Lumbar disc injury?
Have you been diagnosed with lumbar disc injury and you are not sure what to do about it?
Do you have lower back pain with activities such as sitting, bending, gardening or lifting that is limiting your lifestyle and leaving you frustrated? Once you bend over do you have trouble getting back up?
Do you have pain that runs down the back of your leg or pins and needles or numbness?
Being diagnosed with a lumbar disc injury can sometimes be a frightening experience. We have all heard of situations where someone’s disc has popped out resulting in disability and ongoing pain and a lifetime of lower back issues. So, it’s worth us now clarifying exactly what a lumbar disc injury is and what you can do about it to help your symptoms improve.
Let’s firstly expel a few of the myths that create unnecessary fear around lumbar disc injuries.
Firstly, what is a disc?
A disc is simply a thick ligament that connects your lumbar vertebra together. Your lumbar vertebra (bones) stack one on top of the other, like a high-rise building. In between each of your vertebral bones, you have a disc which has some flexibility and movement capacity. A bit like your ankle ligaments, this tissue simply holds the bones together and allows for some movement. When you bend forward, the back part of your lumbar disc has a small stretch. When you twist, your lumbar disc has a small stretch.
Does your disc ‘pop out’?
Well the good news is that your disc does not pop out. This myth has been generated over the years, resulting in many patients seeking treatment to ‘pop their disc back in’. Read more here about our thoughts on words like ‘discs popping out!’
If you can, imagine your lumbar disc like a thick ligament, say like your ankle ligament. If you were to sprain your ankle ligaments by ‘going over’ on a rock, this can create a sudden stretch on the outer ankle ligaments and even small microtears. Once your ligament has a small microtear, it tends to swell up. If your ankle ligament is swollen after a sprain, you certainly cannot seek help to ‘try and pop it back in’.
Similarly, in the lower back, if you bend forward for extended periods of time or lift with a load in a position that creates a twist in the lumbar spine, bending and twisting can cause a slight stretch in the disc tissue and if you do this repeatedly or with load, there are times where disc tissue can have a micro-strain or micro-tear.
Initially what happens when we tear any ligament in the body is that there is some inflammatory swelling in the area. This can create a lot of pain in the lower back as any swelling can be very close to nearby nerves. This does not mean that your disc has ‘slipped out’, it simply means that the swelling needs some time and perhaps medication in order to reduce, much like your ankle sprain.
What can I do to help my disc?
The first part is understanding that your disc has not popped out, it is simply swollen and may have an inflammatory reaction if you have an acute strain. This always settles with time and the right management. This can help reduce fear and fear-avoidance of movement.
Like any acute strain, if you have recently injured your lower back the best thing is some gentle movement and perhaps some medication to help reduce the inflammation and avoiding excessive stretch load in the area for the first period of time.
This means we can minimise bending, sitting and twisting until the swelling has reduced and the acute phase has passed. Much like your ankle ligament sprain, once the swelling has reduced, it’s time to get moving again! It is essential that you seek assistance from your physiotherapist to help guide you back to full movement and strength for your recovery.
In the acute phase, gentle walking exercises in a pool such as swimming or walking in the pool as well as upright stretches can assist with an acute disc injury. Once the acute phase has passed, then we move toward improving your movement pattern and strengthening exercises.
Quick tips for managing acute disc pain.
- Try to avoid prolonged periods of sitting. If you can, use a sit-stand desk at work and change your sitting position regularly. This can reduce your accumulative load. When you are sitting, ensure you are not tucked under or slumped as this can increase pressure on your lower back area. You can improve your sitting posture by widening your hips and if you can elevate your hips higher than your knees, this can help reduce pressure in your lower back. A small lumbar roll cushion in the lower back can also assist some people. Watch our video for quick tips to improve your sitting posture here!
- Understand your core stability muscles. Gentle activation of the lower abdominals and pelvic floor can help provide support to your lower back if you are moving such as getting in and out of a chair or rolling over in bed. These small movements that can be painful in the initial acute stage can be assisted with activation of these supporting muscles. Learn the common mistakes to avoid when switching on your core muscles here!
- Keep moving! Gentle regular short walks and mobility exercises can help- see your local physiotherapist to determine what exercises best suit your body. Try this gentle stretch here!
- Minimise lifting and bending in the short term.
Overall, we can see than managing an acute lumbar disc injury is like managing an ankle sprain. (Think you need an MRI? Think again! This is not always the case!) We do need to ensure that our swelling reduces with the appropriate intervention in the acute phase and this may include anti-inflammatory medications (see you GP for advice).
Once the acute phase has passed and pain is subsiding, then it is a matter of ensuring that the area returns to normal strength and function. This often requires individual assessment with your physiotherapist. Physio-pilates and gym-based exercise can help return you to strength! Find out about our classes specific for the management of back pain here!
Our team here at Synergy Physio offer expert knowledge and care for lower back and pelvic pain. We look forward to helping you understand your back pain and what to do about it! Recover from your back pain and get back to doing the things you love.
Like to know more about back pain? Click here!