You bent over to pick up a sock and BANG. Debilitating, immobilising low back pain. The tiny straw that broke the camels back. Well, not literally, but it sure does feel like it.
A lumbar disc herniation is the injury that the most clients fear. I think it's because we've all heard a story about Liam who 'did his back' and couldn't work for years afterward.
The truth? Yes, In the last 10 years, I've met Liam once or twice. But it's important to keep perspective, and remember the hundreds of other people who have suffered a disc herniation and recovered exceptionally well.
No need to be scared. Just seek help.
Here's a place to start.
Lumbar Disc Injuries
The What, How and Why.
An Intervertebral disc is a cushioning structure that exists between the bony vertebrae of the spine. Think of them a bit like the gooey centre of a macaroon. The discs allow for movement to occur between vertebrae and provide shock absorption.
Disc herniation occurs when a portion of the disc bulges out beyond the edge of a vertebrae. Herniations are sometimes referred to as a disc bulge or disc prolapse.
Disc herniations are most likely to occur as a result of:
Disc herniations can usually be diagnosed following a thorough clinical history and physical examination. A CT or MRI may be taken to confirm a diagnosis and assess the severity of injury.
What will I experience or feel like?
It's true that severe low back, strong muscle spasm and reduced mobility are common following a disc herniation. If the bulging disc compresses a nerve root, you may experience sciatica, a sharp and intermittent radiating pain down the back of the leg and into the foot. You may also experience temporary and reversible neurological symptoms such as numbness and tingling in the leg or foot, or a feeling of weakness.
How can I help fix it?
There is good news! There are lots of successful ways to manage the pain and rehabilitation of a disc injury.
In the first 2-3 days rest moderately. What does that mean? Rest, but don’t stay so still that you seize up. Stay mobile, but not so much that you over do it and aggravate your injury. It’s a fine line to walk and it will be different for everyone.
Icing for 20 mins every 2-3 hours will provide pain relief. Alternatively, you can discuss pharmaceutical pain relief with your GP.
Osteopathic treatment is gentle enough that it can be utilised immediately after injury. It can reduce pain and muscle spasm, and increase mobility. Osteopaths can guide you through gentle mobility exercises and stretches that ease pain and increase movement, and when appropriate prescribe rehabilitation exercises.
After the initial acute phase has passed, it is essential to consider rehabilitation and preventative management to reduce the risk and frequency of re-aggravations.
The choices and actions you make during this period will have the greatest impact on your recovery. It's recommended to
Identify and avoid activities that aggravate your disc injury
Adhere to your rehabilitation exercise program. It should consist of a combination of strengthening, stretching and mobility exercises.
Avoid smoking, and ensure adequate hydration to slow further disc degeneration.
Your osteopath can help you develop a specific plan that meets your needs.
How long will I take to recover?
Once a disc herniation occurs, the integrity of the disc won’t ever be perfect again but the size of the herniation will decrease over time.
It takes time for a disc injury to heal. Most people experience significant resolution of symptoms within 3-6 months.(1) The first 1-2 weeks of the acute phase are the worst and then symptoms will gradually ease and you’ll be on the up and up. The more committed you are to your rehab program, the better your outcome is likely to be.
Down the track, after your initial injury has resolved, you may experience recurrent short episodes of pain, followed by long periods of complete relief. Again, stick to your management plan, and you’ll reduce your risk of reaggravations. Broken record I know, but I can’t stress it enough. There aren’t quick fixes for disc injuries, only committed long term plans.
A few people may experience persistent and progressive pain. In these cases, surgery is considered and aims to correct disc deformities, restore stability and relieve neural compression. If the time comes, this option is best discussed with your GP.
The take home message here is that yes, disc injuries can be very painful. But we have to remember that with the right care and advice, managing a lumbar disc injury and living a pain free, active lifestyle is entirely possible!
Please be mindful that the information contained above is general in nature and is not intended to provide a diagnosis, nor replace the direct care and instructions of a healthcare professional.
If you have any questions about your symptoms or the recommended treatments and management plans, please contact us and will be more than happy to discuss your case with you further.
S, G., Rothman-Simeone and Herkowitz's The Spine. Elsevier, Inc.
2. Canale, T., 2012. Campbell's Operative Orthopaedics. 10th ed. U.S.: Elsevier.
Photos by Sean Stratton & Asaf R on Unsplash