Archive for December 2009

St. Louis Work Comp Lawyer Discusses Herniated Disc Injuries

Very few injuries that we commonly see can change a claimant’s life as dramatically as a “herniated disc”. Many similar terms are used almost interchangeably like “ruptured disc”, “disc protrusion” and “herniated nucleus pulposus”. Doctors often describe disc as being like a “jelly donut” between the vertebrae. When the disc material inside of the disc leaks out and touches on the “sciatic nerve”, severe pain often travels down the injured worker’s leg. Sometimes other structures are affected, like the “spinal cord” or the “spinal canal”. Disc injuries are most common found in the low back and neck and rarely occur in the mid-back. We see a lot of lumbar “laminectomies” in workers who do a lot of heavy lifting. A laminectomy or a microdiscectomy will often produce good results and in many instances injured workers will be able to return to rigorous work. If surgery is unsuccessful, a lumbar or cervical “fusion” may be needed. This often occurs with a condition called “spondylolisthesis” which involves a slippage of a vertebrae. In order to diagnose a disc problem an “MRI” is usually needed. If a condition is diagnosed as a “disc bulge” doctors will normally try treating the condition with physical therapy or steroid injections. If the MRI is negative, doctors may determine that they are dealing with a strained or sprained back or neck. Where surgery is contemplated, doctors will normally do a test called a “myelogram’ with a “cat scan” in order to get the best possible look at the problem. In those cases where multiple surgeries have been performed and a “fusion’ is the ultimate outcome, some injured workers may become “permanently totally disabled” which means that they are unable to work or compete in the “open labor market”. Everyone is different and it is difficult to generalize. I once had a client who had five surgeries, including a disc fusion, who had a body like Charles Atlas and was running 5 miles a day! In any event, if you are confronted with a serious back or neck injury, it is important to ask your attorney about the reputation of the doctor who is treating you.

The contents of this article are intended for educational use only in order to provide readers general information and a basic understanding of the law. If you are seeking legal advice, please consult a licensed professional attorney in your state. The information in this article should not be substituted for experienced legal advice.

Jeff Swaney

Diagnosed With a Herniated Disc? What to Do Next…

You’ve probably heard people say they have a “slipped” or “ruptured” disc in the back. Sometimes they complain that their back “went out”. What they’re most likely describing is a herniated disc. This condition is a common source of back and leg pain.

Discs are soft cushions found between the vertebrae that make up the spinal column (your backbone). In the middle of the spinal column is the spinal canal, a hollow space that contains the spinal cord. The nerves that supply the arms, leg, and torso come from the spinal cord. The nerves from the neck supply the arms and hands, and the nerves from the low back supply the butt and legs. The discs between the vertebrae allow the back to move freely and act like shock absorbers.

The disc is made up of two main sections. The outer part (the annulus) is made up of tough cartilage that is comprised of series of rings. The center of the disc is a jelly-like substance called the nucleus pulposus. A disc herniates or ruptures when part of the jelly center pushes through the outer wall of the disc into the spinal canal, and puts pressure on the nerves. A disc bulge is when the jelly substance pushes the outer wall but doesn’t completely go through the wall.

What do you feel?

Low back pain will affect four out of five people during their lifetime. The most common symptom of a herniated disc is “sciatica”. Sciatica is best described as a sharp, often shooting pain that begins in the buttocks and goes down the back of one leg. This is most often caused by pressure on the sciatic nerve that exits the spinal cord. Other symptoms include:

Weakness in one leg or both legs

Numbness and tingling in one leg (pins & needles)

A burning pain centered in the low back

Loss of bladder or bowel control (seek medical attention immediately)

Back pain with gradually increasing leg pain. (If you have weakness in both legs. Seek immediate attention.)

How do you know you have a herniated disc?

Your medical history is key to a proper diagnosis. A physical examination can usually determine which nerve roots are affected (and how seriously). A simple x-ray may show evidence of disc or degenerative spine changes. An MRI (magnetic resonance imaging) is usually the best option (most expensive) to determine which disc has herniated.

Why do discs herniate?

Discs are primarily composed of water. As we become older (after the age of 30), the water content decreases, so the discs begin to shrink and lose their shape. When the disc becomes smaller the space between the vertebrae decreases and become narrower. Also, as the disc loses water content the disc itself becomes less flexible.

While aging, excess weight, improper lifting and the decrease in water in the discs all contribute to the breaking down of discs, the primary cause of a herniation or bluge is uneven compression and torsion that’s placed on the discs.

This uneven pressure is caused by imbalances in muscles that pull the spine out of its normal position and then your body is forced to function in what I call a physical dysfunction. Every human being develops these dysfunctions over time and eventually they cause enough damage to create pain.

The best treatment options

When it comes to treating a herniated disc, there are traditional treatments such as ice/heat, ultrasound, electrical stimulation, cortisone injections, anti-inflammatory medications and even surgery. While these may deliver some relief, it will usually be temporary if at all.

But the major problem with these traditional treatments is that they can’t fix or heal a herniated disc as they do not address the actual cause of the problem. For example, even if you were to have a surgery and get some pain relief, the fact is the dysfunctions that caused the disc to herniated in the first place are still there and if not addressed, they will continue to place uneven pressure and strain on the discs and sooner or later you will likely have another problem with that disc, or others.

Without identifying and addressing the underlying cause of the problem, which is the physical dysfunctions caused by imbalances in muscles, you will likely continue to suffer with this condition and the continuous flare ups for years.

Unfortunately, most doctors, chiropractors and physical therapists don’t spend time or focus on identifying the physical dysfunctions that are responsible for the condition so most people end up jumping from one useless traditional treatment to the next and suffer for months or years unnecessarily.

If you have been diagnosed with a herniated disc, or are wondering if your back pain may be caused by a herniated disc, either way you must identify and address the physical dysfunctions that are causing your pain as part of your recovery.

Dr. Robert Duvall, Dpt, Atc

Slip Disc – Treating Without Surgery (ayurveda)

The discs are protective shock-absorbing pads between the bones of the spine. Although they do not actually “slip,” a disc may split or rupture. This can cause the disc to fail, allowing the gel to escape into the surrounding tissue. The leaking jellylike substance can place pressure on the spinal cord or on a single nerve fiber and cause pain either around the damaged disc or anywhere along the area controlled by that nerve. This condition is also known as a herniated, ruptured, prolapsed, or, more commonly, slipped disc.

Slip disc or Spinal disc herniation can occur in any disc in the spine, but the two most common forms are the cervical disc herniation and the lumbar disc herniation.

Factors that lead to slipped disc include aging with associated degeneration and loss of elasticity of the discs and supporting structures; Poor posture combined with the habitual use of incorrect body mechanics, hard physical labour (delivery), improper lifting, especially if accompanied by twisting or turning; excessive strain, and sudden forceful trauma. A herniation may develop suddenly or gradually over weeks or months.

People between the ages of 30 and 50 appear to be vulnerable because the elasticity and water content of the nucleus decreases with age. But of late it is seen that even the people around age group 20 – 30 are also getting affected with slip disc, because of their life style and diet habits.

A slipped disc can be symptom free. If it causes pain, it is primarily due to the pressure on the nerve roots, the spinal cord or the cauda equina.

A herniated disc can therefore produce symptoms anywhere along the course of that nerve, though the injury and irritation of the nerve are at the spine itself (referred pain). A slipped disc can produce different symptoms like varying degrees of pain in the back or neck along with numbness or weakness, tingling, Paralysis of single muscles, possibly with pain radiating to the arms or legs, paralysis in the part of the body below the spinal cord pressure, disturbance of feeling in the limbs, muscle spasms, difficulty controlling bowel movements or bladder function, disturbance of feeling in the rectum and the inside of the thighs etc,.

The strength of Ayurveda in the area of spine and joint treatments is globally appreciated. Since it addresses the root cause of the issue the results are fantastic.

CHARAKA offers a very effective treatment methodology based on the classical texts of Ayurveda. The treatment comprises of Detoxification, rejuvenation through Ayurvedic Panchakarma therapy, administration of researched medicines internally.

The therapies like Abyanga swedam, Nasyam, Pathrapotala swedam, Choornapinda swedam, Pizhichil, Shirodhara, Kadeevasthy, Greevavasthy, Navarakizhi, Vasti etc. are done as per the necessity and condition. These therapies are directed towards relieving the inflammatory changes, releasing the spasms and nerve compressions in the affected area, strengthening the supportive tissues holding the spine/joints, nourishing the joints through improving the circulation. Usually the treatment period is 3 – 5 weeks according to the severity of the disease.

In four to six weeks, the majority of patients find their symptoms are relieved without surgery. If patient can come for the treatment in early stages, even total cure without recurrence is also possible.

dr m chandrashekhar