Lumbar Disc injury
Lumbar disc injuries can be present when someone is suffering from lower back pain. Often lumbar disc diagnosis can provoke fear in those suffering, however, there are many treatment options available to be feeling your best as soon as possible.
A disc is a soft, spongy material between each vertebra in the spine. Discs act as shock absorbers and provide flexibility to the spine. The lumbar region of the spine is referring to the lower back region. A lumbar disc injury results from disruption to the disc, such as herniations, bulges, or disc degeneration in the lumbar region.
Disc Bulge: A disc bulge is when the disc extends beyond it’s normal boundary past the vertebral body. It does not rupture but still causes symptoms, especially if compressing on nearby nerves.
Disc Herniation: A disc herniation occurs when the nucleus pulposus (the gel material in the middle of the disc) protrudes outside the disc. There is often a moment when individuals can recall this happening. It can press on nearby nerves and cause radiating symptoms, sensory changes, and weakness.
Degenerative Disc Disease: Degenerative disc disease occurs as we age. The discs lose hydration over time, and the gel-like material is replaced with fibrotic tissue, which impacts their function. Disc height also reduces, which can decrease mobility. All this can contribute to arthritis in the spine.
Causes and Risk
Often disc injuries occur unexpectedly, however, there are a few common causes:
- Age: Disc degeneration is a natural part of aging. According to a study published in The Spine Journal, disc degeneration begins as early as the third decade of life and progresses with age, with most people showing signs by their 60s. The reduction in water content in discs leads to decreased disc height and elasticity.
- Occupational Factors: Jobs that involve heavy lifting, repetitive bending, or prolonged sitting can increase the risk of lumbar disc injuries. The American Journal of Industrial Medicine highlights that individuals in physically demanding jobs are at a higher risk for disc herniation and other lumbar spine issues.
- Lifestyle: Obesity, smoking, and a sedentary lifestyle are associated with an increased risk of disc injuries. Obesity adds additional stress to the lumbar spine, while smoking can impair blood flow to spinal structures, leading to degeneration.
- Trauma to the spine
Symptoms:
Depending on the severity of the injury symptoms and intensity of them will vary.
Common symptoms include:
- Lower back pain
- Radiating pain (i.e. into the glutes, hamstrings, etc)
- Numbness, pins and needles or tingling
- Weakness in the lower limb (in more severe cases)
It is important if you have any bowel or bladder changes or sensation changes in the groin area to seek medical attention as soon as possible as it may be an indication of more serious lumbar injuries.
Diagnosis:
Diagnosis of lumbar disc injuries involves a combination of medical history, physical examination, and imaging studies. If you are experiencing any symptoms it is important to see a health professional, such as a physiotherapist, osteopath, or doctor to get an accurate diagnosis and management plan. A physical examination will typically be conducted, looking at lumbar range of motion, sensation testing, reflexes and other neurological tests. This will help determine what causes pain and if there is any neural involvement. In more severe cases, and cases that are not showing improvement imaging may be used, such as an MRI to determine what may be contributing to pain in the lumbar spine. MRIs can show disc bulges, herniations and some degenerative changes. It is important to note that not everything on the scan may be contributing to the individual’s pain. As mentioned degenerative changes are seen in all spines at a certain age, however, may not be the sole cause of their pain.
Treatment Options
There are a number of different treatment options for lumbar disc injuries. These are largely based on the extent of the injury and the symptoms present and include both non-surgical and surgical options.
Non-Surgical Treatments:
- Physiotherapy/Osteopathy: Manual therapy from the right health professionals can help alleviate the pain and symptoms present with lumbar disc injuries. Additionally, a strengthening program can ensure the muscles surrounding the area are working better to support the spine and prevent further injury.
- Medications: When pain is more severe Nonsteroidal anti-inflammatory drugs (NSAIDs) and analgesics can help to settle symptoms and reduce inflammation. This can better allow individuals to move around, do day-to-day tasks and complete exercise rehabilitation.
- Injections: Corticosteroid injections can also be considered to reduce inflammation of the disc, especially if it is pressing on surrounding structures. These are done under guided ultrasound to ensure the injections are going in the correct space.
- Lifestyle Modifications: Simple changes, such as having a good desk set up at work can help to decrease the pain when someone has injured their back. Having an active lifestyle, correct lifting techniques, and a strengthening program can also be implemented to prevent reoccurrences.
Surgical Treatments:
In more extreme cases of lumbar disc injuries surgery can be considered. There are three main types of surgery:
- Discectomy: Procedure involving the removal portion of a herniated disc to relieve any pressure on nerves.
- Laminectomy: Removal of part of the vertebrae to relieve pressure on the spinal cord or nerves.
- Spinal fusion: Considered in cases of spinal disc degeneration a spinal fusion fuses two or more vertebrae together.
Lumbar disc injuries can be intimidating, however, there is a large variety of treatment options to relieve symptoms and get individuals back to the activities they love. It is vital in the management of these injuries that you seek advice from a health professional to ensure you are getting the best treatment for the situation and to rule out any other serious lower back injuries.
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