Herniated Disc: About back pain and how to treat it.

herniated discLow back pain with pain radiating into the legs is one of the most common injuries in the United States. Many of the patients with these symptoms along with lower extremity weakness may have a herniated disc. Herniated discs are also called protruding, bulging, ruptured, prolapsed, slipped, or degenerated discs. A disc herniation occurs when the cushion that sits between the spinal bones, or vertebrae  moves from its normal position and enters the spinal canal. This is a problem because this is where the spinal cord and nerve roots are located.

What is the spinal disc?

The soft structure that sits between the each vertebrae is referred to as the spinal disc. The disc is composed of a soft center similar to the center of jelly donuts and referred to as the nucleus pulposus. The nucleus is surrounded by several layers of connective tissue that is composed of material similar to ligaments and tendons called the outer annuls and looks like concentric rings, like the annular growth rings of a tree. 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 looses its elasticity and is more vulnerable to injury. As early as 30 a disc may show signs of deterioration and on MRI about 30% of people demonstrate deterioration.

What happens with a ‘herniated disc’?

As we age and the spine becomes less flexible and when this happens the disc may rupture. When a disc ruptures a portion of the nucleus pushes outside of its normal borders and may be completely extruded, outside the disc, this is called a herniation. When this herniation enters the spinal canal pressure can be put on the spinal cord and nerve roots, often referred to as a pinched nerve. There is normal some extra space around the spinal cord but if there is not enough to accommodate the herniation then the nerves are compressed.

What causes herniated disc symptoms?

Once the herniation occurs and a nerve is pinched that is when symptoms arise. 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. Often times when a disc is herniated the person may already have spinal stenosis or a narrowing of the spinal canal. This leads to less space for the herniation and increased pain due to further irritation of the nerve.

What are the symptoms of a herniated disc?

When the spinal cord becomes compressed it does not function properly and may lead to a range of symptoms. Abnormal signals may get passed from the compressed nerves, or signals may not get passed at all. There are several common symptoms of a herniated discs. The pressure on the nerve will 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 or pins and needles are often abnormal sensations associated with disc injuries. These symptoms may be experienced in the same region as painful electric shock sensations, but may not be in the area of the actual injury. Because of the nerve irritation, signals from the brain will be interrupted causing muscle weakness. Nerve irritation can therefore be tested by examining reflexes, testing muscle strength, and assessing sensory input. Of all of the symptoms associated with disc problems the most serious is bowel or bladder problems. These symptoms are important because they are signs of cauda equina syndrome, a possible condition resulting from a herniated disc. This is a medical emergency, and your should see your doctor immediately if you have problems urinating, having bowel movements, or if you have numbness around your genitals. These symptoms are all due to compression of the spinal nerves but that may not be the full extent of the damage, as seen in the cauda equina syndrom organs can also be effected leading to issues with breathing, digestion, or even heart problems..

How is the diagnosis of a herniated disc made?

Most often, your physician can make the diagnosis of a herniated disc by physical examination performed by a chiropractor. By testing sensation, muscle strength, and reflexes, your chiropractor can often establish the diagnosis of a herniated disc.

Often this diagnosis will be confirmed using MRI and other advanced imaging. The MRIs is only useful in conjunction with the physical examination and should not be performed by itself. It is normal for a MRI of the lumbar spine to have abnormalities, especially as people age. Patients in their 20s may begin to have signs of disc wear, and this type of wear would be expected on MRIs of patients in their 40s and 50s. This is the reason that your physician may not be concerned with some MRI findings noted by the radiologist.

The diagnosis and treatment of disc issues are dependent on the physical findings and symptoms. Your chiropractor will also take into account the patients experience and asses the imaging studies. Only once this information is put together can a reasonable treatment plan be considered.

Chiropractic Treatment

Chiropractic care is an excellent treatment choice for the management of herniated disc problems. Chiropractic is safe, non-invasive and non-toxic and it also works! Chiropractic care is a modern treatment approach for herniated discs. Typically chiropractic care involves spinal adjustments, physiotherapies, muscle therapies, such as massage and trigger point work, nutritional support and active care rehabilitation.

What is Lumbar Flexion Distraction technique?

Lumbar flexion distraction technique is, a chiropractic treatment, used in our clinic. It is often referred to as Cox flexion distraction. Cox Technic is non-surgical, doctor-controlled, hands-on spinal manipulation used to help treat  herniated disc symptoms. It is performed with the patient lying on The Cox Table a specially designed chiropractic instrument. This table permits an effective decompression adjustment and manipulation. This is a widely used approach to treating symptomatic disc injuries involving back pain and accompanying leg pain. During the treatment the spine is gently distracted or stretches which allows the chiropractor to isolate the area of disc involvement while slightly flexing the spine in a pumping rhythm. There should be no pain involved in the treatment.

The tractioning or distraction of the disc combined with isolation and gentle pumping of the involved area allows the central area of the disc, the nucleus pulposus, to assume its central position in the disc. Flexion distraction is also thought to improve disc height. Well-researched and documented, flexion distraction and decompression help relieve spinal pain and return patients to their desired quality of life by dropping intradiscal pressure, widening the spinal canal foraminal area, reducing pressure on the spinal nerves, and returning motion to the spinal joints. Cox Technique is appropriate for conditions causing low back and leg pain as well as neck and arm pain. It also reduces pain attributable to disc herniation, a slipped disc, a ruptured disc, facet syndrome, stenosis, spondylolisthesis, and other conditions.


The surgical approach to treating a herniated disc is removal of the disc (discectomy), surgically fusing two vertebrae together with hardware, or cutting away part of the vertebrae (laminectomy) in order to decompress the spine. Spinal surgery has a very poor track record, a 50% failure rate. It is also the most invasive treatment option. Because of this, surgery should only be considered as a last resort not a first choice. You should try everything else available to you before allowing anyone to operate on your spine. Most surgeon would never even consider operating on you until you have first tried all the conservative treatment choices. This would include chiropractic care, physical therapy, massage therapy, medications, acupuncture, etc. Is surgery ever the right choice? Yes, absolutely, there are certain times when the problem is so severe that it is no longer treatable via conservative methods. That being said, you should still always start with the least invasive approaches first and progress from there.

If you have been suffering with a herniated disc call me to schedule a free, no-obligation consultation.

By: Paul R. Mahler Jr. DC
Mahler Family Chiropractic Center
1144 wyoming Ave.
Kingston, PA. 18704
May be reproduced in whole only.
We can treat herniated discs and back injuries and pain  including sciatica, disc, herniation,  slipped disc, stenosis, and much more.

What is lower back pain and how to treat low back pain?

Eighty percent of individuals suffer from some form of back pain in their lifetimes, and back pain is the second most common cause for people visiting the doctor. Back pain, particularly lumbar pain, is outnumbered only by upper-respiratory infections. Seventy five million Americans will have back pain every year, and 80 percent of the adult population will have some type of low back pain. It is the most frequent reason for disability for people in the 30-50 year age bracket, and since these age groups are typically the most productive in the work force, the economic effect of low back pain is huge. Back pain can be explained as follows:

The low back area is prone to injury and pain because it is in a highly unstable portion of the spine, just like the neck is. That instability is one of the reasons for our mobility. This mobility is resposibal for our ability to stand upright, pick something up off the ground, tyeing our shoes and touching our toes, but at the price of increased chance of injury and low back pain.

When the low back is healthy and working properly, it can handle great forces without injury. One illustration is a professional weight lifter who is able to lift several hundred pounds and not injure his lower back. But, if the low back is compromised and out of adjustment or has lost strength in the supporting muscles, an act as basic as lifting a bag of groceries from the trunk of the car, picking up a young child, or bending down to feed the cat can cause a lower back injury.

The old belief that back pain would disappear by itself has been found to be inaccurate. While back pain may disappear for some time even without medical intervention, the latest scientific reports indicate that it will probably reappear. Low back pain should be taken seriously, and it is important to get professional chiropractic treatment. That is particularly true with recurring pain.

Although back pain patients make up the second largest diagnostic group examined by medical professionals, the recommended treatments from these professionals (drugs) are frequently discovered to be less than helpful. A highly regarded medical researcher has suggested that family doctors consider referring their back pain patients for chiropractic treatment, since it has shown to be beneficial for this disorder. Medical intervention is appropriate for lower back pain; a chiropractor can provide that. More and more people every year are visiting chiropractors for help with their lower back pain.

The Causes of Low Back Pain:

Because there are many factors that might cause low back pain, and a few of these factors may be very serious if not treated, it is vital to get the help of a professional. Chiropractors are leaders in determining the causes of lower back pain along with establishing the correct treatment for low back pain.

Lower back pain can be the result of various factors. Among these causes are stress and emotional tension that makes muscles tighten and contract, which results in stiffness and pain. Extra back pain might be due to bad posture and being on your feet for long periods, or sitting improperly (so be careful when you are at the office). A third cause of lower back pain is frequently linked with heavy physical labor, lifting or forceful movement, twisting or bending or awkward positions. This is worsened because of incorrect lifting practices, in other words, mechanical trauma and work. The most routine home or work tasks involving bending, twisting and lifting can stress your lower back muscles resulting in lower back pain. A few of those activities are tennis, biking, gardening, golf and even horseback riding and any of these might potentially injure your back. Finally, mechanical lower back pain might be caused by injuries and accidents, such as car wrecks, sports injuries and slips and falls. Carrying excess weight is another risk for low back pain, since it puts stress and pressure on the back, particularly the low back. Simply getting older is the last risk for back pain. As we get older, the ligaments thicken and discs dry out and we are more prone to back pain. Those age-related changes in the spine can lead to disorders that put pressure on the spinal nerves. The symptoms of pain might be combined with weakness or numbness. You may feel your discomfort on either or both sides of your back.

Our Approach To Your Care:

(treatment for back pain) We provide an all-inclusive, unique approach to treat back pain.

We believe back pain can best be alleviated by chiropractic adjustment. A chiropractic adjustment is an easy, low force correction that realigns the vertebrae, reduces stress to the spine and central nervous system and restores normal joint function. Trigger point therapy is a system of putting pressure on certain points in the body to lessen or get rid of muscle pain. Muscle contraction and lack of flexibility are characteristic of the majority of patients who have long-term back pain. To repair these issues, we create a flexibility and stretching routine that is intended to restore a pain-free range of motion. If the spine has been injured or if an old injury exists that was never properly evaluated and treated, we will frequently combine balance and stabilization rehabilitation to enhance coordination and spinal structural integrity.

The strength of the spine ultimately depends on the strength of the soft tissues supporting it, specifically, the muscles. Back muscles support spines the same way cables support bridges. Back pain can reappear again if any back muscle is not sufficiently strong. To fix this issue, we do a functional evaluation to locate weak spots. The back must be assessed to discover which areas need strengthening to alleviate the condition.

By: Paul R. Mahler Jr. DC
Mahler Family Chiropractic Center
1144 wyoming Ave.
Kingston, PA. 18704
May be reproduced in whole only.
We can treat low back injuries and pain  including sciatica, disc, herniation,  slipped disc, stenosis, and much more.