Disc Injuries & Pathology: the Worst of the Spine by Dr. Arlo Gordin

Next to the words “profound unhappiness” in the dictionary, there is a picture of a person with a disc problem.  That problem is either a disc bulge or a disc protrusion (herniation).  This man or woman suffers from pain often so severe that happiness has been tossed into the dumpster of life.  For some, the pain may come and go, but for many it never goes.  Disc-injured patients seem the most likely to just want to shoot themselves: anything to get rid of the pain.  For this reason, they are a common patient to be prescribed and then addicted to opioid pain-killer drugs.

 

A disc, one of the spacers between the vertebrae of your spine, is made up of fiber material surrounding a gel interior.  If you tear the fibers that hold the jelly inside, then the thick gel will be squeezed out of the disc.  Usually that gel lands on a nerve from the spine, crushing the nerve, or it can compress the spinal cord (the large nerve cable that runs inside your spine).  In either case, pinching or compressing nerves typically means misery. Disc injuries, luckily, are much less common than simple malpositioned vertebrae that pinch nerves.  Nonetheless they are common enough that I diagnose and treat them every week.  The test that shows discs and if they have damage is the MRI (Magnetic Resonance Image).  X -ays show the bones very well, but they show only the spaces where the discs exist.  The MRI will show the actual “soft-tissue” discs and how they are healthy or damaged.

 

When a disc is torn, and the gel squeezed out, that is called a "protrusion", a "ruptured" or "herniated" disc.  The types and location of pain together with hands-on tests performed by an experienced doctor can point to the probability of a disc herniation.  The one test that truly can tell if disc problems exist or not is the M.R.I. (Magnetic Resonance Image). This high-tech testing procedure shows the “soft tissues” of the body, which include the discs. X-rays show only the bones and thus display visibly the spaces between vertebrae where the discs live.   The discs themselves are invisible on x-ray. One item of good news these days is that I have negotiated low prices to get MRI’s done, whereas years ago they were very expensive.  They still can be if you or your insurance is paying “retail” for an MRI.

 

Your M.R.I. of your spine will show if a disc is normal or not.  When abnormal, it can be“bulging” (just worn and smooshed out of shape), and can be milder pain or symptoms than a protrusion. Or it can be "protruded" ("herniated"). It also shows how big a bulge or herniation is and where the nerves are pinched.  Smaller bulges may not cause much pain.  Bigger ones can often be worse.  Similarly smaller herniations can be much less painful, large ones can be more miserable.  But there are many cases where a small disc pathology can feel terrible and a larger one less.  It really depends on the individual way that each disc lands on and pinches the nerve elements.

 

Disc Injuries used to be associated with lifting and traumatic injuries.  But now we see them commonly in people who sit all day:  at desks, in front of computers, etc. 

 

Since you have two dozen discs, the one that is injured will determine which nerves are pinched and affected, and thus also determine what part of the body hurts.  A disc can be ruptured in the low back, neck, or mid-back.  Pain, frequently radiating into the legs or arms, numbness or “pins and needles”, and/or weakness will often result.

 

The low-back (lumbar) discs are the most frequently injured (and a common worker’s compensation injury from lifting or other work-related injury). The most commonly damaged are the two at the very bottom of the spine, which typically pinch the nerves to the low-back and legs.  When the nerve that shoots down the back of the leg is pinched off, the condition is called “sciatica” named for the “sciatic nerve” that travels down the back of the leg.  Sciatic pain can stop at the butt, or go anywhere down the leg to the foot and toes.  As a rule, the farther down it goes, the more severe the nerve problem is. 

 

Low-back disc injuries, because of the nerves that get hurt, can also cause elimination problems, bladder problems, and sexual or female dysfunctions as well.  When they cause severe pain or even unrelenting nagging ache in the back, legs or groin, a life takes a major change in course.  Unable to be active, pursue athletics, lift, bend, have sex, or even stand comfortably, the individual frequently finds true misery.

 

Low back pinched nerve problems that come from discs will show weaknesses in muscles of the hip at the front, and hamstring (thigh) or gluteus (butt) muscles at the back.  The more of the 4 front and 4 back main muscle tests of the legs that show as quite weak and unable to work with force, the worse the nerve compression is that causes those weaknesses.  That is often our greatest “clue” that a disc is damaged in the low back.

 

Injured neck discs can occur in car accidents or other injuries to the neck. When a cervical (neck area) disc is herniated, it will often cause severe pain.  Frequently the nerve problems affect the hand, arm or shoulder.  Pain, numbness, tingling or weaknesses are the usual symptoms.  We have many brilliant results in cases where neck discs had ruined a person’s life, happiness and career.

 

Drugs, painkillers, anti-inflammatories, back braces, bed rest, and injections can typically be tried, often failing.  Orthopedic or neurosurgeons have a mainstay of their business in back surgeries for discs.  However, the outcomes can be poor overall.  Over half of the patients after surgery are as bad or worse than before, according to extensive scientific studies.  And since this is a major surgery, it generally is accepted, by even surgeons themselves, that it is the last resort. Surgery is considered only after “non-invasive” measures were first employed, and found to not succeed.  But what are the most effective non-invasive ways to help?

 

How to save the life of a poor miserable disc-injured patient?  There is a way.  At my clinic I have the most advanced chiropractic, medical, therapeutic and nutritional methods of achieving a pain-free active existence again.  Our uniquely effective “proprioceptive chiropractic technique”* and the use of low back blocks bring often miraculous results to disc patients.  Nutrition to speed healing of damaged tissues, and to naturally reduce inflammation and pain is an invaluable addition to the line-up of procedures.

 

I could relate hundreds of amazing accounts of patients returned to vigorous activities, when just prior it was a major effort to get up from a chair!  Patients, who couldn’t function or even stand up straight, returned to running and playing golf.  Musicians who couldn’t play their instruments or make a living, back into their art and life.  The techniques that our office has for the disc patient frequently bring quite  rapid reduction of pain and restoration of mobility and function.  We achieve this, even though disc injuries are frequently acknowledged to be amongst the most difficult. 

 

And all the techniques used in our facility are safe, designed to be absolutely non-traumatic and without risk to disc sufferers.

 

If you have suffered a disc injury, you owe yourself the opportunity to experience freedom from pain and symptoms naturally without side-effects and risk of surgical error or ill-effect, and find your return to smiling again.