Wellness Osteo

Wellness Osteo

At Wellness Osteo, we are osteopaths who focus on achieving optimal health and wellness, which means treating you and sharing our expertise with you. Read on for the ins and outs of osteopathy.

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Lumbar Disc Bulge

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What is a disc bulge 

Intervertebral discs sit in between your vertebrae (bones in your spine), and act as shock absorbers for your spine. Each disc consists of a hard casing (the annulus) and liquid-like center (the nucleus). 

Osteopaths often use analogies to help explain anatomy to patients. When it comes to intervertebral discs in the spine, an analogy I like to use is the Jam donut analogy. 

In between each vertebrae, is a jam donut, with the outer casing of the donut being the “annulus” and the jam inside being the “nucleus” in the middle. As compressive forces are placed on the donut, the outer casing can break open and the jam will squeeze out and cause pain. In some cases, but not all, the jam that has escaped can press on the nerves that surround the spine and cause burning or electric pain. 

The low back is the most common place to have a disc injury as the low back takes the most amount of compressive forces in your spine.
There are different grades to disc damage (listed from least amount of damage to most):

  • Annulus sprain – outer casing of donut becomes damaged but still intact and no jam pushing through.
  • Disc protrusion/herniation – outer casing of the donut still intact, but the jam is pushing the casing in an outwards direction. 
  • Disc extrusion – Jam escapes donut but is still attached. 
  • Disc sequestration – Jam breaks free of the donut.

Contrary to popular belief, DISCS DO NOT SLIP, they bulge outwards. 

Symptoms

Pain from a disc injury often comes on suddenly and is felt in the middle of your lower back.
The pain is made worse by coughing, sneezing, sitting for long periods, bending forward, lifting a load, twisting, rolling in bed or lifting a leg up.
It often takes a while to stand up straight after sitting, with the first few steps being a shuffle.
The pain can be made better with changing seated positions regularly (keeping moving), lying flat on your back, heat, and gentle movement. 

Disc injuries don’t always have neurological symptoms (pain radiating down your leg). If a disc bulge has not pushed its way out onto the surrounding nerves the pain will only be in the lower back.

Disc protrusions, extrusions and sequestrations and inflammation around a damaged disc can all press on the nerves that run closely alongside the spine and cause a burning/electric type of pain, pins and needles, weakness and sometimes loss of muscle control to a different part of your legs or arms. This is called radiculopathy, where the nerve is compressed, causing pain at a different part of the body.
In severe cases you may experience loss of bladder or bowel control. If this is the case we recommend going to the emergency room immediately.

It is also possible to experience a disc bulge with no pain at all. It all depends on the position and size of the bulge, each individual is different, which is why it is important to seek advice from a health professional if you recognize any of these issues.

Causes
In most cases discs become damaged as we age and the disc itself begins to degenerate, which is completely normal. Just like every part of our body as we age, the disc loses strength and the ability to withstand compressive forces. This can cause small tears in the outer layer, allowing the inner layer to protrude outwards. This doesn’t just happen in elderly people though, and can happen to young people through trauma.
Discs can become damaged through one big force of bending forward to pick up something heavy and then lifting with poor technique.
Discs can also be damaged by repeated microtraumas, such as Mum picking up her baby over and over.
Which is why it is incredibly important to learn proper lifting technique, where we bend mostly through our knees and not our back. 

Diagnosis
Through a thorough case history and physical examination our Osteopaths at Wellness Osteo can make a diagnosis that suggests a disc bulge, but only a CT or MRI scan can accurately diagnose the extent of the damage. 

Management/Treatment
In most cases of a disc bulge surgery is not necessary as most herniated discs can recover without it. 

Manual therapy performed by an Osteopath has been shown to be effective in treating disc bulges. Through various treatment techniques we can reduce pain symptoms, improve range of motion and mobility and educate patients on how to manage their back pain. 

Manual therapy combined with an exercise rehabilitation program that focuses on strengthening the surrounding muscles, and education on proper lifting techniques can heal a disc herniation. 

At home to help with symptoms you can apply:
– Anti-inflammatory drugs such as ibuprofen.
– A heat pack or a hot shower.
– Changing positions every 30 minutes. Don’t sit still for too long.
– Activity within pain limits. Rest is not recommended, but neither is strenuous activity, so find something active that doesn’t bring on too much pain. Walking and hydrotherapy (walking in a pool) have been shown to be fantastic alternatives.
– Maintaining a healthy weight and diet. The heavier you are, the more force is being placed on the discs. 

Some discs can take 4-6 months to heal, so be patient and trust your health professional. If symptoms continue to progress, we may discuss surgery, but this is left as a last resort. 

Here at Wellness Osteo, we treat disc bulges constantly. If you are searching for a diagnosis or wanting to explore other treatment options for your pain, book in with one of our practitioners today.