FYI just because you have a herniated disc doesn’t mean you have to live in pain
At my Dry Needling and Acupuncture clinic in Tampa, FL one of the most common problems I help people with is pain from disc herniations. Despite what your regular doctor or orthopedic surgeon tells you, not all back pain is caused by herniated discs, even if you had an MRI that shows you have a herniated disc.
Long term studies of those who have had back surgery show the results are pretty terrible. About 60 percent of patients report poor outcomes when they were followed for 6 years. 1, 2.
You DO NOT have to live with back pain. You DO NOT have to have surgery to fix your back pain. I help people every single day get out of pain with dry needling & acupuncture. So let’s dive in!
What is a herniated disc
Let’s review your spinal anatomy -Your discs sit between your vertebrae and act as shock absorbers for those vertebrae. You also have little facet joints occurring where every two spine bones move together. Then there are spinal nerves that come out at each facet joint level, one on each side. And to stabilize things, the multifidus muscle provides stability for all of the spinal structures. There are also ligaments that hold everything together.
How common are herniated discs?
As we age just about all of us will have herniated discs, the thing is not everyone will have pain. Here’s a chart from (Brinjikji, et al., 2015, p. 813) to really illustrate that as we age, things are going to look different on a picture. Just remember, PAIN DOES NOT DIRECTLY CORRELATE TO IMAGING FINDINGS. That means you can have degenerative changes on an x-ray or MRI and NOT have pain!
So discs can be herniated and people don’t have pain? YES!
⅔ of disc herniations will heal on their own. The thing is the disc can heal but you can still have pain. So we have to ask the question, was the pain coming from the disc or something else? The logical conclusion is that the pain isn’t always caused by the disc. So what’s really causing your back pain then?
Pain is complicated – it’s never as simple as pointing to a picture and knowing the exact cause. To really find your pain (I call it your pain generator) requires a very thorough physical examination which in and of it self is a lost art. Most doctors (READ orthopedic surgeons) barely put their hands on you these days and even if they do, it’s to justify surgery. They’re missing the big picture.
During my physical exam I’m looking at quite a few different things – what does your tissue feel like, are there changes to it? Are you hypersensitized in areas? Are muscles tight or weak? Does pressing on one area cause pain in another? Can I recreate your exact pain?
This allows me to understand what muscles, ligaments, and nerves are involved in your pain – it’s always a combination of everything. This is why surgery usually fails, because they never take into account the entire picture.
What are my options?
Typically you get told you have 3 main options – over the counter NSAIDs, a steroid injection (epidural) & finally surgery, let’s dive into these before we talk about why acupuncture is the best option.
NSAIDS (Advil / Aleve)
Over the counter medication (NSAIDS) such as Ibuprofen and Naproxen are common choices. If this does not control the pain their doctor may provide stronger prescription medication. However these medication may come with side effects such as addiction, heart damage, liver damage, and GI bleeding. Because of its overuse the U.S. is currently experiencing a crisis known as the opioid epidemic.
Cortisone Steroid Injection
These literally just stop the inflammatory process in its tracks, which in the short term can be great and calm down pain. The problem is they are absolutely terrible for the tissue they’re injected into – they literally eat it up and turn it into swiss cheese. Studies show they might help in the short term but long term the outcomes are actually worse. They increase the chances your pain will re-occur and increase the chances you will require surgery. So not a good option.
Herniated Disc Surgery (discectomy)
While surgery gets sold as this magical fix all, it’s not. Surgery for herniated discs can help relieve the pressure for a disc bulging on a nerve but in the end it makes the disc weak. There is no repair happening here – all the surgeon does is literally cut a part of your disc off. This leaves the jelly donut of a disc with a nice big weak spot. It also leaves the 4 layers of muscle and ligaments in your back weaker. So now you’re vulnerable to re-herniate your back.
Acupuncture & Dry Needling
When it comes to acupuncture, it’s like anything else in the world, there’s a million different ways to practice it. What makes my clinic in Tampa, FL unique is that I practice a special type of acupuncture that is by far the most modern and BEST approach for pain – Neurofunctional Acupuncture.
The official definition of neurofunctional acupuncture is “a precise peripheral nerve stimulation technique, in which fine solid needles are inserted into neuro-reactive loci, and stimulated manually or with electricity for the therapeutic purpose of modulating abnormal activity of the nervous system.”
In other words, we stick needles in people (in a controlled, specific manner) to affect the nervous system (e.g. wake things up, calm them down or reduce pain signals). We also often include some electrical stimulation on the needles to further affect the nervous system.
How does acupuncture/dry needling help with pain?
There are many ways in which electroacupuncture affects pain. Locally, one of the biggest factors is the release of certain neurotransmitters that affect whether or not pain signals are transmitted up to the brain. Electroacupuncture also modulates pain signalling and perception at other levels of our nervous system, all the way up to the brain.
When it comes to pain, you can treat the symptoms by taking NSAIDs, getting a cortisone injection or even surgery – or you could jump to the root cause of the problem and use Neurofunctional Acupuncture to resolve the problem without hard drugs or surgery.
Brinjikji, et al., 2015, p. 813