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Telephone: +44(0)207-631-3067 Emergencies: +44(0)7710-901140
THE LUKLINSKI' SPINE CLINIC
Suite 17, Milford House - 7 Queen Ann St. (off Harley St.), London, W1G 9HN
Established 1969 - over 40 years experience in treating spinal disorders
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SPINAL CONDITIONS & TREATMENT
by Mr B.M. Luklinski
MSc Medical Rehabilitation; MSc Physical Education; Dip Home Med.

HERNIATED DISCS

The diagnosis for bulging and herniated discs can frequently be faulty because MRI scans upon which doctors and surgeons rely can only show about 25% - 40% of the patient's condition - and even then the results of such scans are not necessarily indicative of the real problem affecting the patient. Scans can assist but they cannot provide conclusive evidence of a particular condition. A patient for example may not exhibit any symptoms that might be expected from the scan, and vice versa, so it is necessary to take the history, pathology, and range of movement into consideration, which is beyond the field of study of most general practitioners and surgeons.

In cases of 'torn' muscles or ligaments, it is uncommon for soft tissue to be actually torn: it is more often simply compressed. If passive movement of the joints is impaired by even a tiny misalignment of a joint, the soft tissues and ligaments will go into spasm, which occurs in the majority of cases. The patient might then feel that he has 'torn' a ligament, which is not actually the case.

The nerve roots from the spinal cord are 2/3mm thick, while the distance between the discs and the spinal nerves is 1.2/1.5 mm. The height of each disc in the lumbar region is 9mm, in the thoracic 6mm and in the cervical (neck) 3mm. The spinal nerves can control muscular, motor, or sensory functions or a combination of these - and if effected by a misalignment of a joint or otherwise, the patient will develop a range of different types of pain with tingling or numbness in different parts of the body such as an arm, hand, finger or toe.

Treatment

If a disc is bulging or herniated (a prolapsed disc is when the outer rim starts to break down), it will be necessary to mobilise the joints above and below the disc to enable the nucleus pulposus (which is contained within the disc as a support) to return to its proper place. The treatment involves a painless procedure called mobilisation which has to be conducted over a number of sessions because the nucleus pulposus cannot be forced back into the disc overnight - it has to be coaxed back gradually over a few weeks. The larger the protrusion the more time it will take to return. The outer rim is affected in the majority of cases and following treatment, it will take up to three months to heal. If not treated then the outer disc will become scarred which makes the disc weaker. From the age of 60 the discs lose about 20% of their water content and their ability to recover from a hernia is less, but surgery for this condition is unnecessary and always extremely dangerous at any age, because eventually the neighbouring joints are subjected to constant irregular pressure which can cause pain and stress fractures. These joints are normally strong precisely because they are supported by surrounding ligaments and tissue, which include the spinal discs, and these should be left intact to serve their purpose as best they can. A herniated or bulging disc can impinge on other nerves such as the sciatic nerve, causing sciatica or severe pain in the leg, thigh, buttocks, hip, feet and toes. If upper sections of the back are affected then symptoms will appear in the arms, hands or fingers. The symptoms will determine exactly which disc is affected, and although the condition is very painful, surgery is never required to cure a herniated or bulging disc, and should not be performed.


It can safely be said that for the vast majority of spinal conditions surgery is neither necessary nor effective, as it almost always leads to long term complications and suffering for the patient, out of all proportion to the original condition. The use of metal rods, screws and plates and the cutting away of parts of the spine, even the heating of discs to cause them to shrink (IDET procedure) represent a rather crude approach to the treatment of spinal problems and is not a method of 'treatment' that we can ever recommend.

The procedures of Orthopaedic Medicine outlined above do not involve operating on a patient, and all treatment is safe and manageable as well as being highly effective.