Intervertebral discs are fibrocartilage structures with a gel-like centre. Discs are located between each of the vertebrae in our spine and act as shock absorbers. With age and other factors, the fibrocartilage can weaken, allowing the disc to ‘bulge’ or protrude, or in severe cases the disc may tear or herniate. If the protrusion impinges on an adjacent nerve within the spinal column it will result in various symptoms, depending of the level of the spine and the specific nerves involved, with most disc bulges occurring in the lower back.
Signs and Symptoms of disc protrusion
Disc protrusion most commonly affects young males between 20 – 45 years, and may present as a minor strain, sometimes several days after bending, twisting or lifting activities. Symptoms involve:
- Dull, aching or sharp pain, centrally, or on one side of the spine
- Intermittent pain that is initially relieved by changing position
- Aggravation of pain upon sitting, straining or coughing/sneezing
- Pain that increases overtime and may disturb sleep
- Development of leg pain overtime, usually on one side
- Development of neurological symptoms, such as numbness, tingling, leg cramps and weakness
Treatment and management
Your osteopath can perform an examination to properly diagnose the condition and plan your treatment. This may involve:
- A referral for medical imaging for confirmation
- Rehabilitation exercises and stretches
- Ergonomic modifications
- Osteopathic treatment to relieve associated muscle pain
- Ice or anti-inflammatory medications to reduce inflammation and pain
- Referral to a specialist for steroid injections to reduce inflammation and pain
- Referral for surgical review and intervention may be required in severe cases.
Prognosis following disc protrusion
Unfortunately, disc protrusions do not resolve on their own and cannot be manipulated or massaged into place. While the pain may settle, the protrusion will remain, recurrent episodes of pain/aggravation may occur. Exercise, stretches and ergonomic and lifestyle modifications including weight loss if overweight, can help prevent recurrence and disc degeneration.
What to avoid
- Avoid straining activities, such as lifting, bending and twisting
- Avoid carrying extra weight, or activities that put pressure on the spine
- Do not self-prescribe massage, stretches of medications