Back Disc Bulge Treatment
Cognitive functional approach to back care management of spinal related pain
Low back pain is a very common condition in the population and most likely we will all experience some back pain in our lives.
What are lower back discs?
The inter vertebral discs separate the vertebrae of the spine.
Discs in theory have a role in absorption and stabilisation as well as allowing movement in the back joints.
Causes of disc injury
Specific types of pressure and repeated strain can cause a disc to become irritated.
Terms used to describe disc injury on a CT or MRI scan include:
- disc bulge
- ruptured disc
- herniated disc
- prolapsed disc
Individuals with no history of back pain or back injuries can also have disc changes on their spinal scans including MRI and CT’s.
Pain is not simply related to the level of disc changes on a scan but also has to do with all psychosocial factors. Psychosocial factors include external factors in our life.
Symptoms of disc injury
Some people with disc bulges can complain of
- Back pain
- Radiated pain into the leg
- Numbness or pins and needles into the leg
- Weakness in the leg and foot
- Pain worse with coughing and sneezing
- Pain worse with bending or sitting for extended periods.
What physical things affect disc injuries
- Incorrect lifting techniques – This includes individuals working in a factory, lifting or doing repetitive tasks
- Poor posture has been widely publicised as a caused of disc injury but there isn’t real research to back up this theory. However, Curitn University are currently researching this at the moment and hopefully the results will clarify this for us.
- Obesity– This is still a risk factor in having back pain generally and not necessarily a risk for developing disc budges
- Lack of regular exercise, movement and strength
Self-Care for Disc Bulges
Some things that have been used include:
- Relative rest in the correct alignment, resting in provocative positions such as sitting can worsen the condition
- Over-the-counter pain-relieving medication
- Ice packs or warm packs
- Upright posture
- Resting the back by not bending, twisting or lifting heavy weights
- Warm baths
- Sleeping on a mattress that is not too soft or too hard
- Ergonomic furniture, such as chairs with lumbar support
- Gentle exercises to strengthen and support the lower back
- Gentle walking program as pain permits
Treatment for Disc Bulges
- Medication including pain relief and anti-inflammatories
- Epidural steroid injections into the disc region
- Surgery – in extreme cases where conservative therapy has failed
Surgery for Disc Bulges
Surgery is normally not recommended unless you have:
- Severe nerve compression causing leg numbness
- Loss of muscle strength
- Loss of reflexes
- Loss of sensation
Surgery is only considered treatment such as Physiotherapy and exercise has not helped. Back surgery for back and leg pain only is no more effective than good, high value physiotherapy care.
Here is a link to a great article by a neurosurgeon. Click here
Types of treatments offered by physios
- Soft tissue release – Muscle tension is usually a symptom of the underlying problem and can assist to unwind a tense area.
- Spinal manipulation and joint mobilisations have no clear conclusive evidence that it has any sustained benefit.
- Dry needling or acupuncture has no clear research to back up its effects for disc budge related pain.
- Ultrasound, interferential, shockwave, any most machines haven’t been shown to speed up recovery.
What do we do
Our clinic uses traditional hands on methods of treatment as well as cognitive functional approach to back care management of spinal related pain.
- We do a full assessment to get a clear understanding of your situation, covering all aspects of what we know causes pain and injury
- We will work with you to develop a management program addressing all aspects that are limiting your recovery.