Back pain doesn’t discriminate; it can affect people of all ages, sizes and backgrounds and getting to the bottom of the root cause of back pain can sometimes make a sports physio feel like Sherlock Holmes. With so many structures making up the back and spine, when a patient comes in and lays the blame of back pain on ‘a slipped disc’ or ‘pain in one of the discs’ I have to put my detective’s cap on rather than taking the pain at face value.
What is a disc?
Well it’s not a floppy disc (or so we hope!), it’s actually more like a jam donut. The term ‘disc’ is actually short for the term – ‘intervertebral discs’. Your spine is made up of 24 hard vertebrae that are placed on top of each other like building blocks. Between each of these hard building blocks are the spongy cushions (discs) that separate them. The hard outer shell of the disc is known as the annulus fibrosis and the soft, jam donut inner core is the nucleus pulposus. These intervertebral discs can take quite a lot of pressure before they become damaged, but particular movements and injury pathologies can damage the discs if in the wrong spot.
What are the symptoms of disc problems?
Damaged discs can cause a variety of symptoms and feelings in the area depending on the vertebrae in question and the severity of the injury. It’s actually quite common for disc injuries to fly totally under the radar and only become known from a scan or x-ray. Unless of course the disc has slipped far enough to catch the nerve roots extending from the spinal cord, then it’s a new world of pain. Common symptoms include:
- Pain localised to the back/spine
- Radiating pain in the butt, thighs, lower legs or even the feet
- Pain that gets worse when bending over or sitting down
- Pain exacerbated by sneezing or coughing
- Pins and needles or numbness in an arm, fingers or leg
- Muscular weakness in the back, core or legs
What are the common causes of disc related injuries?
Sports physiotherapists on the Northern Beaches are seeing an increase in disc related injuries that come as a result of inactivity rather than activity. This is because of the increasing amount of time people sit on their butts with poor posture, weak abdominal strength and a lack of stability in the lower back. Disc related injuries are more likely to occur when performing repetitive flexion & rotation movements like lifting heavy loads. The most common causes of disc issues we see normally come as a result of:
- Prolonged sitting (especially with poor posture)
- Bending over without engaging the core
- Lifting (especially with poor form or without safety equipment)
- Twisting
- Pulling or dragging (again with poor back stability or core technique)
Who is at higher risk of developing disc related problems?
Often, there is no recognisable risk factor present that sets patients apart who have disc problems. However, some people are more susceptible to disc problems if they engage in a number of risk activities or suffer from other health problems such as:
- Obesity
- Poor muscle tone
- Lack of regular exercise
- Cigarette smoking
- Advancing age
- Poor posture
- Incorrect lifting techniques.
Do I need surgery for a disc injury?
Luckily for most, surgery is not usually required in order to alleviate the pain caused by disc problems and get patients back to normal programming. With early intervention with a physiotherapist and a bespoke plan in place to treat and combat disc pain symptoms and causes, most flare ups only last a few weeks.
Surgery should only be considered after non-surgical options have been explored and a thorough course of action has been explored by doctors, surgeons and physiotherapists.
