Life happens. You bend over to play with your little one, or to just tie your shoe, and all of a sudden your back seizes up on you. Or maybe, once in a while your low back just grabs at you, and sends out warning signals that it needs a little attention.
I have been there. Through over a decade of driving a heavy clutch I would feel hints of discomfort in my low back, especially during long drives. However, no symptoms really stayed on my radar during that time. Until about two years ago, after one clutch too many, I felt my disc bulge and a very angry nerve down the back of my leg right there on the freeway stuck in traffic. I could barely walk when I finally arrived home. You can read more here. I can also tell you, with a little knowledge, patience and help from your friendly physical therapist you can heal. Currently, my Yoga practice and life movements are full again.
This post is not to help with diagnosing yourself, it is always important to have a Health Care Provider do this. And, in certain circumstances surgery may be required. However, when healing it is helpful to be armed with knowledge about the condition. So today I will talk a little about the discs of the spine.
In between each vertebrae (the bones) of the spine there are discs and nerves. The discs are smallest in cervical (neck) region, and largest in lumbar (low back). It is the ratio of vertebrae size to disc size that allows for appropriate mobility with ease. The cervical region has the largest ratio and largest mobility, then lumbar and then thoracic (mid back).
The discs help to maintain space in between each vertebrae, as well as space in the Intervetebral Foraminas for the spinal nerves to travel through.The outside of the disc is comprised of the Annulus Fibrosus. Inside is the gel like Nucleus Pulposus. Unfortunately the discs’ periphery is the only part to receive direct blood supply, the center receives through diffusion. There is no nerve supply to the disc, but the surrounding structures; ligament, vertebrae, nerve root, facet and even the muscles do have nerve innervation and will let you know if there is an injury.
The movement of a disc can be compared to a balloon filled loosely with gel. If you push down on one end the gel with be forced to the other. This is natural and healthy movement for the disc which happens during our everyday motions. Movement keeps the discs hydrated, and our spines mobile. However, injuries to the discs can happen from repetitive movements with poor bio mechanics, tight muscles, unawareness of body positions, or asymmetries in the body, for example.
When an injury to a disc occurs there are four things which my happen:
1. Protrusion: there is no rupture of the annulus fibrosus but the disc will bulge, typically in the posterior direction.
2. Prolaspe: the outermost fibers contain the middle portion of the disc as it bulges toward the the outer rim, further than in a protrusion.
3. Extrusion: the annulus fibrosus leaks out into the epidural space
4. Sequestrated disc: part of the annulus fibrosus and nucleus pulposus leak all the way out of the disc and remain there outside of the disc.
Depending on what happened to your disc, and the severity, you may feel different symptoms in different positions or even activities involving pressure such as laughing.
Having a disc bulge however, does not have to be a life sentence for low back pain. I can tell you this personally. There are many things a physical therapist can do to help alleviate pain from the disc, nerve, facets, ligaments and muscles.
For example, stretching the hamstrings, working on posture in standing and sitting positions, and traction. In our clinic we are able to create a lot of ways to unload the spine and create traction with the yoga wall, as well as, open the leg and hip muscles through safe Yoga poses.
If you have any questions please feel free to contact me at firstname.lastname@example.org
or visit Embody’s website.