By Alexander Germanis
Although starting as a popular game in China dating as far back as the 13th century, knocking over a standing row or rows of dominoes has become just as popular around the world. From this usage of the little bespeckled tiles came the rise of the idiom “domino effect” — meaning one thing, instance or cause can lead to a sometimes unending string of events or effects.
As we stand, walk and otherwise carry out our normal actions, we constantly place our vertebrae under stress, which, metaphorically, flicks a finger against the first domino in the row. According to Dr. Ramsin Benyamin, founder of Millennium Pain Center in Bloomington, the vertebral stresses brought on by “lift[ing] heavy weights, or accidents” such as falls can cause an intervertebral disc to rupture. The rupture, known as a disc herniation, can then “press against a nerve and cause sciatica.”
This direct link between disc herniation and sciatic pain was first discovered in 1934, by two members of the New England Surgical Society. Dr. William Jason Mixter and Dr. Joseph S. Barr “wrote a very famous paper,” says Dr. Benyamin, about intervertebral disc herniation and the domino effect it can cause in the body. “Since then disc herniation has been known as a major cause of sciatica.”
Sciatica is pain originating at the sciatic nerve, a large nerve that runs down the posterior of the femur where it eventually splits into the tibular and common fibular nerves. Generally characterized by a sharp shooting or burning pain in the lower back and buttocks that extends down the leg, sciatic pain can cause a numbness in the leg and/or foot and can make it difficult to move as well as painful to sit or stand up.
As with many medical problems, sciatica can differ between sufferers, but for those with intermittent or mild sciatic pain, there is the potential of it becoming much worse if the source is left un-treated.
Of course, since “disc herniation has been attributed as a significant cause of back and leg pain since the 1930’s,” Dr. Benyamin continues, “the treatment for disc herniation has gone through a lot of evolution.”
The first step in the treatment evolution was really a quite common solution at the time, and it is one which still flies as a standard of recovery. “In the old days, it used to be pure bed rest and taking some aspirin,” the doctor says. “And then later on, bed rest was deemed to be not an effective way of treating it and the emphasis became on remaining functional. That’s how physical therapy developed. So, people from the beginning of the symptoms encourage you to maintain your activity and do physical therapy. That still continues to be one of the mainstays of this whole treatment plan.”
Physical therapy alone will not treat the cause of the sciatica, however. After all, “the goal of physical therapy is not to treat the disc herniation,” Dr. Benyamin adds, “but to maintain function and hopefully reduce stress on the disc.”
But, the doctor explains, “even though the scientific evidence for it is not very strong, the treatment plan [for disc herniation] still includes physical therapy.” It is simply “because it’s a non-invasive treatment. [That is why] it’s very popular.”
Despite the ‘good intentions’ of physical therapy, “The problem still remains there,” the doctor concludes. The disc is still herniated and will continue to cause problems until it is treated. The first domino needs to be put back before any of the others can be returned to the way they were. Fortunately, the treatment evolution did not stop. In fact, it continues to evolve even today.
For information on intervertebral disc herniation and the continuing evolution of treatments please pick up next month’s copy of Healthy Cells Magazine to read “Walking on Eggshells, Part 3.”
Millennium Pain Center, located at 1015 S. Mercer Ave. in Bloomington, provides the most advanced and comprehensive pain management for a wide variety of conditions. For more information, you may contact them at 309-662-4321 or online at www.millenniumpaincenter.com.