Lower Back Pain - Herniated, Prolapsed or Slipped Discs.

A herniated or prolapsed disc can cause severe back pain and sciatica.

spinal-disc-herniation-prolapsed-sliped.jpgThe Human Spine is fascinating when you look at it. You may have seen one in a Museum or at a Doctor's Surgery. At first sight a spine looks all gnarly and organic, maybe a little bit like the trunk of an old Oak Tree. But we each have one - A Spine - that supports our body and allows us such a fantastic range of movement.

Between the Vertebra there are the flat, thick, plate like Discs. These Intravertebral Discs are what allow Movement to take place. If an Intravertebral Disc packs up - So do we !

The disc is formed of two parts, and outer elastic fibrocartilage and an inner deformable nucleus, basically you have a squidgy ball contained within a firm, elastic mesh. The squidgy ball moves/deforms in regard to movement and other loads.

When a Disc Bulges through the fibrocartilage - a Prolapsed Disc - the bulge will often press on a nerve. This can be disabling, and when serious requires Surgery.

With an uncomplicated Prolapsed Disc in the Lower Back it is important to start a series of back extension exercises as soon as you possibly can. The analogy to describe the Prolapsed Disc would be of someone taking a large bite of a Hamburger, and being unable to close their mouth - then, when they tilt their head back their throat opens, and there now is enough room to close said mouth. Doing these exercises will, hopefully, give the disc bulge enough space to be resorbed back into the disc.

These exercises can be quite uncomfortable to do, the back pain may become worse, but any pain radiating to leg, buttock and thigh should settle. This is because the pressure is being taken off the nerve - the serious part of the injury. The back pain is due to the inflammation around the damaged disc and the associated muscle spasm in the muscles that are splinting the spine.

When the Disc Prolapse is in the Neck - the Cervical Spine - there are similar exercises that should also be followed.
cervical-spine-spondylosis.jpg
At this Acute Stage it is NOT a wise idea to use Spinal Manipulation - as this may make the condition worse. In time, when the inflammation around the Disc and Facet Joints has settled, Spinal Manipulation can safely be used to aid recovery.

There are certain important criteria with Prolapsed Discs. A Disc Bulge will often cause Pain and Parathesia (Numbness and/or Pins and Needles). But in more serious cases the Pain may be intractable, there may be limb weakness, "electrical" sensations and possible loss of Bowel and/or Bladder Control - Cauda Equina Syndrome - loss of sensation in the area that would be in contact with a bicycle saddle - this is serious and requires immediate Medical Attention - Go to Accident & Emergency at once !

The majority of "Slipped Discs' will settle down over three months. An Intervertebral Disk does not have a blood supply, it absorbs fluid from the vertebra above and below. This usually happens at night when there is less pressure on the disc, a person can be up to 3cm taller at the start of the day. This helps explain why a disc injury takes such a long time to completely heal.

Astronauts in space, who are not subjected to the force of gravity, are also much taller when they return to Earth because of this fluid absorption into the disc.

Statistics show that the majority of disc prolapses occur between the ages of 30 and 50, the median age being 40. This is because the degenerative process is not so pronounced in younger people, and in older people the elasticity of the disk is decreased to such an extent that the disc cannot actually bulge. The older population have to contend with conditions such as arthritis and spinal stenosis.

Smoking is also an issue with this disease, a study showed that after two hours of exposure to cigarette smoke metabolism within the disc was decreased by 50%.

The relationship between body weight and back pain is still unclear. It may be that large individuals are less likely to suffer back pain from a prolapsed disc because they are less able to move into positions that will stress the intervertebral disc, and consequently are less likely to suffer a disc prolapse than slender individuals.




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