(KEYWORDS: slipped disk, chiropractic help, arm pain, ATHEROSCLEROSIS SYMPTOMS Low Back Pain )
The intervertebral disc - the material that lies between each adjacent pair of bones in the spinal column - bulges and herniates quite commonly. Few of us escape occasional epidsodes. Mostly pain in the low back only, with the possibility of radiating down the leg, very rarely in the midback, but also quite commonly in the lower neck, with the possibility of pain and tingling in the arm.
The spinal column is made up of 26 vertebrae that are strongly joined together with ligaments to permit forward and backward bending, side bending, and rotation of the spine.
The facet joint, situated immediately behind the nerve root, helps to control and limit these movements.
Each disc is composed of two parts: a gelatinous material not unlike egg-white called the nucleus pulposus, surrounded by rings of a fibrous tissue called the annulus fibrosus.
That gel can bulge and herniate through the surrounding rings. The further it progresses, the more the pain in the leg.
This is typically how it may begin, particularly if you twist and lift, or sneeze at the same time.
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From the Coal Face
'I don't need to ask what's wrong with you, Mr Jones. But tell me how it happened, and when.'
The tall angular man looked like the leaning tower of Pisa. He stood with an acute angled posture, yet declined to sit. Instead he perched on the edge of the desk.
'Six months ago, and gave a hard tug on the sheet on my boat, and felt a sharp stab of pain in my back.'
'My doctor said I had sprained my sacroiliac joint. I had some pills, some physiotherapy, and then after a sneeze it started down my leg.'
We eventually won with Mr Jones' back, but I won't pretend it was easy. It wasn't. It all starts with the right diagnosis. His doctor I'm sure would be streets ahead of most chiropractors in diagnosing pain in the abdomen, but in the back he was out of his depth.
Pain with coughing, sneezing, or straining on the toilet is a
sure sign that you need to be careful. It could be a slipped disk in the
Anything important you would like your chiropractor to know? Six golden rules for chiropractors
In the neck a slipped disk causes a deap-seated ache in the arm. It can be the most dreadful pain, often worse at night, and the only escape may be putting your hand on your head. Read more about arm pain …
In a slipped disk the inner bubble of gel, the nucleus pulposus, herniates or slips through the surrounding annulus fibrosus towards the spinal canal. Initially it causes no frank pressure on the nerve root, but it releases noxious chemicals that may inflame the nerve.
Sudden wrong movements, sneezes, heavy lifting, or just prolonged sitting may cause further bulging, placing pressure on a spinal nerve; with the begin of ominous tingling and or pain in the leg or arm. Further pressure causes more severe pain in the limb and ultimately damage to the nerve.
First the limb becomes more sensitive to pinprick, and
thereafter numb. Then weakness in the leg may start to develop.
Feeling the pinch? Not in your back, but your back pocket? Don't feel all alone. Research proves that low back pain costs the public, insurance companies and the governments billions of dollars.
Strong research by workman's compensation proves that chiropractic help is more effective, far cheaper, and gets patients back to work much sooner. Read more at lower back pain.
Cervical and Lumbar spine
Slipped disk most commonly affects the low back and neck. Prolonged exposure to a bent-forward work posture is correlated with an increased incidence of disc herniation.
This condition is also commonly called a
A sequestrated disc has burst completely beyond the confines of the outer fibres, characterised by severe leg pain, and little back pain. Surprisingly, it too may respond to chiropractic, but if it affects your bladder, you must see a surgeon immediately. IMMEDIATELY. If you cannot void your bladder, it can cause serious harm.
SMOKING AND CHOLESTEROL
You may think it very difficult to quit or change your diet, but current research shows that smoking and raised serum cholesterol are highly related to Low back pain. Why? ATHEROSCLEROSIS SYMPTOMS Low Back Pain ...
THERE ARE FOUR LEVELS OF SLIPPED DISC
For some interesting cases of low back pain (and other) from the Chiropractic Coalface, click here. CHIROPRACTIC COALFACE ...
SYMPTOMS AND SIGNS
Grade 2-4 disc herniations cause pain (or possibly only tingling) that radiates below the knee. The pain is usually aggravated by
Antalgia = Ant-algia = away/ towards the pain
The word "antalgia" means leaning to the side to relieve the pain. It is a reflex action that you cannot control, a temporary posture that the body takes to relieve the pressure on the nerve root. It's a very serious sign, often the prelude to a nasty sciatica if not taken seriously.
Antalgias come in two main types:
The pain of a slipped disk is usually relieved by
Numbness when rubbing the leg, or pricking yourself with a pin is a sure sign of an irritated nerve. In the early stages the skin may be MORE sensitive.
Buckling of the knee, or the inability to stand on the toes or heel is an ominous sign.
Typically, if it's a low lumbar disc, straightening the knee whilst sitting will cause pain in the back and leg.
Low backache is extremely prevalent, and is the second most common reason for the people to seek medical attention. Not all obviously are slipped disks. Low back pain accounts for approximately 15% of the sick leave in First World countries, and is the most common cause of disability in persons less than 45 years of age.
Every year 5% of the population will have a slipped disc. Mostly the prognosis for a grade 1 protrusion is good, and improvement often occurs with little or no intervention.
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However, if it lasts longer than 12 weeks, some authorities say 6 months, we call it chronic, and the chances of progression with leg pain is now much greater.
While it is not recommended that every sore back needs to go to the doctor or chiropractor, pain which does not improve within a few weeks certainly demands an assessment by your chiropractor.
The causes of slipped disk?
Mechanical low backache or musculoskeletal backache as it is called, is the most common form of back pain. This may result from strain of the muscles or the ligaments in the back or sacro-iliac joints.
Only 1 to 3% of the patients with low back ache will have a slipped disk causing frank compression of the nerve root; grades 3 or 4.
Sciatica is the pain due to the irritation of the sciatic nerve root, a nerve which supplies the lower limb, due to lumbar disc prolapse. (There are other causes, such as Piriformis syndrome). Sciatic pain is usually present in the low back and buttock and goes down the thigh and ultimately to the foot.
Several studies have shown that smokers are more prone to get back pain, sciatica and spinal degenerative changes. Smoking also delays bone and disk healing, increasing the chance of surgical failure. Failed Back Syndrome is a reality.
* Your age
* Any history of cancer (like prostate or breast carcinoma).
* Have you lost weight?
* Long term use any steroidal drugs or drugs for AIDS.
* How long has your back been sore?
* Any pain or worsening of pain whilst at rest?
* Drug abuse including smoking.
* Do you have a numb or weak feeling in the leg/s?
* Had a bad fall that injured your back? Fractures? On the ice?
* Difficulty in passing urine
* Previous failed treatment for backache.
* Depression can also be a factor, undermining all your health.
What tests are recommended?
For over 90% of the patients with back pain, no further testing is necessary beyond X-rays in the first month. Otherwise one must proceed with investigations like CT, MRI and bone scan for the back if there is no good response to treatment, or if leg pain is developing. These tests will reveal if there are bony abnormalities, a slipped disk or a spinal tumour.
What are the treatments available?
Low back pain should always be managed conservatively in the initial weeks, unless there is loss of bladder control, or weight loss, or fever.
Non-surgical treatment of slipped disk includes:
Different chiropractors favour differing treatments depending on the seriousness of the condition.
At this link you can read how diabetes and joint problems like slipped disk are effected by smoking. Read more about SmokingAndDiabetes …
In the United States each year, 1.5 million people have lumbar MRI scans to look for the cause of the buttock and leg pain called 'sciatica'. More than 1.2 million of those scans fail to find the cause in the spine. Three hundred thousand of the scans are sufficiently positive that the patient has lumbar spine surgery. Of the 300,000 surgeries for slipped disk, as many as 25% fail to relieve the pain - in many cases this is because the diagnosis of a spinal cause for the sciatica was incorrect.
There are many other causes of sciatica. For example,
Financial burden of Low back pain
Back pain is providing modern society with a huge financial
challenge. Despite huge jumps in technology, the economic burden to both
individuals and society is soaring. For more interesting facts and
click here. LOW BACK PAIN ...
For more information on the dangers of anaesthetics follow this link. ANAESTHETIC ALZHEIMERS ...
More links about SLIPPED DISK and pain in your leg.
Slipped disk in the neck
This page has concentrated on the slipped disk in the lumbar spine.
In the neck, many of the features are similar, only the pain in the arm,
a very deep seated ache, can be even worse than a sciatica.
Read more: ARM PAIN ...
Return from SLIPPED DISK to SLIPPED DISC SYMPTOMS Case File …
Go from SLIPPED DISK to CHIROPRACTIC HELP home page …
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Interesting challenges of the day
1. Mr B has the trophy for the most acute neck in February. He has quite advanced lower neck arthritis for a forty year old, thanks to a severe fall on the head from a trampoline. But this is upper cervical pain. Right rotation is simply impossible. Luckily he is improving rapidly, eighty percent better he says after three treatments. See cervical facet syndrome.
2. Mrs C is a new patient with a long history of lower back pain, hip pain and pain in both feet. We'll see how we get on, Rome wasn't built in a day.
3. Miss U sprained her ankle two months ago, wearing high heels. She still has severe mid foot pain. Xrays and perhaps a CT scan.
4. Mr V is 86 years old and hurt his back helping his wife into the car. Just one treatment of the sacroiliac joint and he's eighty percent better. It's not always like that.
5. Mr W lay on his back knocking down a pillar. Turning his head causes severe vertigo. He needs the Epley exercises, not pills, research shows. Update, he's fine.
6. Mrs X, a young mother has severe lower back pain, with numbness down the posterior thigh, calf and side of foot. It started after a long drive in the car. Update, she's forty percent less painful after four treatments, but the leg is still numb. Update two; she 60% better, but it's slow and is going to take the full 6 weeks to heal. Further update; a setback, after lifting her child she now has leg pain. It's going to the be difficult.
7. Mrs Y, a 70 year old woman is on maintenance care fo a nasty lumbar stenosis despite having to do everything at home. Her husband has a hospital acquired infection in the shoulder. After 4 operations he is incapacitated and going rapidly down hill.
8. Mrs Z, an 78 year old woman is doing remarkably well with a bad sciatica. But at over 200 lbs she is not losing weight, in fact gaining despite my suggestions. She's high risk for a stroke. Referral to a dietician to crack the whip.
9. Mr A, a 73 year old engineer, still working, is doing fine after a long episode of lower back pain. Some pain on the side of the hip remains after five treatments. Reassured him it's not hip arthritis.
10. Mrs B, a 64 year old woman has had Scheuermanns disease; it's left with a spinal kyphosis and chronic middorsal pain. She responds well to chiropractic treatment, provides she come every six weeks or so for treatment.
11. Mr C, a young engineer fell off his mountain bike injuring his cervical spine and pelvis. Luckily both responded very quickly to a few chiropractic adjustments. Update: his neck is sore again. It all goes back to a whiplash injury ten years ago when he was rammed by a fully laden truck carrying a load of stone. Time for Xrays.
12. Mrs D, a middle aged woman with hip pain of one year duration, despite other treatment. Xrays reveal an impingement syndrome and early hip arthritis. There's much to be done.
13. Both Mrs E and I can't believe how much better her lower back and leg pain are. Surgery for a scoliosis and spondylolysthesis three years ago helped greatly for one year. But then her leg went lame and weak. He was responded extremely well despite all expectations.
And so the day goes. Chiropractors shouldn't be treating the elderly? Bunkum.
Have a problem that's not getting better? Looking for a different slant on your pain? Want to pose a question?
Greetings, Dr B.
You helped me quite some time back with a soothing and professional
response which turned out to be exactly correct. I now consult a local chiropractor.
You write a superb newsletter, too.
Your own unresolved problem. Pose a question
Knowing that up to 70% of the time the correct diagnosis is made with no examination, no special tests, no xrays, but just from the history, there's a fair chance I can add some insight to your unresolved problem. But at least 30% of the time, I may be quite wrong! Give plenty of detail if you want a sensible reply.
You visited this chiropractic help site no doubt because you have a problem that is not resolving and want to know more about what chiropractors do.
The quickest and most interesting way is to read one of my ebooks of anecdotes. Described by a reader as gems, both funny and healthful, from the life and work of a chiropractor, you'll love them. Priced right at $2.99, though Kindle fiddles the price without telling me.