“I have a slipped disc.”
Medical providers hear this all the time from people seeking relief from chronic back and/or neck pain, but this phrase has several things wrong with it. Firstly, an intervertebral disc (IVD) does not “slip”. The fibers that make up the disc and bind it to the vertebrae above and below are extremely tough and numerous, so the force needed to cause the disc itself to pull away from the bone and “slip” is extremely high. What most people refer to as a slipped disc is actually better referred to as a herniation, where part of the outer disc fibers bulge outward away from the rest of the disc. This can occur as a result of severe trauma such as a car accident or a falling injury, or simply as a result of aging.
There are four stages to disc herniation: degeneration, prolapse, extrusion, and sequestration. Degeneration is the most common, and occurs when the fibers of the disc bulge outward with little movement of the inner disc material, or nucleus, noted. Prolapse is when the disc fibers are pushed even further outward and weaken, allowing movement of the spongy nucleus into the herniated area. Extrusion is when the outer disc fibers become torn, allowing the nuclear material to become exposed. Sequestration is when the nuclear material of the disc breaks away from the disc itself, moving into the space behind the disc, above or below it. The first two stages are more commonly collectively referred to as “disc herniation”, while the last two stages are collectively referred to as “disc rupture”. The distinction is extremely important when figuring out options for treatment.
Contrary to popular belief, disc herniations rarely require surgery. There are a variety of non- or minimally invasive treatment options available to people with herniated discs, including but not limited to: chiropractic care, non-surgical spinal decompression, injection therapy, physical rehabilitation, stem cell therapy, and platelet rich plasma. The treatment is designed with two goals in mind: to reduce the degree of herniation in order to take the pressure off of sensitive nerve tissue, and to reduce or eliminate the secondary inflammation and tension in the surrounding support structures. When effective, this approach tends to have far better long-term results because it seeks to restore the position and integrity of the disc rather than simply dealing with the symptoms. Surgery for a disc herniation consists of either removing the bulging fibers or removing the entire disc itself and fusing the vertebrae together.Surgery for a herniated disc should only be employed once all other, more conservative treatment methods have been investigated. Even disc rupture, a far more unstable condition, does not necessarily require surgery. If there is no direct pressure on the surrounding nerve tissue, often times a disc rupture can be managed through controlling the secondary inflammation in the support structures and strengthening the core muscles surrounding the injured area to stabilize it. At Lowcountry Wellness Center, our experienced doctors will be sure to fully review and assess your specific condition in order to give you the most appropriate and best treatment options, so you can once again fully enjoy life. Call us at (843) 793-1353 to schedule your consultation appointment today!