Disk Herniation
A herniated disk is sometimes called a ruptured or a slipped disk, and it mostly occurs in the lower back. It is the leading cause for low back pain and sciatica (pain that radiates down the leg). 60% to 80% of the population experiences back pain at some point in their lives, and among those suffering from back pain, a high percentage suffers from herniated disk. In the majority of cases, several months of non-surgical treatment significantly alleviates the symptoms.
Anatomy
The American Academy of Osteopathic Surgeons has a great deal of information about the condition, as well as a thorough description of the anatomy of the spine, and what really happens when herniated disk occurs.
When there is a disk herniation, it is mostly posterior (towards the back) and posterolateral. When standing or sitting, the force on the disk is backward, posteriorly. Behind the body of the vertebra, the disk pushes into the posterior longitudinal ligament. The posterior longitudinal ligament forms the front part of the spinal canal. The backside, posterior, part of the spinal canal is associated with the right and left spinal facet joints.
The disk herniation can be felt, after the vertebral spinal facet joint is released. Diagnostic and release techniques are accurate in their placement of force, and should not cause increased pain. The slight and gentle release is performed a few times in order to assess and treat the viscoelastic properties of the disk and adjacent soft tissues (nerves, blood vessels, lymphatics). This can be done using the “on-side” position or the prone position. My present interest is figuring out how to achieve this release in the supine position.
Cause
The disks in our vertebrae become narrower, and they begin to dry and weaken with age. In addition to aging there are other risk factors to take into account:
Improper lifting
Being overweight or obese
Repetitive motion that strains the spine
Frequent driving, or sitting in the same position for a long time
Sedentary lifestyle, which correlates with sitting in the same position for extended periods of time
Smoking, causing weakening of the disks, by suppressing oxygen delivery to them
Treatment
There have been many osteopathic techniques developed to address spondylolisthesis (slipped disk) and other spondyloarthropathies (bone spurs, calcified ligaments, strains and tears, osteoarthritis, rheumatoid arthropathies). Frequently the disk herniation will be reabsorbed. This reabsorption is one of the reasons why, without Red Flag signs and symptoms, it is best to wait 6 weeks before imaging. Your body will get better on its own. I like diagnosing the pain and facilitating the healing process. My techniques are especially helpful in the acute phase but are clearly well received for chronic conditions.
In some cases, physical therapy, medication, and epidural injections are recommended, in conjunction with these techniques. If the condition has advanced, surgery may be required. For more information about other treatments, please visit Spine-Health.
Techniques
My technique combines elements of Jean-Pierre Barral and Andrew Taylor Still, along with facilitated positional release, counterstrain, and primary respiratory mechanism techniques, in which the joint receives a well-directed sensing force to take the tissues (and joint) in the direction of ease, in order to release the ligaments and other soft-tissues involved in the dysfunction. I find these approaches have a high correlation with symptomatic herniated disks, and it gives me confidence that the suspected herniation will be found on Magnetic Resonance Imaging (MRI).
In addition, these techniques can be combined with direct techniques, such as muscle energy and direct myofascial release methods.
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