The Intervertebral discs are located between the bones of the spine. These discs act as shock absorbers and contribute to the overall mobility and function of the spinal column. There are discs at all levels of the spine, from the neck, through to the upper back and lower back.
During the course of a normal day the discs lose a tiny amount of height due to compressive forces of gravity and from our usual work and movements of the body. Interestingly, this change of height is reversed overnight when lying down to sleep. The discs are made of fibrocartilage, and have a firm exterior surface, with a softer interior.
Disc injuries can range from mild to severe, and symptoms vary accordingly. The disc is described as ‘herniated’ when the material from the inside of the disc breaks through the outer layer. This most commonly occurs in the lower back or lumbar spine segments. A disc can also be described as ‘bulging’, when the outer layer of the disc protrudes beyond the normal margins of the disc. Disc injuries may occur with a sudden onset of pain and symptoms, or over time as a result of degeneration. In some instances disc injury may be completely painfree, and research has shown that many people who have visible disc injuries on MRI scans have no pain or symptoms.
Symptoms may include;
- localised spinal pain
- referred buttock and leg pain (lumbar disc injury)
- referred shoulder, scapula or arm pain (cervical disc injury)
- pins and needles or numbness
- pain with coughing, straining or sustained positions
In some cases, a disc injury may cause changes to the nerves that supply the arms or legs, causing muscle weakness, pins and needles, tingling, referred pain or numbness. These symptoms usually improve with appropriate management and time. In rare cases, disc material may cause pressure on the spinal nerves, and emergency spinal decompression surgery may be required. The indications for surgery may include:
- worsening leg or arm weakness
- altered bladder and bowel function
- numbness of the saddle region (inner surface of the thigh and groin)
Physiotherapy treatment usually involves manual therapy techniques to restore full range of motion, advice for timely recovery, and exercises to reduce pain, restore movement and improve strength. Analgesia and anti-inflammatory medication may assist with recovery, and should be discussed with a Doctor or Pharmacist in each case.
If your Doctor or Physiotherapist suspects you may have a disc injury, they may refer you for an MRI or CT scan to confirm the diagnosis. However, in many cases it will not be necessary to have scans performed, as clinical assessment can identify the structures involved with the injury. The majority of people who sustain a disc injury will make a full recovery.
At Physica, all Physiotherapy staff are skilled and experienced in assessing the spine and providing quality care and treatment for disc related injuries. Physiotherapy will aim to reduce pain, restore full range of motion and help you to return to all your normal activities as soon as possible.