and/or Bulging Discs
disc herniation, commonly called a "slipped disc",
is a medical condition affecting the spine, in which
a tear in the outer, fibrous ring (annulus fibrosus)
of an intervertebral disc allows the soft, central
portion (nucleus pulposus) to bulge out.
It is normally a further development of a previously existing disc protrusion,
a condition in which the outermost layers of the annulus fibrosus are still
intact, but can bulge when the disc is under pressure.
Some of the terms commonly used to describe the condition
include herniated disc, prolapsed disc, ruptured disc, and the misleading
expression "slipped disc." Other terms that are closely related
include disc protrusion, bulging disc, pinched nerve, sciatica, disc disease,
disc degeneration, degenerative disc disease, and black disc.
The popular term "slipped disc" is quite misleading, as an intervertebral
disc, being tightly sandwiched between two vertebrae, cannot actually "slip," "slide," or
even get "out of place." The disc is actually grown together with
the adjacent vertebrae and can be squeezed, stretched, and twisted, all in
small degrees. It can also be torn, ripped, herniated, and degenerated, but
it cannot "slip."
Image For A Larger View)
of Spinal Disc Herniation
Disc herniation can occur in any disc in
the spine, but the two most common forms are the cervical
disc herniation and the lumbar disc herniation. The latter
is the most common, causing lower back pain (lumbago) and
often leg pain as well, in which case it is commonly referred
to as sciatica.
Lumbar disc herniation occurs 15 times more often than cervical (neck) disc
herniation, and it is one of the most common causes of lower back pain. The
cervical discs are affected 8% of the time and the upper-to-mid-back (thoracic)
discs only 1 - 2% of the time.
The following locations have no discs and are therefore exempt from the risk
of disc herniation: the upper two cervical intervertebral spaces, the sacrum,
and the coccyx.
Most disc herniations occur when a person is in their thirties or forties when
the nucleus pulposus is still a gelatin-like substance. With age the nucleus
pulposus changes ("dries out") and the risk of herniation is greatly
reduced. At the same time osteoarthritic degeneration makes its inroads.
Cervical disc herniation
Cervical disc herniations occur in the neck, most often
between the sixth and seventh cervical vertebral bodies. Symptoms can affect
the back of the skull, the neck, shoulder girdle, scapula, shoulder, arm,
and hand. The nerves of the cervical plexus and brachial plexus can be affected.
Thoracic disc herniation
Thoracic discs are very stable and herniations in this
region are quite rare. Herniation of the uppermost thoracic discs can mimic
cervical disc herniations, while herniation of the other discs can mimic
Lumbar disc herniations occur in
the lower back, most often between the fourth and
fifth lumbar vertebral bodies or between the fifth
and the sacrum. Symptoms can affect the lower back,
buttocks, thigh, and may radiate into the foot and/or
toe. The sciatic nerve is the most commonly affected
nerve, causing symptoms of sciatica. The femoral
nerve can also be affected. Can cause the patient
to experience a numb, tingling feeling throughout
one or both legs and even feet.
Causes of a disc herniation can
include general wear and tear on the disc over time,
repetitive movements, stress on the disc that occurs
while twisting and lifting, or other injuries.
While the chief complaint for spinal
disc herniation is lower back pain, symptoms of a
herniated disc can vary depending on the location
of the herniation and the types of soft tissue that
become involved. They can range from little or no
pain if the disc is the only tissue injured to severe
and unrelenting neck or back pain that will radiate
into the regions served by an affected nerve root
when it is irritated or impinged by the herniated
material. Other symptoms may include sensory changes
such as numbness, tingling, muscular weakness or
paralysis, and affection of reflexes. Unlike a pulsating
pain or pain that comes and goes, which can be caused
by muscle spasm, pain from a herniated disc is usually
It is possible to have a herniated disc without any pain or noticeable symptoms,
depending on its location. If the extruded nucleus pulposus material doesn't
press on soft tissues or nerves, it may not cause any symptoms. It has been
estimated that as many as 50% of the population have focal herniated discs
in their cervical region that do not cause noticeable symptoms.
Typically, symptoms are experienced only on one side of the body. If the prolapse
is very large and presses on the spinal cord or the cauda equina in the lumbar
region, affection of both sides of the body may occur, often with serious consequences.
Diagnosis is made by a practitioner based on the history,
symptoms, and physical examination. At some point in the evaluation, tests
may be performed to confirm or rule out other causes of symptoms such as
spondylolisthesis, degeneration, tumors, metastases and space-occupying lesions
as well as evaluate the efficacy of potential treatment options.
|These tests may include
• Computed tomography
scan (CT or CAT scan)
resonance imaging (MRI)
and Nerve conduction
Scan of lumbar disc herniation between fourth and
fifth lumbar vertebral bodies.
Oak Ridge office is conveniently located to serve those from
Summerfield, Stokesdale, Walnut Cove, Walkertown, Madison,
Mayodan, Reidsville, Greensboro, Wentworth, Belews Creek,
Belews Lake, Scalesville, Colfax,
Friendship, Bonanza Hills and surrounding areas.
Salama Chiropractic Oak Ridge
Nc Highway 68 N Ste. E
Oak Ridge, North Carolina 27310
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Carolina (NC) Chiropractors - Greensboro & Winston