Disc Bulge? or More?

Ask the Chiropractor- Have you been told you have a disc bulge?  Why does the disc bulge?  Dr Hulsebus explains. #healthy815 #icachiropractor #palmerproud

www.rockforddc.com

Transcript

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- Hello, I'm Dr. Brant Hulsebus, and welcome to another edition of Ask the Chiropractor. Ask the Chiropractor is our podcast that we do here about chiropractic care and kind of how chiropractic works. A lot of people don't know if chiropractic care can help them or maybe they have a question about care before they start and they're not sure who to ask, or worse yet, they ask somebody who has no knowledge or background of chiropractic care. Often this could be your family doctor or maybe an orthopedic surgeon. You see, orthopedic surgeons and family doctors don't study chiropractic. And almost every orthopedic doctor I've spoken to and every family physician I've become friends with has no idea what I do. I've actually, there's a school here in town that's a school of medicine. I've asked them how, would they learn about chiropractic? And what they learn about chiropractic is they have a professor that comes in for one hour, not from my school but from a different school, and they basically teach them one hour about what chiropractors do. And it's usually the day right before national boards and attendance is not required. So you can imagine it's pretty poor turnout. I know myself, I probably wouldn't go. So if you have a question about chiropractic, who's the only person you can ask? A chiropractor. If you have questions about your teeth, who do you ask? A dentist. You don't ask your family doctor. You ask your dentist. So a lot of people will come out here and ask me questions or submit questions to me and I'd come out here and answer. Now, who am I? I'm a chiropractor here at Rockford, Illinois. For the last 19 seasons, I've been a team chiropractor for the Rockford IceHogs, currently the AHL affiliate of the Chicago Black Hawks. I'm a proud graduate of Palmer College of Chiropractic, and I'm also a proud member of the International Chiropractic Association, where I've served many different roles over the years, including being the representative for the state of Illinois. I also am on the board of the Illinois Prairie State Chiropractic Association. And that association asked just about every single role they have. So questions, people have questions about chiropractic. They send them out to me, I come out and answer. So let's talk about this week's question. This week's question kind of came up from a patient. They said they came to see me for a couple of weeks. They went to their family doctor. Their family doctor was like, you know, your lower back, what's been going on? You know, I've only seen you a couple of times. And they said that your lower back's been kind of a thing here. Let's take a look at you. And they did an MRI and they said, guess what? We found out what's wrong with my back. It turns out all the things you showed me about my alignment, it's actually a bulged disc causing a pinched nerve. Now, as a chiropractor, I always try to keep a straight face. when people tell me this. Any time you go get an MRI done of your spine, that's the verdict any time you go. Next time you, if you're gonna have an MRI of your spine, before you have the MRI of the spine, before the doctor reviews the findings with you, ask the doctor how often somebody comes back without a bulging disc. The reason I say this is because I truly believe a bulging disc is not a problem. I believe a bulging disc is a symptom of a bigger problem and we spend too much time looking at the disc and not enough time looking at why that disc bulged in the first place. Let me try to explain this to you. I have a spine in my hand right here. Now if you look at a spine, in the front you have a vertebral body. Has everyone seen that? In between two of the big bones, a disc is there. Now the disc has an arch that wraps around the back. It forms a spinous process. When you go back and you feel your back, you feel little bumps. So when you give some of the back rub, you feel those little bumps. Those are your spinouses. Now from the body to the spinous about halfway back, there's a joint called a facet, F-A-C-E-T. Now what a facet is, it's another joint in the spine that doesn't get a lot of attention, but it actually can create a lot of the issues. When you have a facet irritation, meaning that this little joint's about the size of a half of a size of a dime and your neck they sit kinda horizontal and your thoracic spine they kind of go straight up and down in your lumbar spine. They turn 90 degrees and kind of go right at it. They change as they go up and down your spine to accommodate the way your spine moves, bends, and twists in the different regions of your spine. Now every joint has a joint capsule around it. So there's a joint capsule that wraps around this facet joint. Now chiropractors and doctors always tell you, don't bend and twist, don't bend and twist and lift the load. Why do we tell you that? Is it because of disc bulge? Well, actually it's more because the facet joint gets under too much stress. You can open that facet joint up and stretch it and then when you switch it, when it comes back it can actually pinch. Now it's not pinching a nerve. You've heard a pinched nerve a thousand times. I'm gonna talk about that in a minute. I'm not talking about a pinched nerve. I'm talking about a pinched joint capsule. Now the pinched joint capsule inside the facet joint will create inflammation, swelling. And what happens is the moment that inflammation is in that little joint in the back side, you will do everything you can not to make it hurt more, and you will lean away from it. I will take that swollen joint, and I will lean the other direction. Now let's talk about the disc. As soon as I lean the other direction, that puts an unbalanced force on the disc. So if you think of a disc like a balloon and I have a balloon in front of me and I take that balloon and I step on one side. I take my big boot and I put it down on one side, what happens to the other side of the balloon? It bulges, right? And so is the problem the balloon bulging or is the problem my foot on the balloon? My problem is the foot on the balloon. That's what's going on. That foot's hitting that balloon, and it's making a bulge on the other side. Now if I let air out of that balloon, will that problem go away? No, that problem will not go away. If I go in there and and numb the balloon, will the pain go away? No. The only way to make this balloon go back to normal is by removing the boot. And once I remove the boot, is the balloon ruined? No, usually the balloon goes right back to where it's supposed to be, and that's the way disc behave, the exact same way. So when we give you a chiropractic adjustment, what we're attempting to do there is restore some of the motion in the normal facet joint so the facet joint can push the inflammation out and go into the healing process. Now what happens is as long as that facet joint's inflamed, you're gonna keep leaning away from it. You're gonna keep that disc bulging and then over time it's gonna get worse and worse and worse. As a matter of fact, as soon as this happens, the body will lock it up and protect it. It says okay, we have stress here. We can't let this get any worse so the muscles will cramp down and say, you're not gonna move no more. We got you in lockdown. Now you're gonna stay right where we want you. This is what happens. And unfortunately all too often when you go into the doctor in lots of back pain, instead of treating the inflammation in the facet joint that's causing the muscles to spasm, what do they give you? They give you a muscle relaxer. And what happens when the muscle relaxer goes in? Well now you twist more. Now you bend more. Now you hit that swollen joint more. Now you get more inflammation. Now the boot pushes on the balloon harder and now the balloon herniates more, bulges more, right? That bulge became bigger because now the muscles aren't there to safeguard us. Chiropractors go in and we make that joint move again, we free it, we make it move loose and we start, when it starts to move, the toxins start to come out, the inflammation starts to reduce, you start to move better, and it starts to ease up the fixation. That's what we try to do. But we don't try to turn those muscles off. We don't try to trick those muscles into relaxing. We try to move the spine to relieve the inflammation, not put a muscle relaxer in, which can create more inflammation. Now sometimes you might take an NSAID, and if you go back and see non-steroidal anti-inflammatory drug, if you go back and see in my previous videos, there's recent research from the 1980s that show that chronic use of non-steroidal anti-inflammatory drugs will create chronic lower back pain and TMJ neck issues. I'm not a big fan of those. Some people say I get them every day to help relieve, get rid of the inflammation, I'm on my way. Well that might be good for today, but long-term effects of this is gonna be really bad. This is why the northern, North America, excuse me, the North America Spine Society composed of all kinds of doctors and I don't think any of them are chiropractors, recommend the number one thing you do for acute back pain is manipulative therapy, which is what chiropractors specialize in. It's what chiropractors do. All right, so back to this bulging disc. So they say this disc will bulge, talking about the muscles locking up. What chiropractors do to remove the inflammation in that little facet joint, get that facet joint moving. Matter of fact, when we look at your x-rays, we can see the way you twist and turn, and why that's so important to us is because we'll decide which kind of line of drive we use. Meaning that are we gonna do a clockwise torque, a counterclockwise torque? Are we gonna start on this side or this side of your spine? Are we gonna loose this lever, that lever? And the whole idea is to go in there and get that facet joint to loosen up with the least amount of irritation to the patient. That's our goal. Now, usually after we adjust you, we'll tell you whenever you stop moving to put ice on it cause when you start moving too much, when you stop moving, that's when inflammation kicks in. So the chiropractor will recommend ice in order to reduce the inflammation. Again, inflammation in that facet joint is the boot on the balloon. The balloon's not the problem. The disc is not the problem. The problem is the facet joint being inflamed, pushing the disc out. So to continue to attack that facet joint will get good success. Now we talked about a pinched nerve. People come in all the time, I got a pinched nerve, I got a pinched nerve. You do understand if your nerve was pinched, the nerve would not work. Meaning that if it was your sciatic nerve, your entire leg would be numb and dragging. It is not a pinched nerve. It is in reality stress chemicals coming from the inflamed facet joint, hitting the nerve that's leaving the spine. So the facet joint again being irritated under stress. There's stress chemicals that kick off the fight and flight chemicals that says we're in danger. Something's not right. It hits that nerve and goes down that nerve wherever that nerve goes. And now that body part is now under fight and flight. It's under catabolic, it's under stress. And that's why you get arm numbness and arm weakness over time because that stress is meant to keep you alive for the moment, not the long haul. And it's a signal telling us, we gotta react, we gotta react, we gotta do something. So it's not a pinched nerve. I mean, if it's a pinched nerve, if I pinched a nerve in my neck here that goes down my arm, I wouldn't be able to move my arm. That will be totally, totally immobilized cause the nerve's not working. It's a stress going on the nerve that makes it behave. And if you actually look at the nerve activity, a lot of times when this is bad, the nerve activity is way up. It's not down, it's up cause it's shooting, shooting, shooting. I mean next time you have arm pain, right, coming from your neck, you tell me the nerve's not working cause you're feeling the pain going up and down your arm. Of course the nerve's working, it's not pinched. It's a stress coming from there. And that's what chiropractors do. When we do that adjustment, we turn off some of those stress chemicals coming off. We've had, I talked in previous podcasts about the different studies from Ogyua that show that. All right, so that's what we do as chiropractors. That's what we do as the disc is taken care of. That's how we attack that, and that's what a pinched nerve is. So when people come tell me, hey, I'm gonna have an MRI, I said, good, I bet you have a bulged disc. So how would you know that doctor? I said, because you got an irritated facet on this side. So I know that disc is gonna be bulging on the other side cause that facet joint's upset. It's just simple arithmetic. Treating the disc is not the solution. Treating the facet is the solution. That's what chiropractors do. So next time someone says, can chiropractic help with a bulging disc? It is funny because yeah, I mean, of course once the facet joint's happy, the bulged disc is gonna go away. Is a chiropractor gonna treat you for a bulging disc? Is a chiropractor gonna say, you got a bulging disc, let me help you. No, the chiropractor in true essence knows that the facet joint's irritated, causing the disc to bulge. We're gonna go to the cause of why that's bulging, not the condition that it's created by the joint being inflamed. So I hope that makes sense to everybody. I hope that everybody understands that what's really going on in your spine, chiropractors understand it. That's our, that's what we do. That's all we do. We help adjust that, remove that. We call it a subluxation. Two bones or three bones are misaligned or fixated and they're not firing right. And there's stress chemicals that come off and the nerve is interfered with, the nerve is altered because of a false fight and flight response. And the body parts that suffer, the chiropractor restores the motion through a chiropractic adjustment. The nerves, the chemicals that come out that create fight and flight go away. The nerve gets happy, the body part gets happy, and you heal. And the next thing with chiropractic is unlike some medications and other things, there's next to no negative side effects. There's like no one's ever said, what happened to you? Oh, I went to the chiropractor too much, and now my health is really bad. That's not something anyone's ever said. So if you have a question, if you've been diagnosed with a disc bulge and you really wanna get to the bottom of it before you dive in to sticking a whole bunch of shots and a whole bunch of drugs and a whole bunch of other things, check with a chiropractor and you can actually bring your findings from your other doctor that you, cause you can't, usually you can't have an MRI without an x-ray first. Bring it to your chiropractor. Don't bring the x-ray report, bring the x-rays. You can bring the MRI report and maybe the MRI. Some chiropractors like to look at the MRI, some it's hard cause with the MRI you usually have like eight or nine screens you're looking at once like that's what the radiologists have. And not every chiropractor is set up to have eight or nine screens open at once. They just like the report. But when it comes to the x-rays, just bring the actual x-ray and don't let the doctor tell you that the chiropractor doesn't need the x-ray, just needs the report. That's not true. Again, they don't study chiropractic. They don't know what we do on the x-rays. If the doctor ever tells you that, just say well this include all the Gonstead listings so my chiropractor knows what's going on. They'll have no idea what you said and came and give you the x-ray. Otherwise your chiropractor can request a copy of everything they need. Also, before your appointment, don't go into the appointment and say that the chiropractor's gonna just request the x-rays that day. Cause I very, very, very very few healthcare systems I know here in Rockford we have a huge orthopedic group, three huge health hospital systems. None of them, none of them went with chiropractors. So even though you might have your chart that you can look online, the chiropractor can't see it. We're not included in that. They don't. We can be, we should be, the Affordable Care Act says that we're supposed to be, but they don't allow us in. So in our reality, just bring it with you. All right, well, I hope I answered the question about a bulging disc and how about what's going on with a bulging disc and what a bulging disc is and what it isn't and really what the problem is and what the problem isn't. And so if you have a question about chiropractic or chiropractic care, go ahead and leave me a message. And if you're listening to me or if you're watching me on YouTube or somewhere else, my website's Rockford DC R-O-C-K-F-O-R-D DC, rockforddc.com. Go on there, you can hit the contact us. You heard me cite previous studies I've talked about. If you go to the website, hit the blog, you'll see them all right there. All right everybody, thanks for listening, and we'll talk to you next time.