Intervertebral
discs are shock absorbers for the spine. Their inner is made of a gel-like
substance called the nucleus pulposus. The nucleus has a high water content and
is enclosed in a tough fibrous casing called the annulus fibrosis) Together
they cushion the spinal joints and allows space for nerves to flow out to
control every part of the body.
This tougher outer
casing of the invertebral disc should hold and support all the inner substance
of the disc material. It is then all
held together by the surrounding ligaments and muscles.
Disc injuries,
sometimes referred to as disc derangement, prolapsed disc, herniated disc or slipped
disc, are extremely common. Many people walk around everyday with a disc herniation
that goes undiscovered until pain occurs.
The most common
age for a disc injury is 30 to 50 but even teenagers can have disc problems. Symptoms
can be a gradual or sudden onset of pain. This pain can be constant or intermittent.
The symptoms can range from pins and needles or numbness right through to
debilitating pain which makes it difficult to move.
Pain can be local to the area or referred
through the gluteus (butt) down through the leg and foot.
Symptoms can be
even or just one side.
A general rule is
that the further the symptoms travel through the limbs the more severe the
problem.
This can also depend
on the amount of the gel like substance (nucleus pulpous) protruding through
the harder casing (annulus fibrosis) and putting pressure on the nerve canal. (see
picture)
Why
do disc bulges occur?
While accidents,
knocks and bangs can cause disc injuries, they are more often the result of damaging
long-term sitting, working or sporting positions along with weak supporting
muscles.
The most common
muscle imbalance associated with disc injuries is a flat or sway back position
(see pic) in the low back with a kyphotic (slouched upper back), This generally
includes tight hamstrings and glutes (butt) and a weak core/abdominals.
This muscle
imbalance puts a constant pressure on the disc that weakens it over time, leading
to the disc material pushing outwards or sideways and pressing on the spinal
canal. Think of it like a hole in the toothpaste tube: if the toothpaste
squirts out it is sometimes impossible to get back in.
If the problem is
not addressed in early stages, sometimes surgery is needed.
There are 7
different stages of disc derangement. if the disc material has protruded a long
way, surgery may be required. A diseconomy is when a surgeon goes in, sometimes
microscopically to minimise scaring and damage, and shaves off the disc material
that is pressing on the nerves and causing pain. This can help relieve the pain
but it does not fix the underlying problem.
Symptoms are our
bodies warning signs. It is important to listen to our body and take action to
address the problem.
Just like the old
saying “A stitch in time saves nine”.
Fixing the problem
Disc injuries can
be slow healing because of the limited blood supply in the discs.
Muscle imbalance
and poor posture must be addressed and movement patterns re-educated from a
neural level to get the body back to function and strength.
It is extremely
important to do the corrective exercises that will centralise and stabilise the
disc. Incorrect movement can push you the body more vulnerable positions.
Learning
functional movement patterns gives a person strength and confidence to lift and
move in the correct way so further injury can be avoided and lifetime activies
can still be enjoyed.
Other factors of
importance are staying hydrated to keep disc’s plump. Dehydrated discs are like
flat tyres to a car - much more likely to wear faster or blow out. As a disc
dehydrates and shrinks it causes the surrounding ligaments to be loose (known
as ligament laxity).
Correct nutrition
and appropriate rest/sleep is also imperative for all healing.