Disc Injuries Explained: Dynamic Osteopaths
Adam R. Whatley
Registered Osteopath
There are many different cases of disc related injuries; most commonly is the prolapsed disc or otherwise know to the public as a ‘slipped disc’, this often causing severe lower back pain and referred leg pain or known as ‘sciatica’. As the disc become prolapsed it often then presses on a nerve root that exits the spine, which can relate to the pain and symptoms in a leg. Osteopaths generally provide manual and physical treatments such as spinal manipulation that in most cases help to treat disc injuries. Surgery may be an option if the symptoms persist and used in worse case scenario situations.
Basic Spine Overview
The spine is made up of many individual vertebrae, which contain a disc in between each one. The discs are made of strong rubber-like tissue which allows the spine to be fairly flexible. A disc has a stronger fibrous outer part, and a softer jelly-like middle part called the nucleus pulpous. Strong ligaments attach these vertebrae together and these give extra support and strength to the spine. Various muscles also surround, and are attached to, various parts of the spine.
What is a prolapsed disc?
As seen in the diagram, the inner softer part of the disc bulges out (herniates) through a weakness in the outer part of the disc. A prolapsed disc is sometimes called a herniated disc. The bulging disc may press on nearby structures such as a nerve coming from the spinal cord, thus giving ‘sciatica type’ symptoms. Inflammation also develops around the prolapsed part of the disc.
Who is predisposed to prolapsed discs?
Back pain are very common. However, less than 1 in 20 cases of acute back pain are due to a prolapsed disc. These cases of back pain are often related to strains within muscles, ligaments, or other structure in the back. The most common age to develop a prolapsed disc is between 30 and 50 years. Twice as many men as women are affected.
What causes a prolapsed disc?
It seems that some people may be predisposed to weakness in the outer part of the affected disc. Various things may trigger the inner softer part of the disc to prolapse out through the weakened outer part of the disc. For example awkward bending, or heavy lifting in an awkward position may cause some extra pressure on the disc. In people with a weakness in a disc, this may be sufficient to cause a prolapse. Factors that may increase the risk of developing a prolapsed disc include: a job involving lots of lifting, a job involving prolonged sitting, weight-bearing sports, smoking, obesity, and increasing age (a disc is more likely to develop a weakness with increasing age).
Symptoms of a prolapsed disc?
Back pain
The pain is often severe, and usually comes on suddenly. The pain is usually eased by lying down flat, and is often made worse if you move your back, cough, or sneeze.
Nerve root pain (sciatica in the lower back)
Pain ofte occurs because there is pressed on the nerve root by a prolapsed disc, or is irritated by surrounding inflammation. Although the problem is in the back, you feel pain along the course of the nerve in addition to back pain. Therefore, you may feel pain down a leg to the calf or foot.
Cauda equina syndrome (Medical Emergency)
Cauda equina syndrome is a serious type of nerve root problem that can be caused by a disc that has prolapsed centrally into the spaniel canal. This is a rare disorder where the nerves at the very bottom of the spinal cord are pressed on. This syndrome can cause low back pain plus: problems with bowel and bladder function (usually unable to pass urine), numbness in the saddle area (around the anus), and weakness in one or both legs. This syndrome needs urgent treatment to preserve the nerves to the bladder and bowel from becoming permanently damaged.
Disc prolapsed progression
In most cases, the symptoms tend to improve over a few weeks. Research studies of repeated MRI scans have shown that the bulging prolapsed portion of the disc tends to get smaller (regress) over time in most cases. The symptoms then tend to ease, and go in many cases. In only about 1 in 10 cases is the pain still bad enough after six weeks to consider surgery (see below).
INFORMATION ON DISC INJURY TREATMENT CAN BE FOUND AT THE BLOG ABOVE
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