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Spinal Disc Herniation

The Facts on Herniated Disc
(Slipped, Prolapsed, Ruptured Disc)

The spine is made up of bones called vertebrae. Between the bones of the spine are small discs or cartilage that are hard on the outside and soft and jelly-like on the inside. The discs act to absorb shocks caused when the spine moves. The spinal cord is a bundle of nerves running through the canal within the spinal column. It carries messages to and from the brain via nerve roots which branch out to the body along the length of the spinal cord. A herniated,prolapsed, or ruptured disc happens when the inner material bulges or bursts through the outer lining of cartilage, and irritates or may even damage the roots of spinal nerves. This irritation causes constant back and leg pain.

 

Herniated discs are common in people between 30 and 40 years old. People who spend a lot of time sitting, like truck drivers, or those who twist their back a lot, are the most likely to develop a herniated disc.

 

Causes of Herniated Disc

A disc can become weak with age or after an injury. The material inside the disc bulges through the outer lining of cartilage and presses on a spinal nerve, causing a herniated or prolapsed disc. When the material bursts through the outer lining of cartilage, it is called a ruptured disc.

 

Symptoms and Complications of Herniated Disc

A herniated disc causes pain, loss of feeling, tingling, or muscle weakness. The symptoms either come and go suddenly or are constant and last a long time. The amount of pressure the herniated disc puts on the spinal nerves determines how bad the symptoms will be. Coughing, laughing, sneezing, urinating, or straining while defecating make the pain of a herniated disc worse.

 

Most herniated discs are in the lower back and cause back and leg pain that won't go away. Intense pain that radiates down from the disc through the buttocks and down the leg to the foot is called sciatica. Intense pain below the knee is a sure sign of a herniated disc, since other back conditions don't cause pain below the knee. A herniated disc in the lower back can cause weakness in the legs and trouble lifting the front of your foot off the ground. If the herniated disc presses on nerves leading to the bladder and bowel, the person will have trouble defecating or urinating. Weakness of the muscles around the anus along with trouble controlling urination is a medical emergency and may need surgery on the herniated disc.

 

Herniated discs also happen fairly often in the neck (cervical spine). They cause pain in one arm, beginning with the armpit and upper shoulder blade, and traveling down the arm to one or two fingers. The pain can also be in the upper ridge and tip of the shoulder. Arm muscles can weaken, making it hard for someone to move their fingers.

 

How does Acupuncture work for the pain relief?

1. Gate-control theory of pain

 

The "gate control theory of pain" proposes that pain perception is not simply a direct result of activating pain fibers, but modulation by the interplay between excitation and inhibition of the pain pathways. According to the theory, the "gate of pain" is controlled by the inhibitory action on the pain pathways. That is, the perception of pain can be altered (gated on or off) by a number of means physiologically, psychologically and pharmacologically. The gate-control theory was developed through neuroscience research independent of acupuncture. Later the "gate control" mechanism was proposed to account for the hypothesized analgesic action of acupuncture in the brainstem reticular formation by a German neuroscientist in 1976.

 

This leads to the "theory of central control of pain gating", i.e. the pain blockade in the brain happens central to the brain rather than at the spinal cord or periphery. This occurs via the release of endogenous opioid (natural pain killers in the brain) neurohormones, such as endorphins and enkephalins (naturally occurring morphines).

 

2. Neurohormonal theory

 

Pain transmission can also be modulated at many other levels in the brain along the pain pathways, including the periaqueductal gray, thalamus, and the feedback pathways from the cerebral cortex back to the thalamus. Pain blockade at these brain locations is often mediated by neurohormones, especially those that bind to the opioid receptors (pain-blockade site).

 

Some studies suggest that the analgesic (pain-killing) action of acupuncture is associated with the release of natural endorphins in the brain. This effect can be inferred by blocking the action of endorphins (or morphine) using a drug called naloxone. When naloxone is administered to the patient, the analgesic effects of morphine can be reversed, causing the patient to feel pain again. When naloxone is administered to an acupunctured patient, the analgesic effect of acupuncture can also be reversed, causing the patient to report an increased level of pain. It should be noted, however, that studies using similar procedures, including the administration of naloxone, have suggested a role of endogenous opioids in the placebo response, demonstrating that this response is not unique to acupuncture.

 

One study performed on monkeys that recording the neural activity directly in the thalamus of the brain, indicated that acupuncture's analgesic effect lasted more than an hour. Furthermore, there is a large overlap between the nervous system and acupuncture trigger points (points of maximum tenderness) in myofascial pain syndrome.

 

Evidence suggests that the sites of action of analgesia associated with acupuncture include the thalamus using fMRI (functional magnetic resonance imaging) and PET (positron emission tomography) brain imaging techniques, and via the feedback pathway from the cerebral cortex using electrophysiological recording of the nerve impulses of neurons directly in the cortex, which shows inhibitory action when acupuncture stimulus is applied. Similar effects have been observed in association with the placebo response. One study using fMRI found that placebo analgesia was associated with decreased activity in the thalamus, insula and anterior cingulate cortex.

 

Recently, acupuncture has been shown to increase the nitric oxide levels in treated regions, resulting in increased local blood circulation. Effects on local inflammation and ischemia have also been reported.

 

Why should you choose Dr. Yu as your primary acupuncturist?

Dr. Yu has over 20 years experience treating spinal and joint disorders with acupuncture. He has also completed multiple research studies specializing in this field. Dr. Yu also published a book specific to the prevention and treatment of spinal disorders called "Disc Herniation - Prevention and Treatment" (in Chinese). In light of his knowledge and understanding about disc herniation, he discovered a group acupuncture points that effectively and quickly relieve pain and assists the healing of the herniated discs and other spinal disorders much faster than the routine treatment. He named the special group of acupuncture points the "ten point treatment". He also uses special combination of herbs that he wraps the patients affected area after the acupuncture treatment to boost the healing process. A spinal disorder acupuncture treatment lasts between 40 to 60 minutes. Regardless if the disc herniation is recent, long term or post-operative, the "ten point treatment" is effective and quick. It takes approximately 10 to 20 sessions to completely treat the problem. Preventative exercise and daily life style factors to reduce re-injury will be taught individually to each patient.