The low back or lumbar spine is made up of 5 bones or vertebrae. In between each of the bones of the neck lies a disc. The disc is made up of tough con-centric outer layers of tissue known as the annulus and a soft jelly like substance in the middle. Due to the structure of the spine and the nature of the way we move, lumbar disc injury is a common condition.
Lumbar Disc Injury, What is it?
Injury to the disc will generally fall into one of the 3 following categories of increasing severity:
Annular Strain
This is where the back portion of the disc becomes inflamed due to sustained or repetitive bending of the neck or as a result of a sudden unexpected force on the neck or arms.
Disc Bulge/Protrusion
This generally tends to occur gradually over a period of time, although onset of symptoms may be quite sudden. With this injury, as a result of repetitive stress on the back of the annulus, it becomes stretched and begins to bulge, generally backwards, towards the nerves and spinal cord.
Disc Herniation
This will generally occur in a chronically bulged disc, where the tissue at the back of the disc fails and the jelly like substance in the middle of the disc leaks out.
Symptoms
- Pain generally on one side of the back, often radiating into the top of the buttocks.
- Painful restriction of movements of the back, especially forward bending.
- Pain is worse with flexion activity such as forward bending and sitting and often relieved after a period of extension, leaning backwards or laying on the stomach.
- Muscle spasm in the back and buttocks.
- A disc bulge and disc herniation, commonly cause compression or irritation of the nerves from the back into the legs, resulting in pain, pins and needles, numbness or weakness in the leg.
Management
The disc is irritated by flexion activity such as sitting and leaning forward. Limiting the amount of time spent in these positions is essential in allowing the disc to settle. Heat and anti-inflammatories are quite useful in settling muscle spasm and inflammation of the disc and surrounding nerves.
Your physio will generally use gentle techniques to decrease muscle spam and restore normal joint mechanics. Occasionally taping the back can be useful in offloading the painful disc. Often you will be prescribed extension exercises laying on your stomach to settle the disc and increase range of motion.
Identification of contributing factors to the injury, such as postural issues and or weakness of the core muscles is essential in prevention of re-occurrence of the injury. Your physio is able to provide you with a range of pilates and corrective rehab exercises to overcome these issues and keep you pain free.
