The spinal disc is a cartilage structure, there is one in between each vertebra in the spinal column. They have a tougher outer case, and a softer gel-like substance contained within this. They function to improve the shock absorption through the spine.
Spinal disc injuries are not uncommon. They can be damaged to varying degrees.
Discs are subject to wear and tear, the same as other areas of our body. This would tend to create some stiffness in movement, and this may be associated with pain.
A common disc injury is a “slipped disc”. This may occur to varying degrees. You may hear descriptions like herniation, prolapse, extrusion and sequestration when a disc injury is described. They define the degree of bulge of the disc, and if the outer casing of the disc has burst, and the internal parts of the disc have leaked out.
Depending on the degree of bulge, the nerve may be pressed upon or irritated by these processes. This can cause pain local to the injury, and into the area the nerve travels.
A disc injury can happen in the neck, upper back or lower back. It is very common in the lower back, and this is where you may experience leg pain, sometimes “sciatica”. Other leg symptoms, or nerve related symptoms anywhere, could include a burning sensation, pins and needles, tingling and numbness.
The picture above is an illustration of a disc prolapse, as seen as a cross-section through the spine. In this example. The disc is pushing against the nerve, and this would more than likely cause pain in the area that nerve travels to.
Anyone may experience a problem with a spinal disc. Typically (although not all disc injuries occur this way) a bending activity through the spine might cause the problem. Especially if in combination with twisting and lifting. Slumped postures may upset discs too. Perhaps if a disc is degenerative it will be more susceptible to further injury.
A disc can be diagnosed through taking a case history (so the details of the onset/pattern of pain). A lot can be determined by further nerve tests. So reflexes, power, sensation and nerve stretch tests. An Osteopath would also palpate the area in question to assess movement, tone and reaction of soft tissues, and any palpable inflammatory changes.
Treatment can consist of physical therapy and pain medication. Discs don’t tend to heal quickly, and may take in the region of 6 weeks to 3 months to resolve. The patient should be monitored to ensure that recovery is taking place, and to see if referral for further treatment is necessary. In the worst cases surgery might be necessary.
A definitive diagnosis can be made with an MRI scan, this gives a good image of the disc.
PREVENTING A DISC INJURY
As with many mechanical problems in our body. If we try and keep ourselves mobile and strong, we can hopefully prevent a lot of injuries. The same applies with discs. So take regular exercise. Try and maintain a good posture as much as possible. Avoid slumped postures, slumping will really over-stress a disc. Perhaps it could cause an injury, or predispose to one if the area is weakened. Practice good lifting technique. Use your legs as much as you can when lifting to avoid the strain coming through the back. Stand straight onto the object you’re lifting, and hold the object close to your body where possible. Don’t overdo it! If its too heavy for you, ask for help or wait until someone is around to help you.
Link to NHS lifting tips http://www.nhs.uk/livewell/workplacehealth/pages/safe-lifting-tips.aspx
Link to NHS tips for sitting correctly http://www.nhs.uk/Livewell/workplacehealth/Pages/howtositcorrectly.aspx
GOOD SEATED POSTURE
Link to previous newsletter for extra guidance on workstation set-up.