What is a herniated disc?
When a disc is herniated and symptomatic, it can be debilitating for the patient, affecting their quality of life, ability to work and causing both local pain in their back and shooting pain into their leg(s).
Disc herniations are when the gel-like middle of the disc gets pushed out through tears in the outer annular fibers either partially or completely. If the disc material is fully pushed out and is uncontained in the spinal canal, it is more likely to put pressure on adjacent nerve roots and create an inflammatory response, irritating the nerve roots and can cause the symptoms down the leg(s).
The onset of symptoms is usually back pain first. You may experience pain with sitting or bending, reduced motion, pain with coughing/straining and leg numbness, tingling, pain that develops days to weeks later. While sitting may be poorly tolerated, it’s possible that laying down may give some relief.
An in-depth look at disc herniations is available here: Disc Herniation: Risk Factors and Signs for Seeking Care
What to expect when you seek chiropractic treatment for a herniated disc?
A full evaluation will occur, with the chiropractor taking a full history and thorough physical exam. The physical examination will include testing reflexes, muscles and sense of touch for a full neurological assessment, as well as orthopedic tests.
This exam helps determine the appropriate treatment method, whether imaging is advisable (X-ray, MRI) and if a surgical consult is required. A rare, but potentially serious red flag is loss of bowel/bladder function and loss of sensation in the groin region. This could be a rare, but serious complication that would require immediate referral for surgery. Another reason why a full evaluation is so important in cases of back pain.
In most cases, a working diagnosis of lumbar disc herniation based on the results of the history and physical exam is sufficient to begin a trial of therapeutic conservative care without need for advanced imaging. Conservative care could include chiropractic manipulations, laser therapy, massage, soft tissue release (e.g. Active Release Techniques), and acupuncture.
What would treatment be like?
At first, finding a direction of motion that relieves symptoms is the first step in treatment. We are looking for a directional preference that relieves the leg symptoms in particular. This will direct home care exercises and chiropractic mobilization/manipulations in the initial phase of care. Tools to assist the patient with day-to-day activities to avoid pain while staying active are encouraged in this phase. The patient may find some immediate relief from pain with these strategies/techniques.
As the treatment program progresses, the focus will shift from the pain relief phase to the rehabilitation phase. The goal during this phase is to introduce functional movements in order to return the patients to their daily activities without limitations. The rehabilitation exercises have a particular focus on developing good core coordination and stability.
What should my expectations be of a full recovery?
Having a disc herniation is not an immediate cause for alarm. Conservative treatment is usually successful, with reports as high at 90% recovering without the need for surgery. Most patients see significant improvement within the first 10 days of treatment, particularly in the reduction of leg symptoms. Over half of patients recover within 3 months, however some patients may require longer. If surgical intervention is necessary, it also has good outcomes for patients’ recovery.
With proper treatment full recovery from this condition is expected, however, recurrence is possible. Education on lifting techniques, hip hinging and other biomechanical techniques are a great way of minimizing the wear and tear on your spine that may lead to disc herniation recurrences.
Since 9 out of 10 patients with herniated discs can heal through conservative care, contacting a chiropractor is an excellent place to start your road to recovery.
To book a chiropractic appointment with Dr. Kathryn Baker click here or email us at info@evolvevancouver.ca.
Please note that any advice in this article doesn’t replace personalized medical advice from a professional.