Discs have certainly got a bad reputation over time. First and foremost, lower back pain is frustrating and I’m sorry you’re going through this right now. I feel you, I’ve been there. Now are you beginning to realise your lower back is connected to everything. Even lifting your arm can cause you to activate a muscle in your core that can trigger your back pain. Now for the good news... You’re not alone! Roughly 80% of people will experience lower back pain at some point in their lives and the vast majority make a full recovery.
What is a disc?
A disc has two main parts that you need to know about. The first part is like a water balloon (nucleus pulposus for us nerds) which takes most of the shock absorption and load when you are standing upright. The second part of the disc is really just a web of ligaments (like ligaments in your ankle, knee etc) that act to hold the water balloon in place known as the annulus fibrosus. So “disc” is really a ridiculous term to describe a really cool piece of anatomy. The “lumbar discs” are just the discs that sit between the 5 lumbar (lower back) vertebrae. These cushiony discs have three main roles:
- Absorb shock that goes through the body
- Allow movement between the vertebrae
- Transmit load from one vertebra to another
How can they get injured?
Given enough forceful load, the water balloon can exert enough pressure on the ligaments to stretch and tear them. The water balloon is normally pushed towards the back of the spine when you are doing activities that involve bending forward like sitting for long periods or squatting down or gardening. If you do this often enough or add weight to the activities the balloon can stretch the ligaments holding it in place. At the back of the disc there are bundles of nerves when these are irritated the pain or sensation can radiate down towards the bottom and leg.
What can I expect during my first Physio session?
Physiotherapy for disc pain is something we see every day. It’s our bread and butter and something that we pride ourselves on fixing here at Fixio. First off it would be great if you could wear a singlet or loose-fitting clothes so that we would be able to roll it up to be able to see your back. Generally we’ll enquire as to the nature of how the injury came about and how long you’ve had it and what tends to irritate your disc. Next we will ask you to do certain movements so we can measure your back range of motion and we may press on specific parts of your back that will give us further information.
At Fixio Physio Dee Why we break the physiotherapy treatment into three broad categories for disc pain. First and foremost we need to try and get the discomfort under control. This may include simple advice regarding pain medication (in conjunction with your G.P) that you could take to reduce the pain, certain positions to avoid so as not to aggravate your back pain like the best sleeping positions. Additionally certain manual therapies like massage, spinal mobilisation, heat, ice, acupuncture can be beneficial to help settle the pain as well as gentle spinal range of motion exercises.
The second part is crucial, which is regaining your range of motion of your lower back, while ensuring the nerves move freely. We are constantly testing and retesting your nerve mobility each and every session and you will be doing exercises at home to ensure the disc ligaments do not adhese to the nerve. This must be done in order to prevent longstanding back pain. Most patients who present with chronic disc pain have never been through this step.
The third stage is to progressively strengthen your back and core muscles surrounding it. This is where it’s important to realise that once you’ve had back pain once you’re more likely to get it again… if you don’t finish the rehabilitation process. Just ask your parents or Grandparents they’ll tell you about that one time they injured their back and how it was never the same since. That’s why it’s important to do an individually tailored exercise program focusing on important muscles around your back depending on your goals. For instance if you want to get back to touch football, we would need to map out a gradual strength and training program that would include a return to run program and look at side stepping whilst ensuring your core muscles are firing the whole time.