Disc bulges and herniations (protrusions) are quite common in our population. People from adolescence through adulthood are susceptible to having them. We have discs up and down our entire spine, meaning in the cervical, thoracic, lumbar, and sacral regions. Discs help to allow for motion and proper function of our spine. Picture the disc as a slice of an onion. Imagine the inner 1/3 containing a toothpaste- like substance and the other 2/3 as being cartilage, not unlike the meniscus of your knee. Over time and due to certain traumas, both macro (big) and micro (small), the jelly begins to break through the ‘rings’ of the outer 2/3 of the onion. Sooner or later the jelly gets to the outer few layers and forces a ‘bulge’ of the cartilage. This is what is commonly considered to be a disc bulge. If a bulge is left untreated, it will most often lead to the jelly breaking through the last few layers and leaking into the spinal canal. This is what we call a herniation. If the herniation breaks off, this is called a prolapse.
Big NewsDr. Manison’s case study on cervical flexion/distraction for a cervical disc herniation was published in the Journal of Chiropractic Medicine (JCM) in December 2011. JCM is a medially indexed, peer-reviewed journal, and getting published as a clinical doctor is a big deal! It’s safe to say that Dr. Manison has the highest level of education and clinical experience in the Columbia / Ellicott City / Baltimore region when it comes to addressing disc pathology!


isc bulges and herniations are many times successfully treated through conservative measures. Unfortunately, disc prolapses/non-sequestered fragments (the broken off pieces) can often times put pressure directly on the spinal cord, and since there is nothing binding them to the rest of the disc, surgery is many times the only option. Luckily, disc prolapses are the end-stage of disc degeneration and a lot can be done prior to getting to this horrible condition.

Tingling (paresthesia, or reduction of sensation) and numbing (anesthesia, or loss of sensation) are common effects of disc bulges and herniations. This is because the disc can directly put pressure on the spinal cord or the nerve roots where they exit from the spine. If the pressure is not reduced, permanent nerve damage can result. There are cases, however, where nerve entrapment distal to the spine can cause a similar condition. It is important that your chiropractor be able to distinguish what your problem is and where it is coming from! In addition to standard chiropractic treatments, Dr. Manison is certified in the Cox flexion/distraction technic. He is one of a few chiropractors in Maryland and the only doctor in the Columbia / Ellicott City / Howard County region licensed in this fabulous technique!  This technique is one of, if not the best, chiropractic technique for disc (and other cervical and lumbar) pathology. Its focus is to create negative disc pressure to help reduce bulges and/or herniations. It is a technique that is specific for each individual disc pathology. It has medical research to back it up! Simply put, there are no other conservative techniques available that offer the scientific backing for the treatment of disc pathology like Cox technic offers! Columbia Advanced Chiropractic, LLC  also has the newest and most advanced automated flexion/distraction table from Hill Laboratories that helps with the treatment of disc pathology.

In the case of burning pain, or radicular pain, the cause is usually irritation of a nerve sheath. Irritation refers to toxin release from damaged discs, muscles, ligaments, joints, etc. that create an inflammatory process that engulfs the nerve. This inflammatory process creates pain and dysfunction.

The doctor’s approach to all the conditions listed above is to correct the faulty mechanical problems and help the patient stabilize the spinal region in question. On some occasions, a MRI is needed to help accurately assess the state of the disc. The Cox technic is very specific for disc problems, and being such, sometimes high quality diagnostic imaging is necessary. Following improved mechanics and an associated reduction in symptoms, Dr. Manison works to teach the patient stabilization and rehabilitative exercises so that the problem can be reduced or contained.