Perhaps the most common type of herniated disc or disc bulge is at the C5/C6 level in the cervical spine (neck) and the L4/L5 /S1 level in the lumbar spine (low back). What’s even more interesting is that research has shown that in some cases more then 50% of asymptomatic people (those with no pain or symptoms) have disc bulge or disc herniations on MRI studies. Whether or not pain is present is a matter of a number of other factors that determine the ‘functional’ capacity of the individuals spine.
If you’re suffering with a herniated disc or disc bulge at the C5/C6 level in the cervical spine or L4/L5/S1 spinal disc herniation in the lumbar spine and are in pain then a number of other factors are most likely contributing to this dysfunction.
A spinal disc functions primarily as a shock absorber and a fulcrum for movement within the spine. The disc is often compared to a jelly doughnut in that it has a central portion that is gelatinous in nature known as the nucleus pulposus and an outer ‘doughnut’ portion that is made up of fibrocartilage and known as the annulous fibrosis. As the spine flexes forward and back the jelly portion acts as a fulcrum and moves in the opposite direction of movement. If the forces applied to the spine are not handled and distributed properly a pathological bio-mechanical movement pattern results and leads to repetitive stress that can eventually damage the annular fibers.
Once this occurs, even without the presence of a sever bulge or herniation, this jelly material can begin to ‘leak’ out of the disc and cause irritation and inflammation of spinal nerves, muscles and other soft tissues. In most cases, this can present as simple back ache, low back pain or the occasional episode of ‘throwing my back out’ which is so common place.
The functional changes that occur can in many cases be rehabilitated successfully without necessarily changing the structure of the disc. Rehabiliation of the neuromuscular system that governs movement can often eliminate or reduce the symptoms completely. Of course, each person is different, and in some cases this is not true.
In my experience, a large majority of patient presenting with simple back pain have some degree of disc derrangement but don’t always present clinically with ‘discogenic’ pain (pain originating from a spinal disc). However, properly addressing all aspect and even suspected involvement of herniated disc and back pain will yield a better clinical outcome and also serve as a protective measure in preventing future injury or relapse.
Unfortunately, most people suffering with disc herniation will likely relapse at some point due to the nature of the injury. Just as a car continues to wear down as you put more miles on it the body is no different. I encourage patients to always continue to use there body and participate in the things they enjoy because of this. This doesn’t mean you should not eliminate certain aggravating factors or limit movement that may be a direct cause or contributor to injury.
If you’re in the NYC area or surrounding areas of Manhattan and are interested in a progressive and comprehensive non-surgical approach to herniated disc repair and rehabilitation I invite you to learn more about our approach.
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