Heard about slipped disc/disc herniation/disc prolapse? Want to know more? Read on …
What is an intervertebral disc?
Your spine is made up of 33 bones, called vertebrae, that are stacked on top of one another. These bones connect to create a canal that protects the spinal cord.
Five vertebrae make up the lower back. This area is called your lumbar spine
In between your vertebrae are flexible intervertebral disks. These disks are flat and round, and about a half inch thick.
Spinal discs separate each individual vertebra and soak up shock. Without them, the bones in your spine would grind against each another, and you’d be unable to absorb the impact of trauma and body weight.
More than just protective, these cushions also give the spine flexibility, making movements such as twisting and bending possible.
Like a coin has 2 sides, discs have a both soft and hard component at once.There’s a tough outer layer, called annulus fibrosus, and a soft, gel-like center, called nucleus pulposus. Fibers on the outside of each disc helps them attach to vertebrae and stay in place. Similar it to a hot lava cake!
If the strong outer layer of the disc ruptures, the gel-like center can “leak” into the spinal canal: the passage that contains the spinal cord and spinal fluid. This is called a disc prolapse or disc herniation. Other term some times used to describe this condition is ‘slipped disc’.
The result can be intense pain in your back, along with weakness in an arm or leg. Numbness can also occur, since the nerve signals are being blocked. Making it all more troublesome is the fact that the gel can release a chemical irritant that may contribute to nerve inflammation and pain.
Risk factors
A.Gender
Men between the ages of 20 and 50 are most likely to have a herniated disk.
B.Improper lifting
Using your back muscles instead of your legs to lift heavy objects can cause a herniated disk. Twisting while you lift can also make your back vulnerable. Lifting with your legs, not your back, may protect your spine.
C.Over Weight
Being overweight puts added stress on the disks in your lower back.
D.Repetitive activities that strain your spine
Many jobs are physically demanding. Some require constant lifting, pulling, bending, or twisting. Using safe lifting and movement techniques can help protect your back.
E.Sedentary lifestyle
Regular exercise is important in preventing many medical conditions, including a herniated disk.
F.Smoking
It is believed that smoking lessens the oxygen supply to the disk and causes more rapid degeneration
What are the symptoms?
1.Low Back Pain
This is the first symptom of a herniated disk.
Other symptoms may include:
2.Sciatica
This is a sharp, often shooting pain that extends from the buttock down the back of one leg. It is caused by pressure on the spinal nerve.
3.Pain when you cough, sneeze, or move into certain positions
4.Numbness or a tingling sensation in the leg and/or foot
5.Weakness in the leg and/or foot
6.Loss of bladder or bowel control
This is extremely rare and may indicate a more serious problem called cauda equina syndrome. This condition is caused by the spinal nerve roots being compressed. It requires immediate medical attention.
Now lets see what are the common Myths surrounding disc herniation
Myth # 1- Surgery is the only and best option…
There are enough studies out there to suggest that pain and discomfort from disc herniation resolves in 90 %of individuals within 2 – months and the prolapsed disc can regress.
The rate of spontaneous regression was found to be 96% for disc sequestration, 70% for disc extrusion, 41% for disc protrusion, and 13% for disc bulging. The rate of complete resolution of disc herniation was 43% for sequestrated discs and 15% for extruded discs.
Most people who have herniated discs respond well to conservative treatment or non operative and do not require surgery.
Non surgical treatment does not mean no treatment.
You’ll be encouraged to adopt some healthy lifestyle practices along with targeted treatment like physical therapy and some pain medications for a few days to weeks.
In other words,there no single strategy to address herniation in a non-surgical way.
In addition to physical therapy and pain-relieving medications as recommended by your doctor, these are a few things you can do to feel better.
1.Dropping some pounds
Excess weight can worsen compression in the spine, so reducing weight helps in the long run.
2.Quit smoking
In addition to contributing to chronic disease, smoking is a major risk factor for degenerative disc disease, particularly in the lower back and neck.
3.Do low-impact activity
Bed rest may be tempting, but it can lead to more muscle stiffness and weakness.
4.Do core exercises
You’ll want to strengthen your “girdle” of core-muscle support in your abdomen and lower back. Your doctor or physical therapist can recommend moves that are safe for you and when to start these once your pain gets better.
If you’ve tried non-surgical strategies and you still have symptoms after 8 weeks , surgery may be a good option.
Spinal surgery has come a long way, even in the past few years. Unless there’s a concern, most people go home the same day or the next day.
Myth # 2 – Moving is bad for my back pain…
Bed rest may be tempting, but it can lead to more muscle stiffness and weakness.
One to 2 days of bed rest will usually help relieve back and leg pain. Do not stay off your feet for longer, however. When you resume activity, try to do the following:
1.Take rest breaks throughout the day, but avoid sitting for long periods.
2.Make all your physical activity slow and controlled, especially bending forward and lifting.
3.Do low-impact activities.
4.Change your daily activities to avoid movements that can cause further pain.
Myth # 3- I’ll never be able to go back to sports,work or being myself again…
Many patients have fear that they may not be able to go back to work, play with their children, returning to playing sports, or simply being able to use their back. It can also effect how well they sleep or even effect their mood and how they interact with other important people in your life.
The good news is that with proper care plan and attention to your back and activities , many of these concerns can be addressed.
It requires the right type of treatment, patience, and education.
With the supervision of surgeon/ doctor and under the guidance of physiotherapist, following a plan to recover initially from the pain and then going on to strengthening your back will lead you back to your better self.
Putting a plan in place to follow these as a part of your routine will see you getting back to most of the things you enjoy.
Myth # 4-Back pain always means disc herniation or slipped disc...
It’s not always possible to identify the cause of mechanical back pain but it’s rarely anything serious.
Most back pain is what’s known as “non-specific” or “mechanical” (the pain originates from the joints, bones or soft tissues in and around the spine).
https://www.myspineworld.com/18-back-pain-exercises-for-you-to-bounce-back/
This type of back pain:
- tends to get better or worse depending on your position – for example, it may feel better when sitting or lying down
- often feels worse when moving – but it’s not a good idea to avoid moving your back completely, as this can make things worse
- can develop suddenly or gradually
- is sometimes the result of poor posture or lifting something awkwardly, but often happens for no apparent reason
- may be caused by a minor injury such as sprain (pulled ligament) or strain (pulled muscle)
- can be associated with feeling stressed or run down
- will usually start to get better within a few weeks
The common causes for mechanical back pain includes
- Muscle strains: One common cause of back pain is muscular strains. This happens when an unexpected force, twist, or pull is applied to one or several of the muscles in the back. As a result, overstretching can occur in the muscle and can cause pain felt in the back.
- Poor posture- slouching
- Arthritis of the joints of the spine (Facetal arthropathy)
- Disc herniation /Degeneration
So… disc prolapse is one among the many causes back pain.
Follow the above with guidance from your doctor or physiotherapist.See you soon with some more spine tips in My Spine World. Remember, we got your back!