Disc Injuries

The intervertebral disc is the spongy cushion that is located between two vertebral bones in our spine – there are 23 discs in the human spine. Its main role is to act as a shock absorber for the daily forces being placed on our spine. The disc also provides the spine with mobility, flexibility and stabilisation.

The disc has a high water content when we are young, however as we age the water content decreases which leads to a more rigid and inflexible disc – this can lead to disc degeneration (arthritis).

The disc has two parts:

1. The OUTER LAYER which is an elastic like tissue called annulus fibrosis

2. The INNER LAYER which is a gel like substance called the nucleus pulposus.

What is a Bulging Disc?

A bulging disc is a condition that can be symptomatic (painful) or asymptomatic (not painful). It occurs when there is a weakening of the outer layer (annulus fibrosis) which allows the nucleus pulposus to move from its normal central position within the disc.

The difference between a disc bulge and a herniated disc is that with a disc bulge the annulus are still intact, therefore the nucleus will not penetrate through the annulus fibres, while if the annulus is torn or damaged the nucleus escapes from the disc, this is called a herniated disc.

What causes disc bulges?

• Degenerative disc disease
• Repetitive trauma
• Bad posture
• Sudden trauma (eg; fall, lifting, car accidents)

What are the symptoms of a bulging disc?

The symptoms of a bulging disc may vary depending on the location in the spine where the nerve is irritated. People often describe the pain in the affected area as sharp, stabbing pain and movement is limited due to the body guarding itself (muscle spasm) from further injury.

Individuals who are suffering a disc bulge in the lumbar (low back) spine may experience pain into the lower extremities including buttock, hip, knee, calf and/or foot pain. This pain is often referred to as sciatica.

Other disc bulge symptoms that you may find:

• Tingling
• Numbness
• Weakness
• Muscular spasm

How is a disc bulge diagnosed?

Diagnosis of the disc bulge includes:

• A thorough history. Detailing the mechanism and duration of the injury.
• An assessment to locate the specific site of injury. Neurological and orthopaedic examination, range of motion, muscle testing and palpation will be required.
• Xrays, CT and MRI scans.

Treatment for a disc injury

Individual trials have demonstrated clinical effectiveness for spinal manipulative therapy for management of acute back pain. For chronic low back sufferers a recent Cochrane systematic review indicated Chiropractic adjustments provided patients with a positive outcome when combined with exercise.

Sims & Finn Chiropractic will provide you with a management plan to ensure you recover as soon as possible. There are a variety of techniques and advice that we offer to aid your recovery:

• Specific Chiropractic adjustments to improve spinal mobility.
• Stretching regime to maintain movement.
• Core strengthening once the inflammation has reduced.
• Home / Work advice to maintain good posture and minimise aggravation to injury.
• What to avoid doing with a disc injury.
• Sitting in a soft couch or recliner will apply more pressure to the disc.
• House or garden work that may aggravate your condition.
• All leisure activities / sports/ gym workouts may need to be modified.
• Bed rest is not advised. Movement is the key – stay mobile.

What to do next?

Call us today to make an appointment time. We will provide you with:

• A thorough Chiropractic assessment.
• Locate the cause of the disc injury.
• Specific Chiropractic adjustments to allow your nervous system to function at its best.

References

1) Goertz, C.M., et al., Adding chiropractic manipulative therapy to standard medical care for patients with acute low back pain: results of a pragmatic randomized comparative effectiveness study. Spine (Phila Pa 1976), 2013. 38(8): p. 627–634.

2) Hidalgo, B., et al., The efficacy of manual therapy and exercise for different stages of non-specific low back pain: an update of systematic reviews. J Man ManipTher., 2014. 22(2): p. 59–74.

3) Balthazard, P., et al., Manual therapy followed by specific active exercises versus a placebo followed by specific active exercises on the improvement of functional disability in patients with chronic non specific low back pain: a randomized controlled trial. BMC MusculoskeletDisord., 2012. 13: p. 162–162.

4) Bronfort, G., et al., Supervised exercise, spinal manipulation, and home exercise for chronic low back pain: a randomized clinical trial. Spine J, 2011. 11(7): p. 585–598.