A herniated disc, or disc protrusion, (often informally called a "slipped disc") is a fairly common injury to the spinal discs, particularly those of the lumbar spine (low back). The discs are situated between spinal vertebrae to provide cushioning and support to the bony vertebrae. The outer portion of the disc is called the annulus, and consists of many cartilaginous layers. The annulus surrounds the nucleus, which is a small circular "jelly-like" substance with the main purpose of absorbing compressive forces transmitted through the spine. As we age, the layers of the annulus tend to weaken which makes it more susceptible to tearing. The nucleus also dehydrates, lessening its ability to distribute force.
Disc herniation's generally occur when the spine is flexed (bent forward) and twisted under load. When this occurs, the nucleus or jelly like centre pushes backward within the disc. If the outer layer or annulus isn't strong enough to contain this movement, the fibres can tear, allowing the nucleus to move out of its central location. Severity of herniation depends on how far the nucleus shifts and if it starts to press on the nerves exiting the back at that level. If this happens it can be very painful and can often cause symptoms of weakness, tingling and tenderness radiating down the leg.
Symptoms often present as sharp/severe back pain after bending. The pain is commonly down one side. Sometimes you might notice a weight shift away from the side of pain and have difficulty bending as well as straightening up. It is important to be aware that if you have loss of coordination or changes to your bladder and bowel function involving either constipation or loss of control you should get to the hospital or medical assistance immediately as this can be a sign of spinal cord compression. This is a medical emergency!
(Source: Texas Spine and Joint Hospital)
Treatment should include a proper diagnosis from a medical professional. Often if your health care professional is suspicious of a disc bulge they will refer you for CT or MRI to get a clear picture. Very commonly disc bulges respond well to treatment including hands on therapy to relieve the muscle tension and pain associated with a disc bulge. This will be progressed to include a graded exercise program to strengthen core muscles around the area. Always make sure your physiotherapist shows you how to relieve tight muscles yourself for prevention and management long term. Depending on the severity of the herniation and if symptoms don't settle it may be necessary to be referred to an orthopaedic specialist who can discuss surgical options. Always remember with your back prevention is the best option. Look after it no matter what stage you are at. Stretch, strengthen and release whenever you can. Start now and get your kids starting as soon as possible.
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