How do herniated discs occur and what are the best treatment options?

“Ouch….I’ve slipped a disc!” 

Low back pain affects over 80% of the population at some point in their lives and it’s the second most popular reason for visiting the GP after the common cold. It comes in many guises but a herniated or ‘slipped’ disc is one of the easiest things to succumb to and is one of the most difficult types of back pain to relieve. 

This article examines the ways in which herniated discs can occur and explains the treatment options available to help patients get back to their usual daily activities.

Contrary to popular belief, slipped discs are not just common to people who do manual work involving heavy lifting: many office-based workers succumb to disc problems as a result of sitting in one position for too long, putting pressure on the disc walls so that they weaken over time.

The spine is made up of 24 individual bones called vertebrae which are stacked on top of each . Discs are the protective circular pads of connective tissue in between - the ‘padding’ which acts as shock absorbers, protecting the spine when we run or jump.

We cause small weaknesses in our spine all day long with prolonged sitting or standing in certain positions, for example at workstations or hunched over the ironing board.

The intervertebral discs are unlike other parts of the body in the sense that they have a limited nerve supply.

Very often we are not aware of the discs being under strain until the accumulation of months or years of stress has reached a point where small tears form in the outer disc wall. These tears can result in several months of nagging discomfort.

As a defence-mechanism against further damage, the body will often react to this situation with muscle spasm or at the very least, ‘muscle guarding’ which is when the long muscles of the spine tighten up. This causes compression of the discs and a lack of mobility in the spine. 

If this situation prevails, the tears can very often become worse and allow the inner jelly like part of the disc – the nucleus – to herniate outwards. This is referred to as a herniated, bulging or ‘slipped’ disc.

Disc problems can also cause pain in other areas of the body, the most common of which is sciatica, a grinding pain which travels down the length of the leg.  Sciatica can be caused by the bulging part of the disc squashes the nerve root next to the disc or when chemicals from a prolapsed disc irritate the nerve endings.  

Neck pain, headaches or numbness in the foot can also be a sign of a damaged disc. So, what are your options for treatment?

Your first port of call should always be a good osteopath, physiotherapist or chiropractor who will have experience in treating disc-related problems. With this type of manual therapy in most cases you should see a marked improvement in your condition in 6-8 weeks.

At the same time, if you are in so much pain that you can’t sleep then your GP can prescribe you painkillers and/or anti-inflammatory medicines which can be taken alongside physical treatment.

If you see no real sign of improvement after eight weeks of manual therapy, it would be advisable to get an MRI scan of your spine to confirm the possible causes of your pain and the location (level) of the spine affected.

If a disc problem is identified, a programme of treatment including IDD Therapy non-surgical spinal decompression may be recommended.

IDD Therapy is a computer-controlled mechanical treatment used by clinicians to gently and safely relieve pressure on specific discs, alleviate muscle spasm and increase mobility in the spine.
 
As part of the IDD Therapy programme, patients undergo a course of core-strengthening exercise to help them maintain their healthy spine.

In a small number of cases, patients with severe disc damage/degeneration may require invasive treatments including injections and/or surgery. Also, in rare circumstances, the patient may require immediate surgery, for example, when the bowel and bladder function is affected.

There are different types of surgery for a herniated disc, the most common is the microdiscectomy where fragments of the disc may be cut away.

Another common type of spinal surgery is the lumbar fusion where the vertebrae surrounding a disc are fused together.

Thus, there are now several treatment options available to patients with herniated discs and indeed, a wider array of effective non-surgical options allowing more patients to avoid invasive procedures.

Robert Shanks BSc (Hons) Ost
Clinical Director
Spine Plus
Tel: 020 8501 0937
www.SpinePlus.co.uk
Spine Plus is a group of multidisciplinary clinics in London and Essex

For more details about IDD Therapy or to find your nearest IDD clinic, call Steadfast Clinics on 01279 602030 or visit www.SteadfastClinics.co.uk

Low Back Pain Treatment - New IDD Therapy video

When people hear about IDD Therapy treatment for the first time, they have no way of appreciating what it is about. 

IDD Therapy Europe has a new video to help people with chronic back pain and neck pain appreciate how the treatment works.



Do you remember the first time you heard the word "Amazon", chances are you thought someone was talking about the rain forest.  You hear about it a few more times and now you think of the Amazon the 'book' seller more than the forest.

As one clinician recently said, "the time will come when IDD Therapy will be the default treatment for herniated discs and sciatica" . 

There is some way to go of course but we are getting there!


To download a patient or clinician information sheet, visit www.iddtherapy.eu  

IDD Therapy - My back pain treatment today at Back Into Shape clinic in London

Today I visited the Back Into Shape clinic in Highgate North London www.backintoshape.co.uk.  The clinic has been providing IDD Therapy with a SPINA spinal decompression machine for a year now and I took the opportunity to have a treatment.

I haven’t had an IDD treatment in quite some time so my body had forgotten what it was like. 

Working with IDD Therapy, people often ask me what is the difference between IDD Therapy and traction.  There is a technical answer or a simple one. I say, "go on the machine and you will understand the difference immediately".

I think I would describe the feeling during IDD Therapy treatment as “comfortable, controlled power”.  You know you are having treatment; the pull or "distraction" from your pelvis is strong, yet you do not feel like it is going to be painful or cause you any harm. 

I’ve seen people on interesting traction devices and they are practically holding their breath to brace themselves during treatment!  Is it any wonder traction doesn’t work?

TREATMENT DURATION

Time on the SPINA machine lasts 25 minutes. The intermittent pulling forces with oscillation are strong and during treatment you feel like a big pressure is being taken off your lower back. 

The pulling force used with each IDD Therapy treatment is calculated as a function of your body weight. 

When you first start, particularly if you have a long standing back problem, the pulling force is calculated at just under half your body weight.  With each new treatment, the pulling force is increased in increments as your body gets used to treatment.  Changes occur in the soft tissues to free movement in the lower back and they become better able to accept higher forces.

In my case today, the pulling force was 93lbs or 43kgs. 

Most back pain can be resolved with manual therapy and exercise.  Some people will argue that all back pain can be resolved with manual techniques alone; we do not agree with that and the incidence of back pain does not support that.

Without going into lots of detail here about treatment, I think of that pulling force in relation to a heavy weight.  If you have ever been to a gym, have you tried to pick up a 40kg weight?  It’s heavy! 

Applying such decompression forces is simply not possible with the hands alone for any period of time.  When you have 40+kgs of controlled distraction and mobilisation of your lower back, this is very different to a manual treatment.

At the end of my session today I can feel the changes.  You can feel slightly light headed from lying down and the work done on your lower back draws blood to the area.

I don’t have a back problem.  However, I do spend a lot of time at a computer or driving and with ageing, my lower back will become more stiff.  After a treatment I feel that my posture has been straightened out.  I feel I am walking taller and I feel that my lower back is less compressed.  That's just one treatment.

After a treatment on a SPINA machine, IDD Therapy clinics will always put a cold pack on the area.  Muscles are subjected to forces they are not used to and so it is natural to feel some soreness after the first few treatments.  This is like doing any exercise after a period of inactivity, your body needs to get conditioned to it.  The cold calms things down.

IDD Therapy has taken some time to get going in the UK.  However, with more clinic owners deciding to find out for why there is so much excitement within IDD clinics, they go on the machines themselves and instantly “get it”.

The reason IDD Therapy is growing rapidly now is because die hard manual therapists who experience the treatment are seeing the opportunity to combine the new category of mechanical treatment with the best in manual therapy and exercise.  Good news indeed for back pain sufferers.

     

We always stress that IDD Therapy is not an appropriate treatment for all conditions, however, when it is suitable, it can make a real difference. 

But don't take my word for it.  If you have a professional or personal interest in develpoments in back pain treatments, go along to an IDD Therapy treatment provider and find out for yourself.  If there isn't one near you today, I am sorry for that; all I can say is that with time there will be! 

The early adopters in the UK and Europe are all passionate and have years of experience.  They are only too happy to let people understand for themselves the objectives and differences in IDD treatment and offer IDD as part of a mix of care.

If you'd like some information to learn more about IDD Therapy feel free to contact me Stephen Small at stephen.small @ steadfastcorp.com

Steadfast is the European distributor of IDD Therapy and SPINA machines.  Our business is to help clinics do more for their patients, it's as simple as that.