An increasing number of people have recurring back issues these days: tight neck and shoulders, sciatica, lower back pain, the list goes on. Most of us never get it thoroughly checked out, get used to chronic pain and it becomes the new normal…until something happens and we are in so much pain that we can’t function. This is when we find out about the dreaded bulging disc, often loosely described as a “herniated” or “slipped” disc. If any of this resonates with you, read on, today’s interview is with an expert in the field, Dr. Madelaine Franklin, founder of Chiropractic and Physiotherapy Center in Dubai. In this article, she explains some of the common sources of back pain, enlightens us on the symptoms to look out for and gives us some insight on a new method to treat bulging discs.
WM: What are the most common back problems you see?
MF: We come across a variety of issues, but the one we probably encounter the most are disc bulges; these are usually in the lower back and cervicals.
WM: What are disc bulges?
MF: Our spine had 3 curves: the lumbar, the thoracic and cervical (neck) curves. This forms a spring. So when we sit at our desks, the lower back flattens, the upper spine becomes curvier and the neck starts going straight. Then we go to the gym and load something heavy, we don’t have the natural spring anymore so all that pressure is now going right into the discs themselves and degenerates them. The disc has a fibrous outer layer and a jelly inside. When the fibrous layer gets weaker and the jelly starts to push out the fibrous layer: that is a disc bulge. People often call it a “slipped disc” but that is incorrect, a disc doesn’t slip, it bulges. If the jelly leaks out and bits break off then we call it a sequestrated disc.
Depending where it bulges it may or may not cause pain. If it is going out from the back or side and pressing against the nerve root, that will cause pain: lower back, sciatic, etc
WM: What are the main causes of disc bulges?
MF: I’ve worked in South Africa, Dubai and Malaysia. The main reasons people came to me with disc bulges in Malaysia was because they were a result of underlying bone issues like osteoporosis. The root cause was their very processed food diet, lack of exercise and the fact they have a high pain threshold, which means it took years before they would notice their symptoms and consult a professional. In Dubai, it is different: people eat better, they tend to exercise and are more health conscious. The real culprits are their poor daily movement patterns and habits. We spend too much time at a desk, in a car, in front of a computer, hunched over a mobile device, we walk less and then, when we workout, we overdo it. We are how we move, so over time, this can lead to disc bulges and other back problems. In fact, people who exercise a lot often experience issues. For example, we find that a high percentage of people who regularly practice activities like crossfit have back issues. It isn’t necessarily the movements themselves that cause the problem but rather, the fact they aren’t done well. Crossfit is very competitive, so people tend to push themselves too far: they load their joints too much, lift heavier weights than they should and do the moves too quickly – all these bad habits done regularly can eventually cause discs to bulge.
The other thing worth noting is that people who come to see us with disc issues are getting younger and younger. It used to be typical of people over 50, but now, most of my patients are in their 30s.
WM: What are the symptoms experienced by patients who have a disc bulge?
MF: They vary depending on where it is located. They can include:
- Pain in the neck, trapezius and shoulders that doesn’t go away despite therapy and massage
- Headaches, tension headaches
- Tingling or weakness in the arms, fingers and hands
- Vertigo: neck muscles, more specifically the sternocleidomastoid, the middle ear and cerebellum all work together to manage balance. People with straight necks and anterior head carriage have neck muscles that are so tight that they send the wrong nervous signals and this can trigger vertigo. These people often have bulging discs
- General lower back pain that is aggravated by coughing or sneezing.
- Pain the lower back area, back of the leg right down to the foot. Sciatic pain or burning pain.
- Tingling in one or both legs
- Urinary and bowel incontinence: this is a red flag. People who have lost control of these functions should seek immediate attention.
At the end of the day, the core chiropractic belief is that the entire spine gives a nervous communication to the glands and organs. So if there is any compression on a specific nerve, it’s not going to communicate properly with these glands and organs and that can cause other symptoms.
WM :How do you treat disc bulges
MF: There are surgical and non-surgical methods and how you decide to treat them depends on the symptoms. We do an MRI scan and correlate it to the symptoms. Often times, surgery isn’t required and we look at non-invasive methods such as decompression therapy to help them.
WM: What is decompression therapy?
MF: It is a non-invasive practice where the patient is treated on a decompression table that uses computerized sensors to gently bring the spine back into its natural shape. We calculate the pull according to your body weight and other factors. Then based on an individualized graph, the machine pulls for a certain amount of time and then releases.
When a disc degenerates it dehydrates and becomes blacker – you see this on an MRI. You need to hyrdrate it and bring it back in. Decompression therapy will take the bulging back in enough so that the disc does not press and irritate the nerve. Every time it compresses, the disc gets blood supply through the arteries that run around the bone and the little branches that come down to the disc. This way, when it release, it gets more nutrients into the disc. A session lasts about 30 minutes and is very gentle, most people are suprised the first time because they don’t feel very much.
WM: How many sessions does one need?
MF: We recommend 12 sessions. The first couple of times they are feeling better but the pain is still there. Then half way through all of a sudden the nerve pain goes. But we have to finish the 12 sessions because the disc can still be close to the nerve. If you have many bulging discs you would need 10 to 12 sessions per disc. During the consultation, we usually do a chiropractic treatment first and then put the patient on the decompression table.
When all the sessions are over, we train the patients to have a better curve through exercise rehabilitation. This will prevent the same problem to re-occur. This rehabilitation is crucial.
WM: Could you put a disc back into place just by moving differently or doing something like yoga or Pilates?
MF: Well, the right movement therapy done consistently could help but in some cases the bulge is too large and dehydrated for yoga or Pilates to make a massive difference. With the disc that dehydrates and starts to bulge and compress the nerve it is important to try and release the pressure on the nerve so that the pain will go away. In these cases, it is important to get the right non-surgical treatment as therapeutic exercise alone cannot treat it.
WM: What tips would you give to keep our spine in shape despite the fact we sit in front of a desk all day long or practice activities that can affect or spine health?
MF: The number one thing I would suggest is that you do daily postural exercises. There are great programmes out that can make a significant difference. The other thing I would say is to look at how you spend your time and study your ergonomics: your office chair (the seat height should be such that your feet are flat on the floor, the height of your arm rest should allow your shoulders to be relaxed, etc), your pillow (use a memory foam pillow that is not too thick or too thin so that your neck is parallel to your bed and your head doesn’t sink in or isn’t too high). There are so many things to mention when it comes to maintaining and improving one’s posture we could probably do an entire article on it!
Dr Madelaine Franklin
Madelaine is the founder of the Franklin Chiropractic and Physiotherapy Center in Dubai. She is affiliated with the Allied Health Professions Council of South Africa and is registered with the Board of Health Funders, as well as the Dubai Health Authority. Madelaine is an active member of the Chiropractic Association of South Africa, Malaysia and Dubai.
Contact information:
Franklin Chiropractic and Physiotherapy Center
https://franklinchiropracticdubai.com
DMCCOffice 2404, HDS Tower, Cluster F Jumeirah Lake Towers Dubai
