Back pain affects people of all ages and is one of the most common injuries seen in our Physiotherapy clinics. Too often people lay the blame of lower back pain on the ‘discs’ as the sole source of their pain. While it is one structure in the back capable of producing pain there are many other structures to keep in mind, explained below is what actually happens when you do what is commonly referred to as “slipping a disc”. Chartered Physiotherapist Ann Prendergast (of our Kilkenny clinic) explains what happens to the discs during back pain.
What Makes up the Spine?
The human spine is made up of 24 bony vertebrae (building blocks) placed one on top of the other. Between each building block there is a thin region of cartilage known as an intervertebral disc.
These discs are like jam donuts – they have a hard outer shell known as the annulus fibrosis and a soft, jelly, inner core known as the nucleus pulposus. Discs act as a cushion between each vertebra.
What Happens When an Injury Occurs?
The jelly centre in these discs can often shift in relation to forces put through your back during the day. Therefore, discs can often be a source of back pain. The most common everyday forces include:
- prolonged sitting (especially with poor posture)
- bending
- lifting
- twisting
- pulling or dragging
These movements, which we carry out repeatedly, can put great pressure on our discs and cause pain as the jelly-like centre is pushed backwards through the hard outer shell. This is known as a disc bulge or disc protrusion. If the jelly escapes beyond the outer layers of the shell it is known as a herniated disc, or, in everyday terms, “a slipped disc”.
It is important to remember that if you have a disc bulge or protrusion this doesn’t necessarily equal pain. Many people live with these changes completely pain free! There are many other structures in the lower back that capable of producing pain so don’t be in a rush to blame the disc for all back pain.
Symptoms of disc related pain:
Symptoms can vary depending on the extent of damage to the disc and whether it is catching on the nerve roots emerging from the spinal cord. Some common presentations include:
- localised pain in the back
- pain in the buttocks, thighs, lower legs and feet
- pins and needles or tingling sensations
- numbness or muscular weakness
Treatment
It is important that a person suffering from back pain is educated about their condition through their doctor or physiotherapist. Initial treatment usually includes:
- non-steroidal anti-inflammatories and pain medication
- heat and ice packs
- physiotherapy
- prescribed home exercise program
- core and lumbar strengthening exercises
All aggravating movements should be avoided initially and a graduated return to activities of daily living should be adopted. Your physiotherapist will advise you through positions of ease and ideal working postures. Manual handling techniques are correct lifting policies should be abided by. They can also advise on the use of lumbosacral supports depending on the extent of damage to the discs.
Is surgery required?
Surgery is not usually required and most disc problems will settle over a few weeks depending on the severity of symptoms and other aggravated structures within the back.
Surgery is only considered after nonsurgical treatments have failed to relieve the pain. A person should consult with their doctor and surgeon before making a decision and should be advised about pros and cons of each procedure.
Don’t suffer from back pain – see your physiotherapist today! Call or email us to book an appointment !
