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Slipped Discs

That's the phrase people use to describe a disc bulge or herniation. I have no idea where it started. Nothing actually "slips". There's another condition that involves a vertebra "slipping" forward called spondylolisthesis, but that's another post.

I've been in court testifying as an expert witness many times. Once, regarding an injured patient who had a disc bulge. The defense attorney in attempting to diminish the importance of this finding on the patient's MRI, asked the rhetorical question "isn't it true doctor, that 40% of people have bulging discs?". The tactic was designed to make it seem as if a bulging disc was a normal finding and therefore if I agreed, it would lower the importance of this in the jury's eyes. I answered, 'Yes, counselor, that IS true. 40% of people DO have bulging or herniated discs somewhere in their spine. It is not a normal finding but a common one. And, if it were YOUR spine, I think you'd rather you did not have a bulging disc.' The jury ruled in favor of the plaintiff (injured patient). I've never testified as an expert where the case was lost.

Discs can be pesky little devils. So much so that grand orthopedic surgery palaces have been built with pianos and fireplaces in their foyers in every metro in the country. The market price for disc surgery is in the vicinity of $50-80k. With 50% of those failing and resulting in a 2nd surgery for another $50-80k. Most of these are unneccesary, but when seeking care in the medical system, the forces brought to bear on back pain sufferers to have a surgery are immense. Largely because so much money is to be made.

Most people are unaware to surgically reach a disc in the low back is not unlike trying to debone a large roast. Then, "tucking" it all back in so it heals up. Even though the disc bulge or herniation may have been successfully removed, the destruction of the surrounding tissues of muscles and ligaments, leaves the whole area incapable of ever functioning normally again. For some, that might be fine and considered as good as it can get.

For similar disc bulges and herniations that some have this surgery for, we approach this conservatively, restoring the alignment and motion that allows the disc to heal. Yes, the disc heals. Even herniations. The issue for most is the timeframe during which this occurs. It is 3 years. That is because discs, unlike muscles, ligaments or tendons, do not have blood supply to repair itself. The disc and cartilage relies on motion and the movement of fluid in the joint to deliver nutrients and remove wastes. Once injured and out alignment, the motion is reduced or stopped and the healing slows down and is impaired. This is why adjustments are absolutely necessary to this healing process. Many in healthcare don't appreciate this mechanism and actually advise wrongly, against this. And many who've had this surgery have been sold on it that if they didn't, they'd be in a wheelchair. Think about it though. How many people do you know in a wheelchair because they DIDN'T have surgery? And, how many do you know in a wheelchair after they HAD surgery?

I should have outlined the real problem with the disc isn't the disc. It's the nerves passing by the disc. The irritation of the nerve either by the disc hitting the nerve or the inflammation in the healing process itself being a noxious stimuli to the nerve, hurts tremendously and can cause effects distant from the low back. Like the legs, and feet. Also, reproductive organs and the large bowel and bladder.

The correction of a "slipped disc" conservatively is the most effective, reliable and successful path. It does require imaging to make sure correction is being applied in the best possible manner. Many offices don't use x-rays anymore largely as a result of health plans not covering imaging in chiropractic offices. Despite most protests that they do, the largest insurer in the state only covers imaging for low back pain if the patient meets specific criteria. Such as, exposure to long term steroid use, history of cancer or suspicion of a fracture. That's CYA in case of osteoporosis. They don't care about identifying scoliosis, swayback, degenerated discs, short legs, etc... The health plans couldn't care less. I'm convinced they prefer to lose $50k doing a surgery rather than $1,000 for chiropractic.

Once you understand the fees for medical expenses are high because the insurers need them high for you to be dependent on them. They can raise premiums because they know you'd be crazy not to have protection from the mafia that is established as medicine. If you are unfortunate to have an interaction that requires hospitalization, the cost is now beyond anyone's ability to pay that bill. You NEED protection or their billing department will put a lien on your home. They know it. We know it. Yet, still....

Those are cost issues. What YOU want however is to be healthy so your only interactions with the system are trauma related. And more importantly, live healthy into retirement and go on hikes, vacation, play with your grandkids... whatever. That requires a conservative and healthy approach. Getting checked and adjusted where your spine is not lined up and damaging nerve function. Do so from birth to death. This is how you're going to get the most out of your life. That's what we do here. I don't give advice that I don't practice myself. My wife and I, as well as my (adult) kids get adjusted weekly. We've been doing so for decades. We would love for you to enjoy your health as much as we enjoy ours.


Dr. Barrett

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