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JarheadChiro
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The Injury
Slipped discs occur most commonly in the lumbar spine, at the bottom of the back. The term slipped disc is not strictly accurate, and the term prolapse better describes what happens.
Between each vertebra (the bones which make up the spinal column) there are what are called intervertebral discs. These discs consist of a tough outer fibrous layer that surrounds a gel-like nucleus. Repeated overuse during bending, lifting, and sporting activities can lead to degeneration of the outer layer of the disc. If this degeneration is sufficient the nucleus material is liable to prolapse out of the disc.
Signs & Symptoms
Usually one offending movement (most commonly bending or lifting) will act as the 'straw that broke the camel's back'. As the nucleus material leaks out of the disc, the onset of pain in the back is sudden and severe. It may be relieved by changing position, but it can be made worse by flexed postures such as sitting. Coughing and sneezing increase the pressure within the disc and exacerbate the pain.
If the direction of the prolapse is back and to the side, it may press on what is called a nerve root, causing pain down one of the legs. Most commonly, the nerve roots affected produce pain in the sciatic nerve distribution, resulting in the condition known as sciatica. This can produce pain in the buttock, the hamstrings, the back of the knee, the calf or the heel.
Treatment
Pain-relieving medication is usually necessary for a prolapsed disc. The acute pain normally lasts for a few days and the patient should rest during this period. In most cases of a prolapsed disc the symptoms can be relieved if the patient gets into a position of spinal extension. This can be achieved by lying on their front and gently propping the shoulders up on the elbows.
This puts the spine in the opposite position to the that in which the injury occurred. This encourages the prolapsed nucleus gel to recede into the disc. The outer layer of the disc will heal with scar tissue over a period of months, but the disc is vulnerable to re-injury and there will always be a weakness. For this reason, and to reduce the chances of a recurrence, the patient should follow the rehabilitation program set by a professional. This will involve regaining the range of movement in the lumbar spine and strengthening the muscles which support the back.
Prevention
Once a prolapsed disc has been experienced there will always be a weakness. In order to avoid a recurrence of the problem it is important to take better care of the back in future. An understanding of good posture is necessary to achieve this. Viewed from the side the spine consists of a series of curves:
These curves increase the load-carrying capability of the spine. The lumbar part of the spine consists of a forward curve and as long as this is maintained, posture will be reasonably good. It is important that this improved posture is maintained during all activities, particularly when sitting for long periods - slumping should be avoided. A lumbar roll placed at the bottom of the back can be effective when sitting. Driving for long periods should be avoided. In the long term, good posture is maintained by increasing the muscular stability of the spine. This can be achieved through specific exercises.
Slipped discs occur most commonly in the lumbar spine, at the bottom of the back. The term slipped disc is not strictly accurate, and the term prolapse better describes what happens.
Between each vertebra (the bones which make up the spinal column) there are what are called intervertebral discs. These discs consist of a tough outer fibrous layer that surrounds a gel-like nucleus. Repeated overuse during bending, lifting, and sporting activities can lead to degeneration of the outer layer of the disc. If this degeneration is sufficient the nucleus material is liable to prolapse out of the disc.
Signs & Symptoms
Usually one offending movement (most commonly bending or lifting) will act as the 'straw that broke the camel's back'. As the nucleus material leaks out of the disc, the onset of pain in the back is sudden and severe. It may be relieved by changing position, but it can be made worse by flexed postures such as sitting. Coughing and sneezing increase the pressure within the disc and exacerbate the pain.
If the direction of the prolapse is back and to the side, it may press on what is called a nerve root, causing pain down one of the legs. Most commonly, the nerve roots affected produce pain in the sciatic nerve distribution, resulting in the condition known as sciatica. This can produce pain in the buttock, the hamstrings, the back of the knee, the calf or the heel.
Treatment
Pain-relieving medication is usually necessary for a prolapsed disc. The acute pain normally lasts for a few days and the patient should rest during this period. In most cases of a prolapsed disc the symptoms can be relieved if the patient gets into a position of spinal extension. This can be achieved by lying on their front and gently propping the shoulders up on the elbows.
This puts the spine in the opposite position to the that in which the injury occurred. This encourages the prolapsed nucleus gel to recede into the disc. The outer layer of the disc will heal with scar tissue over a period of months, but the disc is vulnerable to re-injury and there will always be a weakness. For this reason, and to reduce the chances of a recurrence, the patient should follow the rehabilitation program set by a professional. This will involve regaining the range of movement in the lumbar spine and strengthening the muscles which support the back.
Prevention
Once a prolapsed disc has been experienced there will always be a weakness. In order to avoid a recurrence of the problem it is important to take better care of the back in future. An understanding of good posture is necessary to achieve this. Viewed from the side the spine consists of a series of curves:
These curves increase the load-carrying capability of the spine. The lumbar part of the spine consists of a forward curve and as long as this is maintained, posture will be reasonably good. It is important that this improved posture is maintained during all activities, particularly when sitting for long periods - slumping should be avoided. A lumbar roll placed at the bottom of the back can be effective when sitting. Driving for long periods should be avoided. In the long term, good posture is maintained by increasing the muscular stability of the spine. This can be achieved through specific exercises.
