LOWER BACK BULGING DISC (HERNIATION / PROTRUSION)
The spinal discs functions as the back’s ‘shock absorbers’. They also allow for spinal movement, and also provide the space for where the spinal nerves exit the spinal column (down to other areas of the body).
A bulging disc is a very common condition in the spine (especially as we age), so don’t be alarmed. This injury presents when the annulus (see image) becomes damaged or weakened, where the nucleus pulposus then moves beyond its normal position inside the disc (but does not exist nor protrude out of the disc).
When the outer layer of the disc is damaged and the nucleus escapes from within the disc, this is what we call a herniated disc.
WHAT CAUSES A BULGING DISC
Repetitive trauma: poor spinal posture or repetitive heavy lifting with a poor technique can cause degeneration, or weakening to the disc and therefore cause a bulge. These are typically classed as more chronic conditions, which have strong links to poor core spinal stability muscles, poor spinal flexibility & mobility or obesity.
Acute trauma or injury: can cause a bulge if there is a sudden increase in pressure on the disc, which can typically result in tears to the annulus. Acute trauma, or a sudden force/load on the disc can include a car accident, picking up heavy boxes from the ground or poor technique when lifting heavy weights in the gym.
Spinal/disc degeneration: whilst degenerative changes are expected with the ageing individual, if you have pre~existing issues with posture, spinal flexibility and strength, this could speed up the degenerative process and thus weaken the discs, potentially resulting in a bulge.
SYMPTOMS OF BULGING DISC?
Sharp pain at the level of the disc bulge. Movement typically will make the pain more acute.
Muscular tightness & spasms
Pins and needles
Numbness or weakness to the peripheral limbs (lower body)
If you have a severe disc herniation, you could experience bowel and bladder control issues.
SO WHAT WILL MAKE THE PAIN WORSE?
Sitting: can place more pressure onto the disc due to forming a poor posture
Forward bending or ‘spinal flexion’: is typically a provocative movement for a bulging disc as the disc commonly pushes backwards onto the spinal nerves as you bend forward.
Coughing or sneezing: the sudden increase in intra~abdominal pressure will place pressure where the bulging disc is located, so typically this can be described as a shock or zapping pain when sneezing.
Lifting: whether this is in the gym or just lifting groceries, more strain your spine has to endure when experiencing a bulging disc will cause more discomfort.
PROGNOSIS OF BULGING DISC
If treated correctly (and depending on the severity of your condition), returning to full health following this type of injury could take anywhere from 6~10 weeks. Seeking professional physiotherapy advice for this type of spinal injury is recommended.
Your physiotherapist will assess the basic movement & integrity of your spine to pinpoint the location of the affected disc, followed by a tailored exercise program to improve the mobility & stability/strength of your injured spinal disc.
If severe, the clinician may refer you for imaging (typically an MRI) to specify the exact location of the disc bulge, and will then advise if conservative treatment for your injury fails.
BULGING DISC PHYSIOTHERAPY TREATMENT
Here at Infinite Health, our highly trained physiotherapists will assist you through the healing process, on to resuming pain-free activities, return to day to day normal activities and most of all reduce the risk of recurrence in the future.
Determining the CAUSE of your back pain, and then working to effectively treat this and prevent reoccurrence is the MOST important factor to understand. It is important to continue to keep active and engage in your normal activities as best you can whilst avoiding any aggravating factors whilst this occurs. Though if your pain has not eased in a few days, or in more chronic conditions which are long standing, it is greatly advised to seek the intervention of a physiotherapist.
Every lower back treatment plan is different and specific to each individual but should have the following aims and checkpoints.
Phase 1 - Back pain relief, healing and protection. Hands on treatment and advice. Restoring normal ranges of motion and strength with basic exercises.
Phase 2 - Restoring full function and resuming normal activities along with functional strengthening exercises.
Phase 3 - Preventing a recurrence.
Physiotherapists will also provide you with education and understanding of your spine so the individual is able to self manage their back issues, ultimately providing YOU with the understanding of how to keep your lower back healthy and prevent reoccurrence.
For expert help and treatment visit one of our clinics or sign up for one of our online services. We'd love to help!