Herniated Disc - What you need to know

A healthy spine allows you to move freely and keeps you doing the things you love, pain-free! That’s why it is crucial that we take care of your spine. When back pain strikes, you need to take the right steps to eliminate that pain!

 

Herniated Discs - Causes and treatment options

Our spines are the literal “backbone” of our bodies – as the saying goes!

The spine is a complex bone structure, made up of 33 individual vertebrae and each of those bones contain a soft disc in between each other – these are called intervertebral discs (or spinal discs).

Spinal discs play a crucial role in the spinal structure, serving as shock absorbers between the vertebrae, supporting the entire body, and allowing a wide range of movement in all directions.

Each disc has a form outer covering, called the annulus and, and inside that covering is a soft, jelly-like centre called the nucleus pulpous.

What is a herniated disc?

A herniated disc is when the nucleus of the disc (the soft jelly-like interior) is pushed out of the disc, due to a tear of the disc outer covering (the annulus).

Keeping in mind that the spine has 33 vertebrae (bones), this can happen to any of the discs. When a herniated disc occurs, there are a variety of symptoms, but back and nerve pain are the usual suspects.

A herniated disc is also known as a prolapsed disc. 

What causes a herniated disc?

When a spinal disc tears, it’s called an annular tear, leading to a herniated disc. So, how do these tears happen?

There are many reasons for a herniated disc happening, such as a car accident, a sports injury, or another form of trauma. For example, a disc can herniate while you are twisting or turning to lift an object, or while lifting a large and heavy object as it places strain on the lower back.

Individuals who have a physically demanding job or lift heavy weights in the gym are at risk of a herniated disc. However, the most common cause for annular tears is the natural aging process of our bodies!

As we get older, our spinal discs start to become less hydrated and slowly become brittle - making them more susceptible to tears. This is why herniated discs are generally experienced by people over the age of 30, as our bodies start to become a little more injury prone.

 

Herniated disc symptoms:

Although the lower back is one of the more common areas for a herniated disc, you can experience a herniated disc in any part of your spine, from your neck to your lower back.  Your spinal column is a complex network of nerves, blood vessels and moving parts. As a herniated disc can happen anywhere along the spine, there are a wide range of symptoms.

Herniated disc symptoms include:

• Nerve impingement pain (sharp pain in a specific area)
• Nerve pain and numbness in the affected area  
• Pain that extends from your back down through your leg
• Lower back pain when bending forwards or with certain movements that extend the spine
• Pain that worsens after standing or sitting for a period of time
• Unexplained muscle weakness
• Tingling, aching, or burning sensations in the affected area

The degree and type of pain can vary from person to person. This is why it’s important to see your physiotherapist as soon as you experience back pain, especially if you are feeling any numbness or tingling.

 

 

Who is at risk of a herniated disc?

A herniated disc can happen to anyone and at any age due to the injury relating to physical demand. However, there are some factors that increase the likelihood of someone sustaining this type of injury. These include:

• Age
  The most common risk factor is being between the age of 35 and 50. This is when most injuries occur as you are still generally active at this age and it’s also when degeneration of the spinal discs start to occur
   
• Occupation
  Individuals who have a physically demanding job such as tradespeople, removalists or labourers are at higher risk of developing a herniated disc. This is due to repetitive pulling, pushing and twisting movements while potentially holding heavy objects.
   
• Obesity
  Studies have shown that carrying excess weight puts extra stress on spinal discs and re-injuring the same disc is increased by 12 times. [1]
   
• Family history
  Studies have shown that family history of disc degeneration of lumbar discs is associated with an increased risk of herniated discs in future. [2]

Herniated disc diagnosis:

If you are experiencing any of the symptoms listed above, a physical examination with a physiotherapist is a great place to start. They will ask you about your pain, its location and the source of your discomfort. This usually involves checking nerve functionality, muscle strength and your range of motion.

Imaging tests are very helpful in analysing your injury as they allow you to take an in-depth look at the bones, muscles, and tissue in the spinal area. These include:

• X-rays
• CT Scans
• MRI
• Discograms

Once a review of your imaging is completed and you understand your situation, you can then work towards addressing your pain and working towards a solution.

Herniated disc, bulging disc or slipped disc - what is the difference?

Most of us have heard each term and it can be quite confusing to know the difference - especially as a lot of people believe that they're all the same injury.

The difference between a herniated disc and bulging disc are simple and easy to understand. A good metaphor used to explain the differences is to think of the spinal disc like a car tyre. The car tyre is pumped with air and is surrouded by the outer rubber. If the tyre has low air pressure, the sides will bulge out while you drive however the air stays inside - this is a bulging disc. However, if that tyre becomes punctured and air starts leaking out - it becomes a herniated disc. 

The  term “slipped disc” isn't a real medical term or diagnosis. The term is a slang term and has worked its way in to our vocabulary through misinformation, non-medical blogs and social media content.

However, many people who have a herniated or bulging disc will often refer to their injury as a “slipped disc” 

Herniated disc treatment:

Symptoms start to become manageable within 6 to 8 weeks, but you'll need to take it easy on the physical movements during that time. That might mean lighter duties at work or taking some time off lifting heavy weights to allow the disc to heal.

When considering herniated disc treatment, there are two main options to consider: Conservative (non-surgical) or Surgical treatment.

Conservative treatments include:

• Rest!
  Take it easy for a few days. Where possible, take pressure off your back by laying down and allowing your body to naturally health any irritation or swelling in your herniated disc.
   
• Physiotherapy, exercise, and gentle stretching to help relieve pressure on the nerve root
  A physiotherapist will be able to assist your recovery by working on a strength program with herniated disc exercises to help strengthen the supportive muscles surrounding your spine. Not only can this relieve pressure, but it will help improve posture and reduce the risk of re-injuring the same disc in future.
   
• Ice and heat therapy for pain relief
  Like with many physical injuries, Ice and heat therapy can help improve your pain in the early days of symptoms.
   
• Manipulation (such as chiropractic manipulation)
  A chiropractor can help address back pain and other herniated disc symptoms. Chiropractors analyse the spine as a whole and can make adjustments to relieve pressure from certain areas.
   
• Anti-inflammatory pain relief 
  Using anti-inflammatory drugs such as Nurofen or Advil, can help you manage your pain while your body recovers.
   
• Massage therapy
  Massage therapy can ease back pain by releasing tension, relaxing muscles, and allowing for better blood flow in the surrounding muscle groups.

If your pain and other symptoms of your herniated disc injury aren’t showing any improvement or are getting worse, your physio might refer you to an orthopaedic surgeon to explore other options. Often, at this point most people would have tried a variety of conservative treatments and their pain has not improved, or it has gotten worse.

Surgery may be recommended if:

• The pain so severe that you are having pain or difficulty completing daily functions such as standing, walking, or bending forwards or backwards.
• Your pain is progressing into neurological issues. For example: severe leg weakness, and/or numbness.
• You start to lose control of your bowel and bladder functions (this can happen if the nerves that control your bladder are impacted)
• All other conservative treatments have not significantly eased symptoms.

Most herniated discs tend to improve on their own with a combination of conservative treatment and rest. But they can happen again!

How can physiotherapy help a herniated disc?

Physiotherapy is a recommended treatment for herniated disc recovery, as the goal is to help patients manage pain and to start to get them moving freely again. Physiotherapists will use a variety of treatments to help manage symptoms such as massage, stretches and exercise programs designed to help strengthen the muscles that protect the spine. 

Herniated disc recovery time can vary from person to person and while you recover, your physiotherapist will work with you to re-introduce activities that will allow the injury to heal as well as actively stimulate the relevant muscles, improving core strength and posture. 

To help protect your spine, it is important to strengthen the muscles that support your spine and maintain good posture where possible. Also, remember to use proper form when lifting any moderate to heavy objects.  

Back In Motion is always here to help you!

With practices Australia-wide, we’re Australia’s leading provider of physiotherapy and related services. Contact us on 1300 859 981 to organize a booking with one of our physiotherapists and we can help you with your herniated disc pain today!