Low back and neck disc injuries occur when the intervertebral disc wall, located between the bones (vertebrae) of the spine, weaken, bulge and eventually rupture. It can occur between any two adjacent vertebrae or involve several levels. While a small bulge may not be painful or limit function, a full rupture, or herniation, is painful and very disabling. Recovery from herniation can take months. A bulge can be treated and healed, within a short timeframe and without significantly impacting everyday activities.
A developing disc issue, called a prolapsing disc, is associated with stiffness, especially when changing position, ache and low grade pain. As the damage to the disc increases, symptoms increase.
What can You Do to Minimize and Manage your Risk of Disc Disease?
1. Determine your risk
Those at greatest risk of lumbar disc herniation include:
- Those with jobs or hobbies that require a lot of sitting
- Those with physically demanding jobs or hobbies, requiring a lot of lifting, twisting, working in bent over positions, etc.
- Those who frequently use computers and handheld devices
- Those involved in high impact injuries, such as car accidents and some sports injuries
- Those in poor physical condition
- Those who smoke, or with recent weight gain
Forewarned is forearmed; consider what you can do to change your circumstances. Unchecked, disc damage is progressive (worsening over time).
2. Know the symptoms
Ache, discomfort and stiffness are the earliest symptoms, after being in one position for too long, notably after sitting or upon first arising from bed; or as time goes on when performing aggravating physical activities and hobbies. These symptoms come and go, and are often overlooked.
Next comes pain, of varying intensity and sometimes radiating into buttocks and/or down a leg; or down an arm, sometimes into a hand. The pain is variable, depending upon what position your back is in; and for this reason, may appear to come and go. There may be sensory changes, pins and needles or areas of numbness which may track down into your leg, even to foot and toes.
Full herniation associates with most severe pain and sensory which may be in any or all of the back, buttocks and leg(s); and for which nothing you can do seems to help. People with full disc herniations often require strong pain medication to manage their pain. Within this group,
The ALH Treatment Plan
At our clinic, we recommend a collaborative treatment plan. The plan works best when it is anchored by physiotherapy: to provide you with a good physical assessment to identify muscle issues and misalignments, motor control strategies to help clients to correctly replicate corrective exercise, and provide and update an effective home exercise program to match changing function. Massage and/or acupuncture also play important roles, the former in manually restoring muscle tone; and both contribute to relaxation, stress management and improved sleep.
Low intensity laser, which is the go-to modality in our clinic, is recommended because it accelerates healing. Important to point out that the single most important element of a care plan for mild and moderate disc disease is posture correction and posture habit rehabilitation. It is essential that corrective exercises have proper form. The neurology of the region and the natural neuroplasticity of the brain, can re-inforce rather than correct poor muscle performance and bad habits, if exercise is poorly done.
Laser is recommended if a client has trouble managing pain with movement and positioning. It is always helpful to achieve best outcomes, because of its photobiomodulation effect on injured cells, allowing injured cells to use light energy to heal and resume normal function.
Laser therapy is used to successfully treat most back and neck pathologies, but the course of treatment is longer for disc injuries than many other joints. If the intervertebral disc is involved, it has no blood supply of its own, and relies on diffusion of blood from the vertebrae to provide nutrients to the disc. Also, the disc wall is composed of collagen, always slow to heal and when injured, tends to replace itself with less resilient materials. Laser is effective for all tissue types; it just takes longer for some, such as the cartilaginous tissue of the intervertebral disc. Laser does promote the production of the resilient, Type 1, collagen fibers, securing a stronger fix.
Whatever treatment plan a client chooses, is decided upon once assessment is completed and the course to recovery can be projected. With disc injuries, it is critical that our clients’ are in charge of the treatment decisions, as the onus of success rests with their ability to perform the corrective exercises and change poor posture habits.