Disc Pain

Disc pain can be quite frustrating to deal with but we are well equipped to help you manage it at Khouri Chiropractic & Health Solutions.

Overview

Disc pain can be quite frustrating to deal with. Symptoms are often progressive, meaning the complaint may rapidly increase in pain level and frequency as well as rapidly increase down the closest limb. The progressive nature of disc pain can decrease your quality of life from loss of sleep and ability to perform everyday movements. Thankfully, it is rarely a surgical condition. 

What causes disc pain?

  • Natural aging of the discs
    • As we age, our discs naturally age with us going from a dynamic semi-like, semi-gel like cushion within the spine to a more rigid structure which can also thin over time.
  • Repetitive micro traumas like sneezing
    • As we repeatedly bend in any direction, it causes the inside of the disc, the nucleus pulposus to shift in the opposite direction. 
    • With shifting of the nucleus pulposus it may over time, change the internal forces upon the disc making it weaken over time and be predisposed to bulging or even herniating.
  • Macro traumas like lifting a heavy object in an awkward manner
    • A sudden shift in the internal forces of the spine may be too much for the disc to withstand, forcing an abrupt shift of the nucleus pulposus at a rate which tears through the thick, circular annular fibers of the outside of the disc. 
    • Though a herniation sounds scary, oftentimes they respond well to non-surgical interventions. 

Is disc pain serious?

  • Not usually, oftentimes the pain itself is a flare up of a pre-existing disc condition. As we age, we actually become less susceptible to new disc injuries due to the natural aging process of the discs.
  • Natural disc aging also known as degenerative disc disease is not actually a disease, it is essentially the same as skin wrinkling or our hair graying or turning white as we age.
  • Bulges are fairly common with around ⅓ of the population having at least 1 disc bulge in their spine that they often are unaware of even having
  • Herniations are less common with micro trauma and more common with macro traumas.
  • A thorough baseline exam is necessary to measure symptoms as they decrease and at times increase during the healing process. At times, the symptoms may progress into the upper or lower limb and become completely absent from the neck or back. 
  • Oftentimes, as you’re healing the limb pain will gradually subside and an increase in neck or back pain may happen. That is expected. 
  • Unrelenting or symptoms which cannot be decreased in the limb may at times be a sign that surgery may be a necessary option
  • A steroid injection or oral steroid pack may be necessary to help control the inflammation leading to the progressive symptoms.
    • A micro-discectomy is a common surgical procedure where they cut out just a tiny bit of the problematic piece of the disc.
    • Whereas, a discectomy can be done for larger pieces of the disc which need to be removed.
    • Artificial disc replacements are a surgical procedure where they replace your disc with a fake disc to help maintain spinal movements.
    • A laminectomy is where a section of bone is removed to relieve pressure.
    • Spinal fusion is a surgical procedure where they join the vertebrae together at the site of the disc injury.

Is disc pain serious?

  • Not usually, oftentimes the pain itself is a flare up of a pre-existing disc condition. As we age, we actually become less susceptible to new disc injuries due to the natural aging process of the discs.
  • Natural disc aging also known as degenerative disc disease is not actually a disease, it is essentially the same as skin wrinkling or our hair graying or turning white as we age.
  • Bulges are fairly common with around ⅓ of the population having at least 1 disc bulge in their spine that they often are unaware of even having
  • Herniations are less common with micro trauma and more common with macro traumas.
  • A thorough baseline exam is necessary to measure symptoms as they decrease and at times increase during the healing process. At times, the symptoms may progress into the upper or lower limb and become completely absent from the neck or back. 
  • Oftentimes, as you’re healing the limb pain will gradually subside and an increase in neck or back pain may happen. That is expected. 
  • Unrelenting or symptoms which cannot be decreased in the limb may at times be a sign that surgery may be a necessary option.
    • A steroid injection or oral steroid pack may be necessary to help control the inflammation leading to the progressive symptoms.
    • A micro-discectomy is a common surgical procedure where they cut out just a tiny bit of the problematic piece of the disc.
    • Whereas, a discectomy can be done for larger pieces of the disc which need to be removed.
    • Artificial disc replacements are a surgical procedure where they replace your disc with a fake disc to help maintain spinal movements.
    • A Laminectomy is where a section of bone is removed to relieve pressure.
    • Spinal fusion is a surgical procedure where they join the vertebrae together at the site of the disc injury.

Disc pain looks like

  • Neck or lower back pain initially which may travel down to the upper or lower limbs.
  • Coughing, sneezing, or passing a bowel movement may increase symptoms.
  • Numbness & tingling may be present as well as the nerves becoming involved causing difficulty with brushing your teeth or buttoning clothes with the neck or walking on your tippy toes or heels with the low back.
  • As mentioned before, symptoms may fluctuate, they may feel better and then suddenly worsen in severity or show up further from the neck and low back. This may feel scary but will often calm back down to a more manageable level within 1-2 days.

Rehab for the disc

  • In the neck or cervical region, the C5-C6 discs are the most common site for disc pain to originate. Whereas, in the low back or lumbar region, the L5-S1 discs are the most common site for disc pain to originate. 
  • Due to the nature of the discs’ response to movement, movement tends to be the best starting rehab for the disc pain. 
  • We call this movement end range loading, where we attempt to move the pressure of the disc into a more neutral position which offloads the tissues of the disc and nerves repeatedly. As we do this, symptoms can often immediately decrease for a period of time.
  • The most common beneficial movement pattern for neck and low back tends to be extension. We can achieve that in the neck with an exercise called a chin tuck and in the low back with a prone press up or cobra pose. Initially, these exercises may increase symptoms or rather make you more aware of the neck or low back origin of the symptoms and with repeated repetitions the symptoms will often begin decrease in severity, become less prominent in the limb and more prominent in the neck/back, and/or increased ability to move the neck/back before pain begins.

Other treatments

  • Strengthening the muscles of the spine is important to help reduce the severity & frequency of current and future flare ups.
    • The end range loading exercises are just a small piece of the whole rehab plan that Dr Redmon crafts for disc pain patients.
  • Active rest, meaning activities which do not increase symptoms, such as walking are vital for the healing process.
  • Anti-inflammatory foods such as berries, walnuts, leafy greens, avocados, fruits, fish, and spices may assist with the body’s attempt to control inflammation.
  • Chiropractic adjustments, massage therapy, and acupuncture are great ways to improve movement quality and decrease pain levels though there may be a slight increase in symptoms immediately post treatment which should be communicated to the practitioner should it occur.
  • If you suspect you may be experiencing disc pain it is recommended to schedule an appointment to ensure the appropriate diagnosis is made so the correct treatment can begin ASAP.

Stephen Redmon DC, LMT

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