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Disc Herniations 101

If I had a dollar for every time a patient said, "But Doc, all I was doing was bending over to tie my shoes and my back went out! How did this happen?", I would be rich! Let's explore!


But before we get started, don't forget that it is impossible for your disc to slip out of place :) if anyone tells you that, run!


Let's Go Over a Spinal Disc's Anatomy to Get Started:

You have 23 Spinal Discs throughout your spine. Herniations are one of the most common back injuries we see, and are a complex condition.


These are the 2 important parts to a disc:

  1. Nucleus Pulposus: The most innermost part of the disc. This is full of a gel-like elastic substance. This moves with you, provides shock absorption, and prevents bone on bone contact.

  2. Annulus Fibrosus: This is the structure that encases the nucleus. This part helps resist stress. This is made up of collagen and proteins that form rings around the area. Think about it like a cage that holds in your nucleus pulposus.

Your spinal discs have very low vasculature, meaning that there is not a great blood supply to the area. Which is one of the main reason they get injured and stay injured, because your body can't provide a great blood supply to heal it.


In addition to having low blood supply, the inner part, the nucleus, is not innervated, meaning that there are no pain receptors. However, the outer layer does.


Here is why you 'hurt your back bending over to tie your shoes': You have repeated microtraumas to the inner layer of the disc, that have been happening for months to years.. But remember, it is not innervated, so you can't feel it. You bend over to tie your shoe, and that is the 'final straw microtrauma', and your Annulus can't hold back the nucleus anymore. The nucleus spills out, and is now impacting the Annulus, which does have pain. I like to tell people, you've had 99 tears in your disc, but you couldn't feel it until the 100th one.


This why something as simple as bending over to tie your shoes can cause your back to feel like it went out, when in reality, it was months-years in the making.

As you can see in this picture, the nucleus is bulging out onto the annulus. This then puts pressure on the nerve, which is where your nerve radiating symptoms come from. The most common one we see is Sciatica, which is pressure on your Sciatic Nerve.


Sometimes it is multiple microtraumas that effect the disc, sometimes it is one big event, such as an accident, fall, squatting, etc. Regardless, we want to heal your disc! We do this through a combination of different therapies.


My (very basic) tips for preventing or helping disc herniations:

  1. Work with a professional! Find a chiropractor or physical therapist who can evaluate you and provide a unique care plan that fits your needs. They should be able to help find some contributing factors. Here at Woodland, we offer a decompression therapy: https://www.woodlandchirokc.com/spinal-decompression

  2. Strengthen your core, and I don't mean just your 6 pack abs. Learn to use your deep core muscles, strengthen your glutes, work your hip flexors, lengthen your hamstrings, etc. This helps take some 'pressure' off your spine and strengthens the areas around it.

  3. If you sit for your job, make it a habit to get up and move around every 30-60 minutes. Sitting puts more pressure on your discs than any other position. Set a timer on your computer, and do a 2 minute walk or stretch every half hour to an hour. Your body will thank you.

  4. If you work in a labor demanding job, look into how you can support it. Whether that is finding someone who can help you with proper technique, wearing a stabilizing belt, getting regular decompression treatments, just find something that can help you out.

  5. Take care of your body! Exercise regularly, quit smoking (which has a direct correlation with back pain), eat nutrient dense food, go for daily walks, because all of this will help reduce your inflammation.


Disc Herniations stink and are painful, but they can be healed. Contact us today if you would like to get started!

Komen


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