Chiropractic Patient Case Study: Cervical Bulging, "Slipped", Herniated and Ruptured Discs

Patient History and Examination
When Carlos entered the chiropractor's office, he was experiencing nagging, constant pain in his neck and left arm. As the chiropractor took a complete history, he especially wanted to know if there was any history of heart disease or previous episodes of left arm pain. Carlos had no such history; had seen his family doctor two months ago for a check-up that showed nothing abnormal. It was learned that his arm symptoms always were accompanied by neck pain.

After checking the range of motion in the neck, which was restricted in rotation and lateral bending, the chiropractor performed a neurological screening on the patient. She found sensation at the left thumb and first finger was slightly decreased. The reflexes were normal (intact) but there was some muscle weakness in the arm. When the chiropractor placed the left side of the neck in extension -- when she bent it backwards and to the side, Carlos experienced increased arm pain.

Radiographic Imaging
Carlos was sent to an imaging facility for an MRI (Magnetic Resonance Imaging). The MRI showed a bulging disc between C5-6 (fifth and sixth cervical vertebrae) that was slightly pressing against the nerve root on the left. The MRI study showed that the disc material had not broken away as a loose fragment and that there was no evidence of a ruptured disc.

Making a Diagnosis
The chiropractor correlated her examination findings with the findings of the MRI study to arrive at a diagnosis of Carlos's problem. MRI studies can show bulging discs and other abnormal findings in healthy patients, so imaging studies only have clinical significance when they are used in conjunction with orthopaedic, neurologic, and chiropractic testing.

Carlos was diagnosed as having a cervical disc syndrome with a bulging disc at C5-6 and symptoms of radicular (arm) pain.