSERVATIVE TREATMENTS FOR HERNIATED OR BULGED DISCS

By | Herniated or Bulged Discs

Normally the disc is under a lot of compression, noted by the big blue arrows “squashing” the disc and pushing the disc gel out and onto the nerve

 

 

 

 

 

 

 

 

There is an appropriate time for neck or back surgery, but in many cases, being conservative first is a much smarter decision.  Dr. Uribe, a neurosurgeon in Tampa, FL, says that “surgery isn’t right for everyone and, unlike other interventions, it isn’t reversible.”  He generally won’t see patients unless they have spent at least six months to a year trying conservative treatments.

Our therapy safely and effectively reverses the pressure on the disc and nerve, noted by the big grey arrows opening the disc space, hydrating the disc and pulling the disc gel away from the nerve

The disc, just like every other tissue or cell in the body, needs oxygen, water, and nutrition in order for it to remain alive.  Non-surgical spinal disc decompression therapy is a conservative treatment, which creates a unique set of circumstances that don’t exist in every-day life (see illustration to the right), in order to increase these vital components to the disc (blood, water, oxygen, and nutrition). Our non-surgical disc decompression treatment program creates a de-pressurization of the disc; it decompresses the disc.  This is what the surgical procedures are trying to do as well (two of the most common surgeries are called a decompressive laminectomy and a decompressive discectomy). The obvious difference is that there is no cutting and drilling through your body, all the way down to your spine.

Non-surgical spinal disc decompression therapy is a very specific disc treatment for the neck or low back that was originally pioneered by a medical doctor.  The idea with disc decompression is to create something called negative pressure, which will pull the herniated or bulged disc material back where it’s supposed to be.  Rather than spilling out (herniating or bulging out), it’s pulled back in. Click here to see a video of how our decompression therapy works.  You can read more about how it works at the decompression page of our website.

Unfortunately, your M.D. most likely knows nothing about non-surgical disc decompression therapy, unless he or she is very progressive. The most common conservative treatment that M.D.’s usually prescribe is physical therapy.  Physical Therapists are smart, well-trained individuals who endure a rigorous education.  Their goal is to reduce a patients pain and to return them to their normal activities as soon as possible. Physical therapists do great work, but for patients with disc problems, it can be putting the cart before the horse.  Getting a disc patient to actually strengthen and stabilize their muscles that surround their faulty, degenerative back is a great goal, but only once the patient has been through some rehabilitative therapy  specifically for the disc itself. Once the disc itself has been stabilized and healed, strengthening the surrounding muscles and tissues will add a significant amount of stability to the area, preventing re-injury.

Dr. Steven Atlas, a professor at Harvard Medical School who has studied the escalation in back surgery, says too many surgeons don’t take the time to urge conservative alternatives to back surgery. Fact is, he says, medical doctors make more money doing procedures than counseling caution.

The correct order of intervention should be conservative treatments first, medicines second, and surgery last (if nothing else has worked).  Click the following link to find out how our conservative, non-surgical spinal disc decompression therapy can benefit you.

PART II: THE MEDICAL PROFESSIONS OPTIONS FOR TREATING HERNIATED OR BULGED DISCS

By | Herniated or Bulged Discs

Medical intervention for herniated or bulged discs fall into one of 3 categories:

Medications, Epidural Injections, or Surgery

1)      Medications: Usually pain medication or anti-inflammatories are used.  The problem with these are that people end up using the meds long-term because once they stop using them, the symptoms come back.  All medications have side effects and the long-term usage of medications can severely affect such organs as kidneys, liver, and stomach (gastrointestinal bleeding). Common medicines that are used as anti-inflammatories are the non-steroidal anti-inflammatory drugs (NSAID’s) Ibuprofen, Naproxen, and Tylenol.  Steroidal medication for herniated disc pain is usually given as cortisone injections directly to an area that is painful. The idea with anti-inflammatory meds is that by reducing inflammation, pain may also be temporarily reduced.  The key word is temporarily, if you have any response to them at all (many people get no relief).  Pain meds are also a  “band-aid” approach to temporarily relieve pain.  None of the medications do anything to actually heal the damaged disc.

2)      Epidural injections:  This is a cortico-steroid anti-inflammatory medication that is injected into the epidural space, which is the space between the spinal bones and the spinal cord that’s inside of it.  The idea is to introduce the anti-inflammatory medication directly to the offending area to try to calm down the nerve tissue from being irritated.  The same problem exists, however, in that the pain will often return once the medication wears off. In other words, another temporary fix, if you get any pain relief at all (many people are non-responsive to epidural injections).

3)      Surgery:  All spinal surgeries use high-speed surgical drills that are heated with an electric current in order to cut through tissue and bone.  More recently, laser devices have been used to do the same thing.  Some of the most common spinal surgery classifications are as follows:

  • Discectomy is a partial removal of the offending disc gel material that has pushed out and is causing symptoms. You may see the term “micro-discectomy” being used, meaning a large microscope is used outside of the body in order for the surgeon to see more clearly where he or she is operating.  A lot of invasive opening, cutting, and drilling is used to access the area.
  • Laminectomy is where a part of the bone (called the lamina) is removed to allow for more space, so that the nerve tissue has less pressure on it.  Sometimes they’re called decompressive laminectomies.  A lot of invasive opening, cutting, and drilling is used to access the area.
  • Spinal fusion is where the surgeon fuses the area together with a bone graft or with hardware such as rods, screws, plates, and cages.  Fusion surgeries also will usually involve a discectomy, laminectomy or foraminotomy (to open the area called the neural foramen, which is where the nerve root exits from).  The idea of spinal fusion is to permanently join an area of the spine so that it can’t move anymore.  Even the medical literature is replete with research that shows that the areas above and below a fused area of the spine are much more likely to give you problems in the future.
  • Minimally invasive spine surgery The idea here is to make a smaller incision to supposedly decrease the amount of surgery or minimize the effects. However, just because the incision is smaller doesn’t negate the fact that they’re cutting deep into the surrounding tissues, drilling into bone, removing structures, and working in an area a fraction away from your nervous system.  It’s actually a traumatic access operation. This doesn’t sound “minimally invasive” to me! It’s the same as the other procedures, except it leaves a smaller scar on your skin.
  • Laser spine surgery is a spinal surgery using a surgical laser device (a focused beam of light).  The only difference is that a light beam is used for a very small part of the operation, not the whole operation. Laser surgery still involves surgery with drills to cut through muscle and the other tissue in order to gain access to the spine, then drilling through bone, and only then is the laser used to remove some of the soft tissue over the spine. It should also be noted that H. Gordon Deen, M.D., of the world renowned Mayo Clinic, states that “at the Mayo Clinic, we don’t use or recommend laser spine surgery.”

If none of the above procedures sounds appealing, try something safe, effective, and conservative first. In our office, we use something called non-surgical spinal disc decompression therapy, which is effective and non-invasive. Our spinal disc decompression therapy safely, without surgery, pulls the herniated or bulged gel back to where it’s supposed to be, allowing the torn disc to heal.

Is there a time and place for medications or surgical procedures for certain people’s back problems? Yes, absolutely.  But in the majority of cases, they’re not the first interventions that should be used.

As long as there are no contraindications for the decompression therapy you can also do a free trial, with no-obligation to continue, in order to feel how decompression works and whether it’s the right thing for you.  Click here to see a video of how it works.  You can read more about it at our decompression page of our website.  A simple consultation at our office can give you more information about your case.

PART I: WHAT IS A HERNIATED OR BULGED DISC? THE RELATED ANATOMY AND SYMPTOMS

By | Herniated or Bulged Discs

Our spine has 24 bones (vertebrae). All those bones, except for the very top two, are separated by cushiony pads called discs.  The discs keep the spinal bones linked together, while at the same time allowing your spine to have a great degree of movement. The disc is a soft tissue structure that can tear, just like when you sprain your ankle or pull a muscle.

The spinal disc has 2 basic parts: an inner gel-like fluid called the nucleus pulposus and an outer multi-layered lining called the annulus fibrosus.  The outer lining is extremely strong and contains the inner nucleus gel within the center of the disc.

There is a very intimate relationship between the disc and your nervous system (the spinal cord and the nerve roots); they are both directly next to each other.  Some of the things that can break a disc down are general wear and tear, being deconditioned and having weak core strength, being over-weight, or trauma.  When a disc tears, it is the outer annulus fibrosus lining that tears, allowing the inner gel to seep out, often putting pressure on the spinal cord or the nerve root(s).  This phenomenon, where the outer layer tears and the inner gel pushes out is referred to in many ways, including herniated disc, bulged disc, prolapsed disc, slipped disc, ruptured disc, disc protrusion, disc extrusion, HNP (herniated nucleus pulposus), canal stenosis or foraminal stenosis.

Symptoms from a torn disc in the neck (cervical spine) include:

  • neck pain
  • shoulder pain
  • pain or numbness/tingling anywhere in the arm or hand
  • weakness anywhere from the shoulder down
  • increased symptoms or discomfort when the neck is moved in certain directions
  • Clinically we refer to these symptoms as cervical radiculopathy or radiculitis, brachial radiculopathy or radiculitis, or brachial neuritis.

Symptoms from a torn disc in the low back (lumbar spine) include:

  • sciatica
  • a dull ache, burning, or pulsating pain in the leg, hip, or buttocks
  • numbness/tingling in the leg, hip, or buttocks
  • pain or numbness in the back of the calf or sole of the foot
  • a grip-like feeling at the bottom of the buttocks or in the hamstring
  • pain or inability when bending your body forwards (or sometimes backwards)
  • increased pain or inability when bending your leg up to put pants or shoes on
  • weakness anywhere in the leg or foot
  • Clinically we refer to these symptoms as sciatica (pain in the back of the leg), sciatic radiculopathy or neuritis, femoral neuropathy (pain in the front of the leg), or lumbar radiculitis or neuritis.

In our office, we use something called non-surgical spinal disc decompression therapy for the previously described disc conditions in both the neck or the low back.  Our disc therapy creates “negative pressure” that will bring the herniated or bulged fluid back in place, allowing the torn disc to heal (see the illustration below). Click this link to see a video of how our therapy works (click the play button once the video comes up).  You can read more about our effective, non-surgical disc treatment at the decompression page of our website.

Part II of this blog will discuss the medical treatments that are available for herniated or bulged discs. Part III will discuss some of the alternative or conservative treatments available for herniated or bulged discs.