Hernia and chiropractic - Chiropractie Centraal

Anatomy of a hernia

Intervertebral discs act as cushions between moving vertebrae, absorbing shock and maintaining the spine's flexibility. They consist of a gel-like core surrounded by a network of strong fibers.

Functions of intervertebral discs:

Causes of hernias

Contrary to popular belief, a herniated disc is rarely the result of a single incident, such as a fall, a wrong movement, or the infamous sneeze. At Chiropractie Centraal, only 20% of the herniated discs we see are related to an accident (usually a car accident). Much more often, it begins with mild pain or stiffness that gradually worsens, with episodes of pain becoming more frequent and severe. The main cause is prolonged, repetitive strain, such as sitting for long periods, lifting repeatedly, or poor posture.

Stages of hernia development

Dysfunction

A healthy intervertebral disc needs daily movement to stay hydrated. This hydration keeps the disc supple and functional.

Trauma, such as a car accident, or repetitive microtrauma, such as poor posture, can cause the joints of the spine to move less smoothly or incorrectly.

Features phase 1

No or mild pain
Light stiffness
Often unnoticed
Can take years

Dehydration

Lack of movement reduces the disc's ability to absorb moisture, leading to the buildup of waste products. These waste products damage the disc's building blocks, reducing its ability to retain moisture.

The incorrect movement pattern accelerates wear, similar to how a misaligned car tire wears out faster.

Visible on MRI:

On an MRI (T2 image) this is visible as a disc with a darker center than the healthy discs next to it.

Degeneration, cracks and collapse

A dehydrated disc is more susceptible to small tears in the fibers surrounding the gel core. Only the outer third of these fibers contains nerves, so tears usually only become painful when they reach the outer layers.

Nerve compression: As the tears progress, the disc loses its shape, bulges, and the distance between two vertebrae narrows. If the bulge impinges on a nerve, you may experience pain, numbness, tingling, or muscle weakness in the area supplied by that nerve (usually an arm or leg).

Difference between hernia, degeneration and protrusion

Hernia

Often used when symptoms suddenly become severe, for example, when the fibrous ring can no longer contain the gel core and it enters the spinal canal. This causes a severe inflammatory reaction and possible nerve compression.

Disc bulge / Degeneration

The process is usually slower, and the gel core emerges slowly or not at all. Symptoms develop gradually over a longer period.

Other medical terms:

Extruded disc
Posterior lateral disc

Prolapse
Stenosis

Broad based disc
Arthritis

If you're unsure what your diagnosis means, we offer a free consultation where one of our chiropractors will be happy to explain it.

Symptoms of a hernia

Initial phase

Advanced phase

Characteristic symptoms:

Pain in the middle of the back
Worsening with movement, coughing, sneezing or straining
In case of nerve compression: numbness, pain, tingling and muscle weakness in the leg
Some positions are more comfortable (bent over, arm above head)

Medical Emergency

Very rarely, loss of control of bladder and/or bowel function and paralysis in the legs can occur — this is called cauda equina and is a medical emergency.

Advice for home

Important: Stay active

Bed rest used to be recommended, but research shows that this can actually be harmful. Staying active within your pain threshold is important to prevent muscle breakdown and worsening symptoms.

Practical tips:

Movement

Walk around regularly, gently move the pain-free joints.

To sleep

If you have lower back pain, place a pillow under or between your knees while sleeping.

Heat

Heat (20 min) may reduce pain; repeat every 2 hours if necessary.

Cold

Cold application may also help for some.

Resources:

TENS devices

Can provide temporary relief of pain.

Warming creams

Menthol and capsicum may provide temporary relief.

Targeted exercises

Helps reduce muscle cramps and strengthen the back in the long term.

Braces & A-frames

May provide short-term relief, but use only after consulting a chiropractor.

Chiropractic treatment of hernia

Intake and diagnosis

A thorough intake determines whether chiropractic care is suitable. If necessary, additional examinations are performed with x-rays or MRI. If suitable, we follow a four-step plan:

Our four-step plan:

Adjust (correct)

The chiropractor locates poorly functioning vertebral joints and restores their movement with a gentle impulse.

This ensures:

Improved nutrition and removal of waste products in the disc
Reduced muscle tension and pain
Restoration of normal movement
Support for optimal nerve function

Strengthen (strengthen)

Customised exercises strengthen the back muscles and improve posture to prevent recurrence.

Lifestyle Advice

Together we analyze which habits have contributed to the problem and look for feasible improvements, such as drinking enough water or an ergonomic workplace.

Maintenance

Regular check-ups keep the spine healthy, especially with continuous stress such as sedentary work.

Forecast and results

Excellent results

Most of the hernia patients we see achieve excellent results and are able to enjoy life to the fullest again.

From top sport to work, hobbies and family life

When to refer?

In some cases referral is necessary to:

Physiotherapists
For surgical procedures
Nerve blocks
Discectomy

Hernia Treatment: All about intervertebral disc problems

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