The vertebral segments of the spine are separated by intervertebral discs from the second cervical vertebra trough the Sacrum at the base of the spine. These discs are softer than bone and have a fluid filled center which acts as a shock absorber for the spine. When this fluid filled center escapes its capsule the disc is then considered herniated. There are various degrees of herniation:

The weak spot in a disc is directly under the nerve root, and a herniated disc in this area puts direct pressure on the nerve, which in turn can cause pain to radiate all the way down the patient’s leg to the foot.
Approximately 90% of disc herniations will occur at L4- L5 (lumbar segments 4 and 5) or L5- S1 (lumbar segment 5 and sacral segment1) and C5-C6 (Cervical segment 5 and 6) which causes pain in the L5 nerve, S1 nerve, or C6 nerve respectively. This often results in radicular pain extending into the arms and legs along the affected nerve root.
Evaluation for a disc herniation
There are several orthopedic and neurological tests that can indicate a herniation in either the neck or low back has occurred. Ultimately the most definitive diagnostic tests are Magnetic Resonance Imaging (MRI) or Computed Axial Tomography (CAT Scan). These studies allow the visualization of the disc as well as the associated spinal nerve. Our office works closely with local imaging centers which provide fast comfortable service including open style MRI units that allow the greatest comfort for the patient. Below are examples of Cervical and Lumbar disc herniations:

	lumbar spine (back)			cervical spine (neck)

*The small black bulge at L4-L5 and the disc on the right at C4-5 represent MRI images of Lumbar and Cervical Disc herniations, respectively.
In some cases disc herniations can result in surgical intervention. (*Should you experience saddle numbness (numbness in the groin region), loss of control of bowel or bladder function immediately seek care with your local hospital emergency room.) However, the majority of cases can be very effectively treated conservatively.

"Conservative Treatment for a Lumbar Herniated Disc"
by Peter F. Ullrich, Jr., MD

In many cases, conservative treatment options can help reduce the back, neck, leg and arm pain and discomfort caused by the herniated disc.
- Chiropractic manipulation restores normal motion to the joint allowing faster healing and more effective rehabilitation
- Traction and passive therapy modalities
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- Oral steroids (e.g. prednisone or methyprednisolone)
- An epidural (cortisone) injection

Lumbar and Cervical Traction Therapy:
Traction (decompression) therapy is very effective in treating disc herniations. Since the disc is a fluid filled structure, traction provides a negative pressure inside the disc. This “vacuum effect” pulls the herniated portion of the disc back relieving the pressure and irritation to the nerve root.
With lumbar traction, we utilize various angles to more effectively affect the injured joint segment. Traction therapy is followed by passive therapeutic modalities to decrease pain and discomfort. If necessary, Aquatic Physical Therapy is also used during the rehabilitative phase. Rehab in water allows you to accelerate the strengthening of your low back by reducing the resistance of gravity. Once your neck and/or back are stronger other exercises can be added for rehab in our office or at home.
We currently have an 85-90% success rate with lumbar and cervical disc herniations.