Disc Bulge

Written by Dr. Alison Gault B. App. Sci. (clinical sci) B. Osteo. Sci.  from Vale Osteopathy Clinic located in Ascot Vale and Pascoe Vale, Melbourne, Victoria, Australia.

Other common names for the same thing are: disc prolapse, disc herniation, blown disk, slipped disc and pinched nerve.

A Doughnut…

We first need to understand a little more about the disc.  The best way to describe it is a comparison to a jam doughnut!

The disc is made up of a strong outer layer (the crusty outside), lots of water (the soft, squishy dough) with an inner core or nucleus (the jam).

Moving Disc

With a doughnut, the jam can be squeezed around depending on where you put the pressure on the bun. If you squeeze it too hard, then the jam will escape.

It is just the same with the disc. When you bend forwards or sit down, the pressure is placed on the front part of the disc. This has the effect of squeezing the disc core (shown in red) backwards. The more bending you do, the more you are encouraging the disc to move in a backward direction.

If you decide to lift something with your back bent, then you are adding a tremendous force to your disc. Basically you are asking for trouble!

Prolapse, Herniation…it’s all the same thing!

And so, if pressure is placed onto a part of the disc, the central core material will be squeezed to the area of least pressure (think of the doughnut!). In the diagram you can see a birds eye view of what happens when you bend forewards. The disc corel tends to move backwards.

If there is too much pressure on the disc or too frequent high pressure on the disc, it can bulge out into the outer wall. This is when you get a disc bulge, prolapsed disc or slipped disc! This bulge in the disc can then press on the spinal cord or nerves as they pass out from the spine.  This pressure on the nerve effects its ability to function causing pain, numbness, tingling and weakness.

Symptoms

Symptoms of a prolapsed disc can vary widely. It ranges from simple localised lower back pain to raging leg pain, weakness, numbness and/or pins and needles. The leg symptoms are most commonly down the back of the thigh, the outer side of the leg and the top of the foot.  You may have difficulties walking due to muscle weakness.  The symptoms tend to get worse with sitting, sneezing, coughing and going to the toilet as there is extra pressure on the disc and therefore also the nerve.
It can occur in any age group but is most common between the ages of 20-40 when the disc is most mobile.   Unlike the typical movie version of someone lifting a heavy weight and then collapsing on the ground, the most common way that the symptoms start is actually the next day after lifting something heavy.  The patient wakes up not being able to move with the pain.

Treatment

Treatment is usually conservative with manual therapy such as osteopathic treatment to get everything around the effected disc moving to decrease the pressure on the disc.  However, in severe cases, especially those involving muscle weakness, surgery may be required.  Exercise such as core strengthening and swimming are of great benefit. Anti-inflammatories and ice can help control the symptoms.  In general, it can take about 12 weeks for the symptoms to go however there will be a weakness in the disc for the rest of the patients life.  Regular treatment and strengthening exercises will be needed to help prevent reoccurance.

How do I prevent it??

• Get regular maintenance treatment especially if you lift often in your day to day life such as tradesmen and parents of young children. Treatment will ensure that all your joints are working properly so that one joint isn’t getting most of the load.
• Use good lifting techniques. This means using your legs not your back!! Rather then bending at the hips and back to pick up your child, bend at your knees keeping your back strait!
• Tighten your core stabilising muscles whenever you lift something. If you don’t know how to do this, ask me next time you have appointment or start learning clinical pilates.
• Stretch!
• Keep your weight within the healthy range for your age and height. Being overweight puts much more strain on your joints and discs which increases the chance of a bulge.

Disclaimer: information provided on this post is of a general nature and should not be used in place of advice from either myself or another medical  professional.

Vale Osteopathy Clinic provides osteopathic services to patients from a wide number of suburbs such as Ascot Vale, Pascoe Vale, Flemington, Melbourne, Australia, Footscray, Maribyrnong, Essendon, Essendon North, Moonee Ponds, Strathmore, Niddrie, Keilor, Coburg, Brunswick, Oak Park, Glenroy, North Melbourne, Avondale Heights, Airport West, Travancore.

Tags: Back Pain, disc, disc bulge, low back pain, osteopathic treatment, sciatica, slipped disc, treatment