Lumbar Disc Injury

Commonly referred to as a ‘Slipped disc’ – which is no longer used as your disc cannot actually slip out of place, but instead bulges out of it’s normal margins.

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It may also be referred to as a ‘disc bulge’, ‘disc protrusion’ or ‘disc herniation’.

Background

Due to poor posture or loading (particularly if repeatedly bending forward or lifting heavy loads) more pressure can be placed on one side of your disc. This may cause the disc to protrude out of its normal space. ‘Disc bulges’ are commonly found on imaging (according to a study by Brinjikji et al 2014 – 30% of 20 year olds have disc bulges on MRI, and 84% of 80yo’s) and usually do not cause any pain or symptoms. Therefore, it is important to know that disc bulges shown on MRI’s aren’t always the source of your pain. However, a bulge is usually a sign that you are not distributing the load on your spine evenly, and this becomes a problem when the disc starts to press on nerves around the area – therefore causing leg symptoms (nerve pain, tingling, numbness). ‘Sciatica’ is when the disc presses on the sciatic nerve, causing leg symptoms.

Symptoms

  • Lower back pain, and possibly buttock/leg pain (usually shooting/nerve type pain, sometimes a tightness), leg pins and needles or numbness.
  • Pain with coughing or sneezing.
  • History of repeated bending forward or lifting.

Care

  • Reassurance! Prognosis is very good; a disc injury will heal – usually within 6-8 weeks.
  • Advice on what to avoid (in early stages usually bending forward/lifting activities, and sitting for long periods).
  • Taping – to avoid going into flexion.
  • Muscle release – usually with massage or dry needling.
  • Postural advice and education on a neutral lower back position.

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