Intervertebral discs are structures that separate adjacent vertebrae and allow the spine to move in all directions. There are generally 23 discs located throughout the spine, varying in size and shape depending on the area. Discs are built like a jelly donut, there is a gelatinous center (nucleus) that is surrounded by a fibrocartilaginous exterior (annulus). A disc bulge or herniation occurs when the annulus is ruptured, and the nucleus protrudes through the annulus.

CAUSES

Discal pathologies (disc bulges, herniations and degenerative disc disease) usually build up over extended periods of time as a result of gradual wear and tear, until a sudden movement or action causes the annulus to rupture. However, in many cases individuals are unable to pinpoint the cause of their injured disc.

SYMPTOMS

Most disc issues occur in the lower back, although they can also occur in the neck, and, rarely, in the mid-back. Signs and symptoms depend on where the disc is situated and if it is pressing against a nerve. They usually affect one side of the body but in some cases both limbs may be affected. If you are suffering from a disc pathology you may experience:

• Local pain at the site of injury
• Stiffness and decreased range of motion
• Radiating pain, numbness, tingling and weakness in certain areas of the body caused by compressed or irritated nerve roots. Discal pathologies in the lower back may cause pain to radiate down the buttocks, thighs, calves and sometimes all the way down the toes, while a disc injury at the neck may result in pain down the shoulder, arm and hand.
• Shooting pain down the arm or leg when you cough, sneeze, or move in certain positions.

What can often make disc issues so painful is that they can press directly on the nerves responsible for relaying pain signals to the brain. However, in some cases local pain may not accompany radiating nerve pain in the limbs. It is also possible to have a discal pathology without symptoms at all. Specialized spinal imaging, such as MRIs and CT scans, are often inconclusive.

RISK FACTORS

Factors that can increase your risk of developing discal pathologies include sedentary work, prolonged sitting postures, obesity, strenuous physical occupations, performing repetitive tasks (ex.: lifting, pulling, pushing, bending, twisting), and smoking. Some people may even inherit a genetic predisposition to developing degenerative disc disease. The incidence of disc protrusions/extrusions (disc bulge/herniation) is highest in populations 20 to 40 years of age, while older individuals are more likely to experience disc-related pain through degenerative processes. Proper lifting techniques and posture will reduce your risk of developing disc issues.

PREVENTION

Your first line of defense against developing discal pathologies is minimizing risk by adopting healthy daily habits. Maintaining a healthy weight, staying active, maintaining good posture, and limiting repetitive stress on the spine constitute the first steps in avoiding excessive stress to the spinal discs. Using your legs to lift heavy objects, strengthening and increasing trunk and core muscles, and increasing coordination to help stabilize and support your spine, can also help mitigate the risks of developing a discal pathology.

TREATMENT OPTIONS

Chiropractic care can help maximize joint mobility and normalize muscle tension created by disc pathologies, thereby decreasing strain on the disc and allowing it to heal more quickly and become stronger. Laser/photobiomodulation therapy can help by directly influencing tissue regeneration, increasing blood flow to the injured area, and controlling inflammation, and ultimately leading to long-term positive outcomes. Surgery is a last resort when it comes to disc pathology management and is usually only necessary in extreme cases.

WHAT’S NEXT?

It’s important to note that once you acquire this type of injury, you become predisposed to recurrences. Therefore, to decrease the risk of re-aggravation, it’s important to continue maintaining proper posture and movement patterns, to keep going for regular spinal assessments, and to continue doing rehabilitative exercizes even when you’re feeling asymptomatic. The Robichaud-Lévesque clinic offers treatment using sophisticated technologies that directly target specific discal issues in view of a better outcome.