Disc Problems & Back Surgery

 

At this very moment people are lying in bed in agony from disc pain. Is surgery their only option? Can chiropractic help?

 

What Is The Intervertebral Disc?

The intervertebral discs lie between the spinal bones and act like shock absorbers, preventing the bones from painfully rubbing together. They are made up of a tough fibrous outer ring (annular fibrosis) and a gel-like center (nucleus pulposus).

Your 23 spinal discs help give your spine its sideways curves (a curved spine is sixteen times stronger than a straight one) and also join the vertebrae together. Discs contribute to your height, in the morning you are about 1/4-1/2" taller than you were the night before because your discs thin a little during the day and expand a little while you sleep.

 

The Cause Of Spine Pain

Today many researchers believe that the disc is one of the most common sources of lower back pain. (1,2)

 

Disc Protrusion & Prolapse    
 
Surprisingly, the disc may start showing signs of wear and tear as early as age 15.(3) As you age, the disc may lose fluid and small cracks (lesions) form in the outer walls. This aging may be accelerated by the vertebral subluxation complex, a spinal distortion chiropractors correct. If the nucleus pulposus begins to push the annular fibrosis a little out of shape, it's called a herniation. If the herniation causes the disc to bulge a little, it's called a protrusion. If the disc bulge goes into the spinal cord or puts extreme pressure on the lumbar nerves, it is a disc prolapse. A prolapse may cause such severe pain that sitting, standing, walking or lifting could be impossible. Other symptoms can include pain when urinating, defecating, sneezing and coughing; numbness of the leg or foot or a loss of muscular control may also occur.  
   
 

 

Slipped Disc

"Slipped disc" is a misnomer - the disc cannot slip since it is knitted into the vertebrae from both above and below. What sometimes slip are the vertebrae, which may put pressure on the disc and contribute to its damage. Many "slipped discs" would be more accurately called slipped vertebrae.

Regular x-rays cannot see a disc. Today magnetic resonance imaging (MRI) and CT scans are the best way to look for disc problems. They are revealing the complexities of spinal pain.  Those with much pain have shown no disc problems while people with no pain may reveal massive herniation. (4)

 

 

Organic Disc

Disc degeneration may damage spinal nerves and contribute to conditions in the pelvic area. Among these are endometriosis, infections (bladder, vaginal, kidney), urinary retention, prostate problems, miscarriage, sterility, sexual impotence, cystitis, menstrual cramps and constipation. It is not uncommon for an individual who has a chronic back problem to suffer from one or more of the above problems as well.

 

The Medical Approach

The medical approach to disc problems is often a combination of painkillers, muscle relaxers and physical therapy, which may involve hot or cold packs, baths, traction, electrical stimulation and surgery.

 

Nobody should be allowed to have back surgery unless they have seen a chiropractor first.  
  Dr. Robert Mendelsohn M.D.

 

Is Back Surgery Effective?

 

Dr. Mendelsohn's remark has been underlined by reports from many medical doctors and others who find that many patients who decide to pursue a non-operative approach towards disc herniation may not need the surgery.(5) Back surgery, usually performed by an orthopedic surgeon, is at times warranted. We must mention here, however that cauda equina syndrome, which includes buttock numbness, leg weakness and bladder and bowel dysfunction is considered by many to be the only absolute indication for surgery.  

 

Surgery can be highly effective in some patients who suffer from sciatica or low back pain but results can vary widely. This approach is controversial with some individuals claiming that relief following back surgery is often short-lived and that after about six months to one year many of the spinal problems recur.(6) Back surgery has a high failure rate and there is much controversy in this area. America has a very high back surgery rate and many wonder if it's due to too many surgeons, not because Americans have more spinal problems. Many people who have had spinal surgery claim that within one year after surgery their symptoms are no different than before they had the surgery.(7-8)

Sadly, however the number of spinal surgeries is increasing much faster than the population.(9) One observer explained this increase in purely monetary terms: "Surgery rates are influenced by the ratio of surgeons to population."(10)

 

Failed Back Surgery

Back surgery for herniation should only be attempted as a last resort. That is because back surgery is a dangerous procedure with a high failure rate. The failure of back surgery is so common that those suffering from it have Failed Back Surgery Syndrome. About 600,000 back surgeries are performed per year with an average failure rate of 53%.

 

The Chiropractic Record  
A proper alignment between the disc, the vertebrae and other structures in the spine is essential for healthy discs and that is why chiropractic has such an excellent record with disc sufferers, often saving them from the bleak prospect of surgery. Chiropractors have claimed reduction of lumbar disc protrusion as a result of spinal care.

 

How To Prevent Disc Problems

Chiropractic spinal care may help prevent your spine from deterioration and your discs from herniation. Can chiropractic help even if you've already had surgery? Yes! Chiropractors can often help relieve the pain and frustration of failed back surgery and may help prevent future operations. Please, before your spine gets worse, have a chiropractic spinal checkup.

 

References

 

 

    1. Bogduk, N. & Aprill, C. On the nature of neck pain, discography and cervical sygapophyseal joint blocks. Pain, 1993, 54, pp. 213-217.
       
    2. Kuslich, S. et al. The tissue origin of low back pain and sciatica: A report of pain response to tissue stimulation during operations on the lumbar spine. Orthopedic Clinics of North America, 1991, 22.(2), pp. 181-187.
       
    3. 'Direk, S. Orthopedics: Principles and their application, 27, p. 748.
       
    4. Quon,J.A., Cassidy,J.D., O'Connos S.M., & Kirkaldy-Willis, W.H. Lumbar intervertebral disc herniation: Treatment by rotational manipulation. JMPT, 1989,11, pp. 220-227.
       
    5. Saal, J. & Saal, J. Non-operative treatment of herniated lumbar interver-tebral disc with radiculopathy: An outcome study. Spine, 1989, 14(4).
       
    6. Hakeluis, A. Prognosis in sciatica. Acta Orthop Scand (Suppl), 128.
       
    7. Salenius, P. & Laurent, L.E. Results of operative treatment of lumbar disc herniation. Octa-Orthop Scand, 1977, iS, pp. 630-634.
       
    8. Dommisse, G.E & Grahe, R.P The failure of surgery for lumbar disc disorders. Disorder of the lumbar spine. Lippincott, 1978.
       
    9. Davis, H. Increasing rates of cervical and lumbar spine surgery in the United States, 1979-1990. Spine, 1994, 1,9(10), pp. 1117-1124.
       
    10. Wennberg, J. & Gittelsohn, A. Variations in medical care among small areas. Scientific American, 1982, 246(4), pp. 120-134.