Herniated Disc / Bulging disc
By Darren Macfarlane, Sports Injury & Rehabilitation Specialist
The spine is made up of 33 bones know as vertebrae which are separated by discs called intervertebral discs. Their function is to act as shock absorbers and cushion the spine and to allow movement in spine. The intervertebral discs are filled with a gelatinous substance in the middle called nucleus pulposus. Excess stress on the spine can damage the discs or as a disc degenerates it can herniate. This is when the inner core to leaks out. The weak spot in the outer core of the disc is directly under the spinal root, so the herniation in this area puts direct pressure on the sciatica nerve. Depending on where the sciatic nerve is pinched will determine where you feel the pain which can radiate to the front of knee or right down the back of leg to calf or foot.
Approximately 90% of disc herniations will occur toward the bottom of the spine at L4-L5 or L5-S1. The majority of disc herniations are of posterior protrusion, which means that the disc is bulging towards your back side. Most posterior disc bulges cause pain when bending forward. This causes the disc to move posteriorly, thus compressing on the sciatica nerve.
Symptoms
• Acute low back pain.• Constant sharp pain which radiates down leg sometimes as far as the calf or foot.
• Pain may be worse by sitting for long periods, coughing or sneezing, lifting heavy objects or moving your back will increase pain.
• Pins and needles may be felt in the back of the leg.
• Numbness in the buttock leg or foot.
• Pain can be better in morning after a nights rest.
• Muscle spasms in lower back.
• Weakness in big toe or ankle.
Treatment Options for a Herniated Disc.
• Visit your doctor for diagnoses and treatment options.• Treatment options will depend on the length of time the patient has had his or her symptoms and the severity of the back pain. Is there any weakness or numbness present and the age of patient will be considered. Patients will be advised to start with 6 to 12 weeks of non surgical treatment, such as physical Therapy, epidural injections or non-steroidal anti inflammatory drugs.
• Physical therapy treatment can help reduce back, leg pain and discomfort caused by the herniated disc. The physical therapist will also advise on rehabilitation corrective exercise programme and lifestyle changes to help reduce pain.
• Surgery may be recommended such as a microdiscectomy to alleviate the pain from a herniated disc if after 12 weeks of non surgical and the pain is still severe.
• For most patients symptoms from lumbar herniated disc will resolve with no surgical treatment such as physical therapy but it may take a prolonged period of time.
Tips
• Stay off your feet, this will keep the pressure off your spine and you will heal a lot faster. Walking and sitting are the 2 worst things you can do besides sleeping on your back or stomach.• Sleep on your side with a cushion between your knees, a cushion behind your back and in front of your chest. This will help keep the pressure of the hips and the lower spine and will prevent you from rolling over.
• Avoid bending over, this will make condition worse.
If you have been diagnosed with a herniated disc physical therapy will help reduce your pain. Contact our Galway clinic on 086 1957378
