Do adjustments fix a disc bulge?
Can a chiropractic adjustment prevent disc degeneration?”
There are more but they all have the same answer: NO.
I know… now you may be double-checking, “I thought a chiropractor wrote this blog.” No, you’re not mistaken. If chiropractic adjustments fix or prevent a degenerated disc then we haven’t seen any evidence to prove it. If you’ve heard a chiropractor say that it can then either 1) they weren’t being straight with you (oh look! A pun!) or 2) they aren’t familiar with what the research has to say about it.
But think about it for a second. How would adjusting a spine magically fix a bulging disc? These typically aren’t problems that happen in a moment. They develop over time. It wouldn’t be reasonable to think that one quick thrust to the joint would be enough to fix the problem. (Or six or a dozen quick thrusts for that matter).
In this post I’ll explain what a disc is, how disc problems develop, why adjustments won’t fix a disc and exactly what a chiropractor CAN do if you have a disc problem.
First things first, let’s cover some anatomy.
The bones in your back are called vertebrae and they stack on top of each other to make up your spinal column. You can feel part of these bones in the middle of the back. The bones connect to help you stay upright and mobile. They also serve to protect your spinal cord which is the tissue that connects your various parts to your brain.
In between each of these vertebrae is a disc that acts like a cushion and provides some stability and flexibility to the spinal column. You can think of each disc as being like a jelly doughnut. I don’t know how discs taste but these two things are built alike. The center of the disc is less solid than the rubbery outer layers. The middle is called the nucleus pulposus (don’t worry, there’s no quiz later) and the outer layers are called the annulus fibrosis.
As you move your spine, the center of the disc will get squished away from wherever you are bending. For example, if you bend forward like you’re touching your toes, the center will get squished toward the back of the disc and when you lean back it will squish to the front. Sometimes if there is damage to the outer layers of a disc some of the material from the center will get pushed into the cracks and cause the disc to bulge out. Sometimes that is painful but often it isn’t. Other times, if those cracks get big enough or the pressure in the disc is high enough, the material from the center will push all the way through the outer layer. That’s called a “herniated” disc. Sometime people refer to it as a “slipped” disc, which is a term I personally don’t like because it conjures up images of a disc clanging around inside you like a hockey puck. That’s not the way it works.
When a disc loses some of its height and seemingly deflates a bit, we call this disc degeneration. It sounds awful right? Well, it’s actually pretty normal and most of the time people with these kinds of disc changes don’t have any symptoms at all.
BUT WAIT! My doctor took an MRI and told me I had back pain because I’ve got degenerated discs!
Well, your doctor is wrong. You might have degenerated discs and you might have back pain but MRIs don’t tell us anything about what causes pain. In fact, studies have been done where they have taken MRI images of many backs and have found that a lot of these had some degeneration of discs. The only problem (or rather the good news?) is that very few of these people also had back pain. Therefore, we can’t really conclude that just because you have back pain and a degenerated disc that these two things are related.
So degenerated discs don’t cause pain?
Well, they can but so can discs that aren’t degenerated. One study of twins estimated that there is 6-12% of the time that disc degeneration seen on MRI that was related to pain symptoms. We would determine whether the disc was the problem by doing exam procedures. These help pinpoint which movements cause you pain and other symptoms such as sciatica. That is pain, numbness, or tingling beyond the knee. It can also cause muscle weakness in the legs. BUT WAIT! I have pain that radiates into my buttocks and my doctor said it’s sciatica! Again, your doctor is wrong. Sciatica goes past the knee.
Now chiropractic adjustments mainly affect the joints in the back of the vertebrae, not the discs. So, while an adjustment can give pain relief and help you move better, they don’t heal disc injuries. It’s a supportive treatment for somebody with a disc injury but it isn’t a fix for this particular problem.
How can a chiropractor help a disc problem then?
The first thing we do is get you an accurate diagnosis. No other healthcare professional gets as much training in the diagnosis and treatment of spinal problems as a chiropractor. A good chiropractor can spot a disc problem in his or her sleep. With the right diagnosis, a chiropractor can teach you exercises and modifications to your daily routine that will help you to fix your own disc problem. There’s also traction which is a treatment that will help to alleviate disc pain. Will you be adjusted? Probably, but this isn’t to fix your disc problem. It’s to help with the pain symptoms you may be having and make sure that your spine is biomechanically sound.
This is how we operate at Body of Health Chiropractic & Wellness Center. We know the power of a good spinal adjustment but we also understand the current evidence to make sure that our patients get the appropriate diagnosis and treatment. If you’ve been told by a doctor that they can see your back pain on an X-ray or that your problem is “arthritis” or “degeneration” or any other manner of scary-sounding things, we’d love to offer a second opinion. If this sounds like what you need, please get in touch.