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The Valley, November 2011
Back Talk by Dr. Joseph Kauffman
What Is A Herniated Disc?
Most of my topics that I write about come from either patients or other people I know asking me questions about how chiropractic might help certain conditions. After I explain to them how it works, I often think that the public may have the same questions. If you would like me to cover a certain topic, please contact me. Today’s topic comes following an inquiry at church. I was asked about how Chiropractic could help a herniated disc. Due to time constraints when I am answering questions, I sometimes feel as though I cannot give as thorough of an answer as I should. I am sure many people would like information on herniated discs so I am going to tell you what it is and how the medical profession diagnoses and treats them. I will elaborate on how Chiropractic works to help herniated discs and then, you, the reader, can make an informed decision on which route is best for you or your family member. What is the spinal disc? The spinal disc is a soft cushion that sits between each vertebrae of the spine. This spinal disc becomes more rigid with age. In a young individual, the disc is soft and elastic, but like so many other structures in the body, the disc gradually loses its elasticity and is more vulnerable to injury
What happens with a ‘herniated disc’? As the spinal disc becomes less elastic, it can rupture. When the disc ruptures, a portion of the spinal disc pushes outside its normal boundary--this is called a herniated disc. When a herniated disc bulges out from between the vertebrae, the spinal nerves and spinal cord can become pinched. There is normally a little extra space around the spinal cord and spinal nerves, but if enough of the herniated disc is pushed out of place, then these structures may be compressed. A herniation is a displaced fragment of the center part or nucleus of the disc that is pushed through a tear in the outer layer or annulus of the disc. Pain results when irritating substances are released from this tear and also if the fragment touches or compresses a nearby nerve. Other names given to herniated discs include slipped discs and bulging discs. You may also see disc spelled as disk. A herniated disc may occur suddenly in an event such as a fall or an accident, or may occur gradually with repetitive straining of the spine. Common symptoms of a herniated disc include: •Electric Shock Pain
Pressure on the nerve can cause abnormal sensations, commonly experienced as electric shock pains. When the compression occurs in the cervical (neck) region, the shocks go down your arms. When the compression is in the lumbar (low back) region, the shocks go down your legs. •Tingling & Numbness Patients often have abnormal sensations such as tingling, numbness, or pins and needles. These symptoms may be experienced in the same region as painful electric shock sensations. •Muscle Weakness Because of the nerve irritation, signals from the brain may be interrupted causing muscle weakness. Nerve irritation can also be tested by examining reflexes. •Bowel or Bladder Problems These symptoms are important because it may be a sign of cauda equina syndrome, a possible condition resulting from a herniated disc. This is a medical emergency, and you should see your doctor
immediately if you have problems urinating, having bowel movements, or if you have numbness around your genitals. How is the diagnosis of a herniated disc made? Most often, your physician can make the diagnosis of a herniated disc by physical examination which includes testing sensation, muscle strength, and reflexes. An MRI is commonly used to aid in diagnosing a herniated disc. It is very important that patients understand that the MRI is only useful when used in conjunction with examination findings. It is normal for an MRI of the lumbar spine to have abnormalities, especially as people age. Making the diagnosis of a herniated disc, and coming up with a treatment plan depends on the symptoms experienced by the patient, the physical examination findings, and the x-ray and MRI results. Only once this information is put together can a reasonable treatment plan be considered. Most often, treatments of a herniated disc begin conservatively, and become more aggressive if the symptoms persist. The first treatment is to rest and avoid activities that aggravate your symptoms. Many disc herniations will resolve in given time. Ice and heat application can be extremely helpful in relieving the painful symptoms of a disc herniation by helping to relax the muscles of the back. Physical therapy and lumbar stabilization exercises do not directly affect the herniated disc, but they can stabilize the lumbar
spine muscles. This has an effect of decreasing the load experienced by the disc and vertebrae. Stronger, well balanced muscles help control the lumbar spine and minimize the risk or injury to the nerves and the disc. Non-steroidal anti-inflammatory medications (NSAIDs) are commonly prescribed and often help relieve the pain associated with a disc herniation. By reducing inflammation, these medications can relieve some pressure on the compressed nerves. NSAIDs should be used under your doctor’s supervision. Oral steroid medications can be very helpful in episodes of an acute (sudden) disc herniation. Medications used include Prednisone and Medrol. Like NSAIDs, these powerful anti-inflammatory medications reduce inflammation around the compressed nerves, thereby relieving symptoms. Other medications often used include narcotic pain medications and muscle relaxers. Narcotic pain medications are useful for severe, short-term pain management. Unfortunately, these medications can make you drowsy and can be addictive. It is important to use these for only brief periods of time. Muscle relaxers are used to treat spasm of spinal muscles often seen with disc herniations. Injections of cortisone can be administered directly in the area of nerve compression. Like oral anti-inflammatory medications, the idea is to relieve the compression on the nerves. When the injection is
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We fix computers !
International Solar Power Show from page 21 converts DC to AC at each panel and the unit is mounted on the back of each panel in the array. If there are 20 panels in an array and 10 panels are wired together in series, there will be two “strings” wired back to the inverter near the electrical panel. If any of the solar panels are shaded due to clouds, trees, etc., the output from all the panels in that string will be reduced to that of the shaded one. With the microinverter, a reduced output from one panel does not affect the output from the balance of the panels; in addition, each solar panel can be monitored to confirm the output. We will give you updates on this important technology in future articles. Curt Bierly is president of the bierly group incorporated of which Stanley C. Bierly (HVAC System Design and Installation) is a division. He graduated from Penn State with a BS in Mechanical Engineering and is a member of the Penn College HVAC Advisory Board. You can contact him at cbierly@bierlygroup. com. a
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