Disc Protrusion And Prolapse

The disc is the part of the spine that has been the focus of attention over the past few years.  We have heard the term “slipped disc”, “ruptured disc” and “herniated disc” but most people are unclear about what these terms mean.

The disc is a structure located between the spinal bones, or vertebrae, and is called the intervertebral disc.   It is made up of a tough fibrous outer ring, annular fibrosis, and a gel like center, nucleus pulpous.  It separates the vertebrae and serves as a shock absorber between the bones.  It joins the vertebra together and gives the spine its cured appearance.  There are 23 discs in the spinal column, and these discs lose fluid during the daily activities of living, making us shorter by approximately one half to one-quarter inch by the end of the day.

The discs start to show wear and tear by as early as age 15.  Over the years small lesions begin to appear on the outer walls due to fluid loss.  The nucleus pulpous buldge and push the annular fibrosis out of shape.  This protrusion may become so prevalent that the disc may prolapse and separate.  This is the cause of severe pain when sitting, standing, walking and makes moving painful and extremely difficult.  In some cases numbness and loss of muscular control are the result.

Discs, contrary to popular belief, do not slip as they are knitted to the vertebrae.  It is in fact the vertebrae that sometimes slip and put pressure on the disc causing pain.

Organic Disease

Lumbar and sacral nerves are usually damaged by disc degeneration, causing pelvic disorders such as endometriosis, prostate problems, miscarriage, sterility, sexual impotence, urinary problems, cystitis, menstrual cramps and constipation.

The Medical Approach

Medical treatment for disc degeneration usually focuses on a combination of pain killers, muscle relaxers, physical therapy and some exercise.  A myelogram is sometimes performed to identify disc problems, injecting a dye into the spinal cord and running x-ray series to track the dye’s path to restricted areas.  The problem with this type of diagnostic testing is that there is a 30-40% margin of error. 

Spinal Surgery

If medical treatment fails a laminectomy, back surgery, is performed by an orthopedic surgeon.  This involves the removal of the back of the vertebra and scraping the disc.  Once the disc is gone the vertebra may fuse together.  Symptomatic pain usually returns after about six months, and there is no difference in the pain level when compared to the pain prior to the surgery.  A study showed that approximately 56% of back surgery candidates had the same low back and leg pain as they did prior to the surgery.  Because of these alarming statistics failed back surgery has earned the clinical term “failed back surgery syndrome”.  Of the 600,000 back surgeries performed each year, 50% show a failure.

The Chiropractic Approach

Chiropractic has excellent statistics in saving disc pain sufferers from the bleak prospect of surgery.  It has even been an effective care for those who have gone through failed back surgery.  One study tracked 1,536 lumbar spinal patients, and revealed a 96.4% success rate with surgery resorted to in only 3.4% of the patients.  Even if surgery has been done, and has permanently altered the spinal column, it is never too late for chiropractic care.  It can alleviate the chronic pain and prevent the need for additional surgery.