How Serious is a Herniated Disc?

Between each pair of spinal vertebrae is a spinal disc, a flexible cushion that is filled with a gelatinous substance. Injury or weakness may cause the jelly-like substance inside to bulge or herniate through the outer wall into the spinal canal, putting pressure on the spinal nerve.  This can occur as a result of trauma, hereditary factors, lack of proper exercise, obesity, or just as part of the aging process.
 

Over the years the spinal discs degenerate as they wear down from use.  This may be accelerated by degenerative disc disease, trauma, hereditary factors, sports or physical labor or lack of proper exercise.
 

 In degeneration, the outer wall of the disc is not compromised and the contents are intact. 
 

Herniated discs vary according to their symptoms, but most progress through four stages over time before reaching complete herniation.   The seriousness of your condition and the care required depends on the stage of herniation.

What Are the Stages of a Herniated Disc?

Stage 1: Degeneration 

This is the mildest form, at this stage, there is not an actual herniation, but the disc has become weakened and there is enough pressure to produce some pain and numbness.
 

Stage 2: Prolapse 

At this stage the inner gelatinous contents of the disc are pushing with force on the outer wall, causing an obvious bulge, but not tearing through the wall. As this bulge exerts on the nerve(s), it will cause pain, tingling and numbness.
 

Stage 3: Extrusion. 

The inner gelatinous fluid inside the disc begins to break through the disc’s outer wall.  There is an actual tear in the outer wall at this point, but not all the way through the wall.  The inner contents remain contained inside the disc walls, but the bulge is more pronounced.

This herniation will compress the nearby nerves causing painful symptoms.

Stage 4: Sequestration. 

The gelatinous inner substance has escaped through the outer wall and broken off into pieces. 
 

The disc has now ruptured, causing the inner substance to spill out from the disc center.  The fluid may begin to drip out of the disc in pieces, which will interfere with the nerves and other structures around the spine.  Symptoms, especially pain, at this point may be severe due to extreme inflammation of the related nerves.

This is considered a complete herniation.
 

Where Can I Get a Disc Herniation?

Herniated discs can occur anywhere between the pairs of 33 spinal vertebrae in your spine.

The area in which your symptoms occur will differ depending on the region of the herniation.
 

• Cervical – There are 7 cervical vertebrae extending down from the base of the skull.  A herniation in the cervical region may cause headaches, neck pain and numbness through the neck, shoulders, arms and hands.

  • Headaches.

  • Pain between the shoulder blades.

  • Radiant pain, tingling, or numbness down the arms and into the hands and fingers.

  • Muscle spasms in the neck and shoulders.

  • Difficulty using hands and fingers to grasp or pick up objects.

  • Loss of balance.

Thoracic – There are 12 thoracic vertebrae extending down from the lowest cervical verterbrae.  Thoracic herniations do not occur often.  Their symptoms include:

• • Radiant pain or numbness from the back of the rib cage to the front of the chest.

  • Pain in the back between the shoulder blades.

  • Lack of balance that may result in falling.

  • Weakness or stiffness in the legs.

  • Pain or numbness down the arms and into the hands.

  • A herniated disc in this region can cause cauda equina syndrome, which requires immediate medical attention.

  • Pain in the middle back.

Lumbar –  There are 5 lumbar vertebrae in the low back.  A herniation in the lumbar region may cause pain in the buttocks, tailbone, thighs, legs and feet (sciatic pain).

• Pain and difficulty getting into or out of a sitting position.

• Pain and difficulty lying down or sleeping.

• Increased pain with prolonged time in any one position (sitting or standing).

• Increased pain sitting in a car, a recliner, or a couch (these give no support and allow the disc to protrude out the back).

• Muscle spasms in the lower back.

• Pain in the middle of the buttocks and/or radiating pain, numbness or tingling down the legs and into the feet (sciatica)

• Difficulty walking due to muscle weakness.

• Reduced reflexes in the ankles or knees.

• Pain in the tailbone.

Coccyx – Although there are discs between the 2-3 coccyx vertebrae, a herniation in this region is extremely rare.  Most disc herniation-related pain in this region is caused by lumbar disc herniations.

What is the Recommended Treatment for a Herniated Disc?

For stages 1-3, conservative, non-surgical treatment is the preferred treatment.
 

When a disc is compromised, the adjacent spinal vertebra will rotate or twist out of their proper position, compressing nerves and causing pain and inflammation.
 

Physical therapy may be helpful in restoring muscles, but physical therapists are not skilled or licensed to move the vertebrae back into their proper position.
 

Chiropractors are skilled in adjusting the spinal vertebrae back into their proper position, relieving the pressure on the nerves and thereby reducing the pain caused by herniated discs. This also allows the muscles to gain balance and strength again.
 

It will take a sequence of adjustments over some time for the vertebrae to stabilize back into their proper place.  Chiropractors may also recommend specific exercises and stretches to strengthen the muscles and help restore proper spinal structure and function.

Stage 2 and 3 cervical and lumbar herniations often benefit from spinal decompression therapy, which helps relieve pain and restore the injured disc.  By drawing the disc back into its proper position and pulling vital fluids and nutrients back into the disc, spinal decompression therapy helps speed the healing process.  This therapy also strengthens the ligament bands that hold the disc in place, making healing more permanent.
 

For stage 4, more conservative flexion/distraction chiropractic treatment could help stabilize the spinal vertebral segments at this stage as long as symptoms show improvement.

If the herniation has sequestered into the spinal canal, surgery is indicated.
 

If symptoms continually worsen instead of improving over time, even with chiropractic care, surgery may be required to relieve symptoms.  If you lose bladder control, this may indicate spinal cord compression with swelling and edema, which requires immediate medical attention.  If you experience this, contact your medical doctor or go to the emergency room immediately:
 

What Happens if a Herniated Disc Is Left Untreated?

A herniated will not heal properly without proper treatment.  The disc may temporarily heal in the compromised position, causing your body to attempt to fix this misalignment by utilizing calcium in your system to build bone spurs and boney bridges to help support the area. This will reduce your range of motion and may weaken your muscles and cause pain over time.

Without corrective care, your herniation will continue to deteriorate because the forces working on it have not been properly resolved.  Any further trauma or injury to the affected area may result in more severe symptoms that require a longer treatment program to correct or may be beyond repair without surgery.

When Should I Start to Receive Care for a Herniated Disc?

Generally, the longer you wait to receive care, the more your condition will deteriorate and the longer it will take to resolve your condition.
 

The good news is that 90% of disc herniations can be resolved without surgery..  The sooner you begin care, the sooner you will begin to recover and can return to your normal activities without pain!

 Dr. Hunter Greenwood DC ND MTAA at Chiropractor Plus in Nixa is a chiropractor and naturopathic physician certified in acupuncture and with 40 years of experience treating patients with disc herniations.
 

If you are suffering from the symptoms of a herniated disc, call Dr. Greenwood today at 417-725-6655 to schedule your appointment.
 

Isn’t it time YOU felt good again?

 

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The contents of this website are based upon the opinions of Dr. Hunter Greenwood DC ND.  The information on this site is not intended as medical advice.  Dr. Greenwood recommends that patients make their health care decisions carefully after doing their own research and consulting with a licensed health care professional.