Hernia

The term hernia often brings up confusion as to what it exactly means. People  associate intense pain in the back as to being part of the condition. Chiropractors treat both acute and chronic hernias where there is no neurological fall out. To explain what exactly a hernia is and how we treat it, its important to get a good understanding of what the function of an intervertebral disc is.

Intervertebral discs are flexible shockbrakers which are positioned between the moveable vertebrae. They absorb compression and ensure the flexibility of the spine. The discs have a soft gel like internal nucleus (nucleus pulposus) which is surrounded by multiple bands of very strong ringed fibers (sharpey’s fibers) that connect to the vertebrae (see the above image). This construction hold the vertebrae in place and together with the discs form a strong flexible structure we call the spine.

What causes a hernia?
We use the term hernia when the internal nucleus of the disc protrudes outward. This can cause compression on the nerve complexes which are located posterolateral. If this is the case, the patient might experience intense pain. If the location of the hernia is in the low back, the pain is usually radicular into the leg, it can even go as far down as into the foot. If the location of the hernia is in the neck, the pain can also be radicular extending as far as to the arm and fingers.

The cause of the hernia can be acute. An example may be a sudden twisting movement of the back or neck. A common cause is also bending over and lifting something heavy . However even a fall or intensive sneezing can cause a hernia.

Hernia paralysis / symptoms

A hernia in the low back often expresses itself as a sudden sharp pain in the low back with radicular pain extending to the leg and possibly into the foot. Often the muscles in the low back cramp up. The patient might experience weakening of the muscles in the involved leg an notice that when walking they might fall through the involved side. Other symptoms might be numbness or tingling in the leg. Some patients can experience foot drop which is caused by paralysis or weakening of the muscles involved in lifting the front part of the foot. In extreme cases, a patient might even experience a loss of bladder control. In these circumstances an operation to remove the hernia might be unavoidable.

Chiropractic treatment of hernias

Chiropractic is form of healthcare which exists already more than a hundred years. The treatment performed by a chiropractor is directed towards the function of the musculoskeletal system and its relationship to the nervous system. With regards to the spine the chiropractor will look for areas where the vertebrae in relation to each other are tighter and less moveable. We call this a fixation. Following a complete orthopaedic and neurological examination, the chiropractor will localise and correct this fixation. This is often achieved by manipulation of the spine. The result is that the spine flexibility is restored and the nerve irritation reduced where by the body’s healing ability is aloud to follow its course.

The first consultation

Intake                         
A patient questionnaire is filled in followed by a discussion with the chiropractor in order to establish a thorough case history.

Examination              
Chiropractic tests
Neurological test
Orthopaedic test

X-ray, MRI, IDXA          
Whichever is indicated necessary

Diagnosis                       
Given by the Chiropractor

Treatment                      
Nearly always already on the first visit

The chiropractic treatment

Through their specialistic education and knowledge, chiropractors examine the spine and nervous system in order to determine the precise location and cause of the patients symptoms. Often this precise location may be referred to as a point of fixation or blockage in the spine. With chiropratic treatment, the patient who is suffering from a disc herniation, is often alleviated from their symptoms. By relieving the pressure on the disc and nerve, further damage may be prevented. The goal of the treatment is to restore spine and nerve function. The patient experiences a greater range of motion and a restoration of nerve function. An example might be, with respect to radicular pain from the low back into the leg and weakening of the leg, the reduction in pain and  the restoration of muscle strength and control of the involved leg. Once the condition has been stabilized, the chiropractor might advise periodic control visits to ensure that the condition does not relapse and the spine remains in optimal form. We refer to this as maintenance care.

The most common questions regarding disc herniations

Can I prevent having to undergo a hernia operation?
Yes most disc herniations can be successfully treated by chiropractors, as long as the symptoms do not involve to extensive nerve damage or paralysis.

Can an hernia reoccur?
If you load the discs too much through irresponsible activity, yes the hernia can return.

How do I prevent a hernia forming?

1. Don’t load your back unnecessarily while doing heavy tasks
2. Lift and bend over carefully. Ensure that while lifting your back is as flat and straight as possible. Bend through your knees and keep the object you are lifting as close to your body as possible. Do not twist or rotate whilst lifting!
3. If you are planning an intensive training programme, have your chiropractor check your spine to ensure that its functioning optimally. Preventative care will limit the chances of injury.
4. If your work entails sitting behind the PC all day, make sure you stand up and move about regularly. Sitting for too long periods builds up pressure in your low back and discs.
5. Make sure your office chair and car seat support your low back sufficiently.
6. Do regular exercise which improve your low back motion and strength. Your chiropractor can help you advise the appropriate exercises.

How do I alleviate the pain of a hernia?

1. When the pain is acute, lay down on a bed and place a cold compress on the low back. Do this no longer than 20 minutes and always ensure that the cold compress has a tea towel wrapped around it so that you don’t burn the skin.
2. Repeat the cold compress a number of times per day, though ensure that you have at least 2 hours between each session. It’s also important that once you have used the compress, stand up and walk about so as to improve the range of motion in your low back
3. Avoid all activity which loads your back too much. These might be activities such as lifting, bending, sport, household chores etc.
4. Avoid sitting too much. Sitting increases the pressure on the discs and can cause the hernia to worsen.
5. To alleviate muscle tension in the back, you may lay on your back with your knees slightly bent and place a cushion under your knees.

Hernia therapy

Through their specialistic education and knowledge, chiropractors examine the spine and nervous system in order to determine the precise location and cause of the patients symptoms. An orthopaedic and neurological examination is done followed by the chiropractic treatment . This may involve techniques to reduce the pressure on the discs and improve the spine range of motion. The goal is to reduces the pressure on the spinal nerve and improve spine function.

Hernia and chiropractic treatment

Through their specialistic education and knowledge, chiropractors examine the spine and nervous system in order to determine the precise location and cause of the patients symptoms. Often this precise location may be referred to as a point of fixation or blockage in the spine. With chiropratic treatment, the patient who is suffering from a disc herniation, is often alleviated from their symptoms. By relieving the pressure on the disc and nerve, further damage may be prevented. The goal of the treatment is to restore spine and nerve function. The patient experiences a greater range of motion and a restoration of nerve function. An example might be, with respect to radicular pain from the low back into the leg and weakening of the leg, the reduction in pain and  the restoration of muscle strength and control of the involved leg. Once the condition has been stabilized, the chiropractor might advise periodic control visits to ensure that the condition does not relapse and the spine remains in optimal form. We refer to this as maintenance care.

Hernia symptoms and pain reduction

The goal of chiropractic treatment is to reduces the pain caused by a disc herniation. In order to accomplish this the chiropractor uses treatment modalities to reduce the pressure on the disc. By doing this the pressure on the nerve is subsequently also reduced thereby reducing the pain and restoring function.

Should I seek care to treat my hernia?
We strongly advise patients who have hernia complaints to seek chiropractic care. You are welcome to have a free spinal screening at one of our chiropractic clinics. We have free spinal screenings at all of our clinics every Friday from 16:00 to 16:00 . Feel free to come by, an appointment is not necessary. Alternately you can call the clinic and make an appointment for a free spinal screening at an appropriate time for you.

Finally!

Consult your chiropractor regularly. A hernia is a chronic condition. By having your spine regularly treated by a chiropractor, you ensure its optimal function and the risk deterioration of your condition is reduced.

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