Lumbar Disc Prolapse

    Description

    Lumbar disc prolapse also known as a slipped disc, bulging disc or a spinal disc herniation.
    A lumbar dics prolapse is where excessive stress is placed on the disc and the gel inside the intervertebral discs damages or breaks through the surrounding cartilage. This may cause the release of inflammatory chemical mediators causing significant pain.
    The prolapsed disc protrudes through the surrounding cartilage it may place pressure on your spinal cord or nerve roots and cause irritation and potentially pins and needles, numbness or weakness throughout the legs.

    Common causes of a lumbar disc prolapse include:

    • Lumbar flexion/bending forward especially if you bend from your back and not your hips.
    • Twisting.
    • Vibration relevant if you are a truck driver.
    • Lifting an object or carrying a weight.
    • Poor lifting technique, the further an object is from your body the higher the lumbar compression forces will be.
    • Prolonged poor posture such as slouching. Are you slouching in your chair right now?

    Poor sitting posture at least doubles the force on the lumbar disc. Over time this pressure adds up making you more susceptible to a lumbar prolapse. By far the worse movement possible for your lower back discs are combined flexion and rotation movements while lifting.
    You are typically weak in your disc with rotation as the fibres in your disc are obliquely orientated so only half of the fibres are
    resisting a rotational movement. By combining this with flexion places your lumbar discs at higher risk of injury.
    If you are lifting something it is vitally important you try to keep you back flat and you move through your hips especially as you rotate as this will eliminate the rotational force on your lower back.

    Symptoms

    Common symptoms include:

    • A deep ache in your lower back.
    • Low back discomfort with periods of poor posture including sitting or sustained lumbar flexion.
    • Difficulty with bending forwards (touching your toes) or pain that may refer into your buttocks or legs.
    • Possible radiation of pain/numbness or pins and needles into your buttocks or down your legs.
    • If you have pins and needles, numbness, weakness or difficulty with bowel and bladder functions please go straight to your doctor.

    Treatment

    Physiotherapy treatment may consist of:

    • Massage and gentle mobilisations to relax the muscle spasm.
    • Gentle exercises to regain movement in your lower back.
    • Taping to hold your back in a safe position and give support to prevent further aggravation.
    • You may be given extension exercises to help return the disc to its original position, however these are only suitable for certain people as the differing anatomy of the spine and pathologies between different individuals could make your symptoms worse.
    • Strengthening and ensuring correct activation of lumbar stabilisers.
    • Postural analysis.
    • Biomechanics analysed to ensure correct movement and lifting patterns.