Sciatica/Herniated disc (slipped disc)

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Discs in the spine do not slip, they herniate. This is badly understood and it is important that you understand what has happened if you suffer from this, so you can have it correctly diagnosed and treated.

Understanding disc anatomy

In between every vertebra (bones of the spine) you have a disc. This provides padding so the vertebras are not sitting on top of each other, bone to bone. A disc is comprised of two parts, called the Nucleus pulposus (centre part of the disc) and the tough outer part of the disc, called the Annulus fibrosis.

  • Nucleus pulposus (soft inner part of the disc)
  • Annulus fibrosis (tough outer part of the disc)

A disc herniation means the Annulus fibrosis has broken down, and the Nucleus pulposus herniates (bulges) out.

This can happen at any level of the spine, including at the neck, upper back, mid back or lower back. Most patients come in to the clinic for discs that herniate in the lower spine (lumbar area). The most common area to have an issue is around L4 (the fourth lumbar vertebra). This is what happens when people get diagnosed with sciatica, meaning the disc has herniated and is affecting the sciatic nerve.

Image showing left and right Sciatic nerve brances

Common symptoms of sciatica relate to ‘nerve impingement’, and the patient will usually feel pins and needles, numbness, altered sensation anywhere from the lower back to the toes, lower back pain, burning sensation, lack of feeling,  or any combination of these.

Definitive diagnosis is made via MRI or CT scan. An X-ray will only show the bones and not the soft tissue so, is not helpful. I test my patients with the ‘straight leg raise test’, which is fairly accurate but not as good as an MRI or CT scan.

A model of the spine showing disc herniation touching the nerve, indicated in red.

Where you find pain, you find inflammation. Acupuncture is particularly effective in reducing both pain and inflammation, as it stimulates natural chemicals in the body that reduce pain (endorphins), while needling itself is anti-inflammatory.

Above we see what a normal disc looks like to give you a different perspective

Above we see a partially herniated disc, notice the red inflamed area to the rear.

Above we see a fully herniated disc, notice the disc bulging and compressing the nerve. Very painful!

The treatment involved depends on the severity of the issue. In severe cases I usually see a patient 2-3 times per week, or until the pain starts to reduce. Other patients I might only see once a week. I also use traction, a gentle technique which directly takes pressure off the inflamed nerve.

I also highly recommend dietary changes, as diet and inflammatory foods will strongly promote pain. Patients need to understand what not to eat, and then what to eat to give the tissue the best chance of recovering.

Most important is to have the correct treatment, and I specifically caution my patients that the worst thing they can do in this situation is to lift anything and twist, as this causes severe pain and makes the condition worse. I also strongly advise them NOT to have any type of manipulation, as this can also make them feel much worse.

Contact me at the clinic for specific advice on your particular case. Inquiries welcome! Wishing you a speedy recovery…

Comments

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