The Truth About Herniated Discs




By Dean Moyer
Author of Rebuild Your Back

To hear some people tell it, you’d think that almost all back and neck pain must surely be caused by herniated discs. In fact, for years we’ve been told over and over again how the bulging disc - encroaching into the spinal canal - was pinching nerves and causing back pain, neck pain and various neurological disorders such as arm, shoulder and leg pain.

And, to make matters worse, for years we’ve been led to believe that surgery was the only sure way to correct these problems. But - like many things we’ve been told over the years - the truth turns out to be quite a different story.

Researchers are beginning to realize that herniated discs may not cause back pain at all.

And what’s more, they have discovered that herniated discs – if treated with the correct exercises - will completely heal and shrink back to their normal shape and TOTALLY DISAPPEAR.
Study Shows Herniated Discs Seldom Cause Back Pain

To get the full story we have to go back about ten years to a study published in the New England Journal of Medicine involving the use of Magnetic Resonance Imaging (MRI) to diagnose back pain. In this study researchers (who were intrigued by the findings of several other studies concerning herniated discs) selected 98 subjects who did not have back pain or any other back related symptoms and sent them to be evaluated by MRI scans. What makes this interesting is that the evaluators were not told that these people did not have back problems.

The results were pretty astounding and sent a shock wave through the medical community at that time. What they found was that 64 percent of the test subjects came back with MRIs that showed disc problems that normally would have marked them as prime candidates for surgery… except, of course, for one little problem… and that was that they did not have back problems at all!

Over half of the test subjects turned out to have herniated discs, and a large percentage of these people - who did not have any back pain whatsoever - were diagnosed as having such things as spondylolysis, spondylolisthesis and stenosis of the spinal canal. Here are the exact findings:

The most common nonintervertebral disk abnormalities in people without symptoms were Schmorl's nodes (herniation of the disk into the vertebral-body end plate), in 19 percent of the subjects; annular defects (disruption of the outer fibrous ring of the disk), in 14 percent; and facet arthropathy (degenerative disease of the posterior articular processes of the vertebrae), in 8 percent. Seven percent of the asymptomatic subjects had spondylolysis, 7 percent had spondylolisthesis, 7 percent had stenosis of the central canal, and 7 percent had stenosis of the neural foramen. [1]

With the results of the two readings averaged, 52 percent of the subjects had a bulge at at least one level, 27 percent had a protrusion, and 1 percent had an extrusion. Thirty-eight percent had an abnormality of more than one intervertebral disk. [1]

Herniated Discs Just Innocent Bystanders?


Well, needless to say the researchers were stunned. These results called into question nearly everything that they had previously believed about herniated discs and back pain. In addition, these results clearly showed that MRIs are not reliable tools for determining the cause of back or neck pain.

After carefully considering all the facts, the research team finally concluded that - if people could have herniated discs and other spinal abnormalities and not have any back problems whatsoever - then maybe the herniated discs weren’t causing back pain after all. Maybe the presence of herniated discs in people with back pain was just a coincidence…

Conclusions On MRI examination of the lumbar spine, many people without back pain have disk bulges or protrusions... Given the high prevalence of these findings and of back pain, the discovery by MRI of bulges or protrusions in people with low back pain may frequently be coincidental. [1]

And, as I mentioned earlier, there have been a number of studies that have arrived at similar conclusions. I won’t bore you with all the details, but suffice it to say, the results of these clinical studies have cast considerable doubt on whether herniated discs have anything to do with back pain at all. And furthermore, they call into question the wisdom of diagnosing back pain with inaccurate and unreliable imaging technologies. [2,3,4,5,6... 16]
Herniated Disc Opinions Changing

Here are a few select opinions that I thought you’d find interesting:

Contributing to the rush to surgery has been the widespread use of magnetic resonance imaging (MRI)… But what may look like a trouble spot often is not. Abnormal-looking disks in the lumbar spine are almost as likely to show up in people with no back pain as in those with pain. That is, abnormalities that show up in MRIs are not necessarily related to back pain. And some people with severe back pain have normal-looking MRIs. [18]

The relation between abnormalities in the lumbar spine and low back pain is controversial. Previous autopsy studies, as well as myelography, computerized tomography (CT), and magnetic resonance imaging (MRI), have shown abnormalities in a substantial number of people without back pain. A recent study using MRI reported a high prevalence of disk herniation in people without symptoms and urged caution in relating symptoms to such lesions. [1,2,3,4,5,6,7,8]

Can disc herniation cause back pain? According to Bogduk, nerve-root compression (i.e., from a bulging or herniated disc)… is unlikely to be a common source of back pain. "There is no evidence that nerve root irritation causes back pain… " he says. [19]

Discs have been blamed as the troublemakers for years. If you had sciatica, it meant that a disc had popped out or ‘slipped’. But how wide off the mark that glib diagnosis can be. This is just not the way discs behave. Discs never slip anywhere, in or out. They simply bulge and, even when they do, that bulge may be painless and harmless. [17]

Doctors Slow to Change

Today medical experts agree that there’s very little evidence to suggest that herniated discs are the cause of back or neck pain. [20-26] Unfortunately, far too many doctors have been slow to embrace this current research. And what’s more, they still insist on using MRIs and other expensive scans even though the results are often inaccurate and misleading.

We could speculate all day as to why this is so, however, that would not get us any closer towards our goal of rebuilding your back or neck. What we need to focus on right now is the fact that any bulging discs you may have are - in all likelihood - just a coincidence.

Which means the presence of one or more herniated discs on an MRI is not a cause for alarm. It probably has nothing to do with your back or neck pain and it is DEFINITELY NOT an indication that you need surgery.

The results are back from that MRI you didn’t really want in the first place and the doctor is standing there telling you that you’ve got a couple of herniated discs… and he’s using words like ‘degenerative disc disease...’ and you’re thinking, “Oh my God, I’ve got a disease?”

And now he’s saying something else that you don’t quite get because all of a sudden you’ve got a sinking feeling in the pit of your stomach and your head’s feeling a little light… but the word ‘surgery’ was in there somewhere... and you’re trying to pay attention while at the same time you’re slowly seeing your life slipping away…

So you take a deep breath and it’s, “Okay, I can handle this...” but as the realization hits you, that feeling in the pit of your stomach turns into fear and fear turns into despair and despair gives way to depression and… Hey, hold on a minute!

I’m going to let you in on a little secret. (Okay, it’s not really a secret… but it’s not exactly common knowledge, either.)

Where was I?

Oh yeah… guess what?

Herniated discs just go away.

That’s right, I kid you not. I’ve got scientific proof straight from the big boys themselves that herniated discs -– if treated properly -– will not only heal on their own, but will shrink back up and totally disappear about 90 percent of the time.
Study Shows Herniated Discs Do Heal

In a previous article we saw a number of clinical studies that indicated that herniated discs were not the major cause of pain we once thought they were. [1] And, while that’s great news, it still doesn’t dismiss the fact that we need to do something about them. After all, just because they may not be painful, that doesn’t mean they aren’t a degenerative condition.

Fortunately, there have been a number of major breakthroughs along those lines starting a few years back when two doctors set out to test a theory. A theory that is very near and dear to us here at Rebuild Your Back as you’ll see in a moment.

They decided to test their theory on 24 consecutive patients with cervical disc herniations. All the patients were diagnosed via MRI to have disc herniations greater than 4mm. All complained of arm pain and “the majority had neurological deficits,” which means there was serious nerve impingement and they were experiencing things like numbness and tingling in their arms, hands and shoulders.


What Was different About This Study

What makes this study particularly interesting for us is that the doctors decided to treat their patients with exercise instead of surgery. Which is pretty surprising when you consider that, based on their symptoms, these patients were prime surgical candidates.

I don’t think I can overstress that point. These were not just people with ordinary neck pain and minor disc bulges. This study was conducted on people who fell into the one to two percent range for whom surgery would typically be recommended. Which makes the results that much more exciting when we learn that “22 of the 24 had good or excellent outcomes” and “19 of 22 returned to work at the same job.” [2]

Only 2 of the participants actually had to have surgery, which seems to indicate that perhaps even from within the small percentage of people for whom surgery “might be beneficial” only a tiny fraction of those surgical procedures are actually necessary. [2]
Herniated Discs Simply Go Away

Many more studies involving exercise have since been conducted including several where they took people with herniated discs and checked them at six month intervals and they found that - If treated properly – the herniated discs actually healed on their own and shrank back to normal.

Here are a few related quotes that I think you’ll find interesting:

In other recent studies, sequential MRI scans done at six month intervals have shown that disc herniations more often than not are resorbed by the body. The studies found that larger disc herniations DO NOT correlate with a poor prognosis. They go away. As Ian McNab, MD said of disc herniations… “90% of patients will get better and stay better with conservative care.” [3]

I have personally seen more than 5,000 people with low back pain. And a huge percentage of these people had already been diagnosed as having irreversible disk damage, ruptured disk, degenerative disk disease and more. Yet somehow, almost all of them seem to recover without the supposedly needed surgery. [4]

The decision to do surgery is based primarily on the physical exam, not the MRI or CT scan. In fact, some of the worst looking disc herniations on scans produce very little and sometimes no symptoms at all... Furthermore, large disc herniations often shrink and totally disappear on scans reflecting the body's ability to heal. [5]

In summary, when faced with a disc herniation… Don’t panic. As long as neurological deficits are not deteriorating, observation is warranted… Consider exercise a treatment for acute disc syndrome. Most patients get well on their own and many disc herniations disappear. [3]

There is a lot of information here to digest. And it may conflict with what many doctors consider to be proper treatment for disc herniations. But such information cannot be ignored. Given the costs and potential complications from what in many cases may be unnecessary surgical intervention, caution is certainly indicated. [3]

In light of these discoveries the American Academy of Orthopedic Surgeons now recommends that you wait at least three to six months before deciding to have surgery unless there is a progressive neurological deficit.

And even the Agency for Health Care Policy and Research in their publication, Guidelines for Acute Back Pain has specifically stated that “the body heals itself” and they recommend that you “not rush into the surgical pathway.”
No Reason To Worry

So you see, there is no reason to become anxious or depressed simply because your doctor has discovered a herniated disc in your back or neck. And there’s certainly no reason to assume that your life is over just because you’ve developed a few bulging discs.

Many of the top medical experts in the country are convinced that herniated discs have little to do with back pain and - as we’ve seen - they now know for a fact that discs do heal and that they will disappear if given proper treatment.

This is not to say that you shouldn’t be concerned about degenerating discs, but only that you shouldn’t jump to the conclusion that a herniated disc is directly causing your back or neck pain. And whatever you do, don’t rush into surgery because of something that shows up on an MRI or CT scan.

The smart thing to do is to get started rebuilding your back or neck as soon as possible and just take care of the matter. A strong, healthy spine is well within your reach. It’s not that difficult… it costs virtually nothing… and the rewards are priceless.

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2 comments:

jimstinnett said...

I respectfully disagree. I have had a LOT of pain caused by a herniated disk. When I say a lot, i'll just say that the pain caused me to faint and lie on the floor screaming for about an hour.
MRI did show a big old herniation at the top of my lumbar spine, right at L1-L2.
Also totally numb right leg from groin to knee in front, constipation, urinary retention and I lost 40 lbs in 2 months. This is NOT a joke, dude.

PT has helped a lot, but I am thinking it will take a year or so to re-absorb or whatever it does.

Just saying, of course....
JS

George said...

It's a nice suggestion in the herniated disk when faced with a disc herniation… Don’t panic. As long as neurological deficits are not deteriorating, observation is warranted… Consider exercise a treatment for acute disc syndrome.