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Chiropractic Care and Osteopathic Medicine | Eastside Chiropractor

Chiropractic is a healthcare profession dedicated to the nonsurgical treatment of disorders of the nervous system or musculoskeletal system. Chiropractors maintain a focus on therapy and spinal manipulation for structures.

Can chiropractic care be paired with other treatment methods?
Several studies have concluded that manual treatments commonly used by physicians are usually effective for treating lower back pain, lumbar herniated disc for radiculopathy and neck pain, as well as other ailments. In fact, when patients using non-invasive chronic low back pain have been treated by chiropractors, the long-term outcome is improved by obtaining maintenance spinal manipulation after the first intensive manipulative treatment. New research studies have found that a combination of chiropractic and other treatment modalities can help further provide relief.

Chiropractic and Osteopathic
Chiropractic and osteopathic medicine represent another non-surgical treatment option for patients with spin…

Herniated Discs: Definition, Progression & Diagnosis





What is a Herniated Disc?

Herniation of the nucleus pulposus (HNP) occurs when the nucleus pulposus (gel-like substance) breaks through the anulus fibrosus (tire-like structure) of an intervertebral disc (spinal shock absorber).

normal disc, vertebra, nerves

A herniated disc occurs most often in the lumbar region of the spine especially at the L4-L5 and L5-S1 levels (L = Lumbar, S = Sacral). This is because the lumbar spine carries most of the body’s weight. People between the ages of 30 and 50 appear to be vulnerable because the elasticity and water content of the nucleus decreases with age.


herniated disc

The progression to an actual HNP varies from slow to sudden onset of symptoms. There are four stages: (1) disc protrusion (2) prolapsed disc (3) disc extrusion (4) sequestered disc. Stages 1 and 2 are referred to as incomplete, where 3 and 4 are complete herniations. Pain resulting from herniation may be combined with a radiculopathy, which means neurological deficit. The deficit may include sensory changes (i.e. tingling, numbness) and/or motor changes (i.e. weakness, reflex loss). These changes are caused by nerve compression created by pressure from interior disc material.
?disc

Progression of Herniated Disc

The extremities affected are dependent upon the vertebral level at which the HNP occurred. Consider the following examples:

Cervical – Pain in the neck, shoulders, and arms
Thoracic – Pain radiates into the chest
Lumbar – Pain extends into the buttocks, thighs, legs

Cauda Equina Syndrome occurs from a central disc herniation and is serious requiring immediate surgical intervention. The symptoms include bilateral leg pain, loss of perianal sensation (anus), paralysis of the bladder, and weakness of the anal sphincter.


Diagnosis of a Herniated Disc


The spine is examined with the patient laying down and standing. Due to muscle spasm, a loss of normal spinal curvature may be noted. Radicular pain (inflammation of a spinal nerve) may increase when pressure is applied to the affected spinal level.

A Lasegue test, also known as Straight-leg Raising Test, is performed. The patient lies down, the knee is extended, and the hip is flexed. If pain is aggravated or produced, it is an indication the lower lumbosacral nerve roots are inflamed.

Other neurological tests are performed to determine loss of sensation and/or motor function. Abnormal reflexes are noted as these changes may indicate the location of the herniation.

Radiographs are helpful, but Computed Axial Tomography (CAT) or Magnetic Resonance Imaging (MRI) provides more detail. The MRI is the best method enabling the physician to see the soft spinal tissues unseen in a conventional x-ray.



Radiographic Evidence of HNP




herniated disc

The findings from the examination and tests are compared to make a proper diagnosis. This includes determining the location of the herniation so treatment options can be reviewed with the patient.

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