Lumber Disc Injury, Herniated Disc, Bulging Disc, Low Back Pain, Sciatica, Spinal Traction Therapy, Wasaga Beach Chiropractor, Collingwood Chiropractor, Dr. Wayne Coghlan Chiropractor
Lumber Disc Injury, Herniated Disc, Bulging Disc, Low Back Pain,
Sciatica, Spinal Traction Therapy, Wasaga Beach Chiropractor, Collingwood Chiropractor, Dr. Wayne Coghlan Chiropractor
Lumbar disc injuries range from strained tissue, to a bulging disc, to complete rupture and herniation. The pain and disability is usually proportional to the degree of injury and complications, especially if a bulging or herniated disc is pressing on a nerve. And yet, at times, a disc can herniate with minimal pain or disability. It is usually the tissues around the disc that cause the most pain. Similarly, there can be much pain with even a relatively minor disc injury.
A disk injury does not exist on its own. It is usually the result of progressive wear and degeneration and repeated low grade stress and micro injury. There is usually concurrent problems with the muscles, ligaments and vertebral (spinal) mechanics. This is where medical treatment falls short unless it will deal with the concurrent issues and why chiropractic is a beneficial method of spinal care.
A lumbar disc injury, as with a broken ankle or sprained knee, needs to be respected lest it becomes a chronic if not permanent disability. The problem is because we can't actually see the swollen tissue and many people just try to tough their way through the injury ... or fail to recognize what they are doing to aggravate it.... and make it worse.
It is wise to see a health care professional to evaluate your injury and ensure that any red-flags - indications of a more serious illness or injury - have been recognized and dealt with. A potentially worrisome example is a middle-aged person with pain that develops without a defining injury event. A younger and fit person with a sudden onset of pain while or shortly after reaching out and lifting something heavy is a fairly typical and consistent with a herniated disc.
Generally a herniated disc can be diagnosed in how the injury developed and how it is affecting the patient. X-rays are useful to evaluate the overall health of the lumbar spine. Generally, a lower grade injury and monitor for improvement is appropriate. A CT scan or MRI can be more definitive in diagnosing a herniated disc and ruling out pathology, however, advanced imaging does not necessarily change how a moderate disc injury ought to be treated unless there is indication of nerve damage.
An indication that a disc is pressing on a nerve is typically pain radiating down one or the other leg as with sciatica. The more severe the disc bulge or herniation pressing on the nerve, typically the further down the leg and the more severe and longer lasting the leg pain. Also, there may be impairment of nerve function indicated by numbness and weakness in some part of the leg or foot... such as an inability to walk on one's heel. An indication that such a disk injury is recovering is the pain gradually becoming more central to the lower back.
At one time, disc surgery was much more aggressively encouraged...and it seemed to provide relief in the short term. However, with long term follow up, it was determined that people who had disc surgery were no better off, and sometimes worse, than people who did not have surgery and learned to manage their condition conservatively.
If the pain is central to the lower back with minimal radiation down the legs, and the person is improving week by week.... conservative management is appropriate.
Where there is evidence of loss of reflexes and muscle weakness, surgical evaluation is appropriate and advanced imaging is useful to evaluate if the patient is a candidate for surgical intervention.
Regardless of conservative management or surgical intervention, correcting one's back care habits is essential to long term improvement and stability.
While a disc injury is very painful, yes .... it is very rarely dangerous to one's life. There is one exception when the disc presses on the nerves to the bowel or bladder.... if there is a loss of sensation in the saddle region, or loss of ability to control one's bowel or bladder ... either you can't go or can't stop from going ... OFF YOU GO TO THE EMERGENCY ROOM AT THE HOSPITAL for surgery, lest the condition become permanent and potentially fatal due to complications.
For non-complicated disc injuries...
Lumbar disc injuries range from strained tissue, to a bulging disc, to complete rupture and herniation. The pain and disability is usually proportional to the degree of injury and complications, especially if a bulging or herniated disc is pressing on a nerve. And yet, at times, a disc can herniate with minimal pain or disability. It is usually the tissues around the disc that cause the most pain. Similarly, there can be much pain with even a relatively minor disc injury.
A disk injury does not exist on its own. It is usually the result of progressive wear and degeneration and repeated low grade stress and micro injury. There is usually concurrent problems with the muscles, ligaments and vertebral (spinal) mechanics. This is where medical treatment falls short unless it will deal with the concurrent issues and why chiropractic is a beneficial method of spinal care.
A lumbar disc injury, as with a broken ankle or sprained knee, needs to be respected lest it becomes a chronic if not permanent disability. The problem is because we can't actually see the swollen tissue and many people just try to tough their way through the injury ... or fail to recognize what they are doing to aggravate it.... and make it worse.
It is wise to see a health care professional to evaluate your injury and ensure that any red-flags - indications of a more serious illness or injury - have been recognized and dealt with. A potentially worrisome example is a middle-aged person with pain that develops without a defining injury event. A younger and fit person with a sudden onset of pain while or shortly after reaching out and lifting something heavy is a fairly typical and consistent with a herniated disc.
Generally a herniated disc can be diagnosed in how the injury developed and how it is affecting the patient. X-rays are useful to evaluate the overall health of the lumbar spine. Generally, a lower grade injury and monitor for improvement is appropriate. A CT scan or MRI can be more definitive in diagnosing a herniated disc and ruling out pathology, however, advanced imaging does not necessarily change how a moderate disc injury ought to be treated unless there is indication of nerve damage.
An indication that a disc is pressing on a nerve is typically pain radiating down one or the other leg as with sciatica. The more severe the disc bulge or herniation pressing on the nerve, typically the further down the leg and the more severe and longer lasting the leg pain. Also, there may be impairment of nerve function indicated by numbness and weakness in some part of the leg or foot... such as an inability to walk on one's heel. An indication that such a disk injury is recovering is the pain gradually becoming more central to the lower back.
At one time, disc surgery was much more aggressively encouraged...and it seemed to provide relief in the short term. However, with long term follow up, it was determined that people who had disc surgery were no better off, and sometimes worse, than people who did not have surgery and learned to manage their condition conservatively.
If the pain is central to the lower back with minimal radiation down the legs, and the person is improving week by week.... conservative management is appropriate.
Where there is evidence of loss of reflexes and muscle weakness, surgical evaluation is appropriate and advanced imaging is useful to evaluate if the patient is a candidate for surgical intervention.
Regardless of conservative management or surgical intervention, correcting one's back care habits is essential to long term improvement and stability.
While a disc injury is very painful, yes .... it is very rarely dangerous to one's life. There is one exception when the disc presses on the nerves to the bowel or bladder.... if there is a loss of sensation in the saddle region, or loss of ability to control one's bowel or bladder ... either you can't go or can't stop from going ... OFF YOU GO TO THE EMERGENCY ROOM AT THE HOSPITAL for surgery, lest the condition become permanent and potentially fatal due to complications.
For non-complicated disc injuries...
- If you allow yourself to be injured, you allow yourself time to heal. I am not talking about bed rest for weeks on end... and that would actually lengthen recovery.... But somewhere between babying and abusing one's self is a golden path.
- Accept that it is going to be sore. The pain won't kill you. It will get better with time.
- Rest as is necessary.
- Ice is best when the injury is fresh and pain is more intense. Use off the shelf medications as necessary.
- When you are tired of resting do some gentle activity.
- Initially it may take all the character a person has just to go to the toilet.
- As the pain diminishes over the next few days to week, gradually increase activity.
- When you are tired of being active, rest again.
- Stretching such as knees to chest, pelvic tilts, camel/cat stretches are helpful. Gradually progress toward strength exercises such as planks. Sometimes laying on your stomach and holding yourself up on your elbows will reduce the pain... if so.. do more of it... if it aggravates your condition... then don't do it.
- You will probably find that when you move the wrong way, you will feel a twinge, tense your back and then your back will spasm. In that half second you can learn to relax instead of tensing up... this will help reduce the painful spasm. As best you can, relax through the pain, instead of tensing up. It helps. I've been there.
- You will also find, as you become more able, that some activities such as bending forward without bending your knees first, or sitting in soft slumpy chairs will make your back worse. Learn that the things you do to protect your back when it is sore, are the same things that will protect your back when it is not sore. This is good to practice indefinitely lest the same things you have been doing to get injured in the first place, will continue to injure you in the future... until you do learn and practice this lesson.
- Returning to regular activities too soon or for too long too soon can aggravate an new injury.
- You cannot cure a disk injury. You can, however, manage it. The degree you can manage a disk injury varies with each individual and what you are willing to do to help or further hurt yourself. Most of us get by very well with only minimal pain and occasional flare ups... but if you neglect some basic back care habits... it will be very sore again. See item 14 below.
- Learn proper back hygiene and body mechanics. Work on good posture and core strength.
- Traction therapy is not indicated for new injuries. It may help for longer term management. Inversion tables (hanging upside down) is just as effective if you can tolerate the head sensation of pressure in the head. If you wish to consider your options.. talk to me. See item 14 above.
- A relatively minor back injury may take a few days to a week before the person feels confident in their daily activity. Moderate injuries may take several weeks before cautious resumption of daily life. Severe disc injuries may take months to even years before it seems stable. In general, the pain of a severe back injury has a half life of about 6 weeks. See item 14 above.
- There is a tendency for an injured disc to progressively deteriorate until it stabilizes. Then it just continues to get older and more worn down. Working with your chiropractor can help slow the deterioration process and promote long term stability. See item 14 above.
- Whatever you are doing, if you are becoming aware of aching in your back, it means you are stressing it. Change what and how you are doing it or risk re-injury. See item 14 above.
- Chiropractic therapy is directed toward correcting and improving the movement of the joints. It is a good thing to help through the initial recovery and long term improvement.
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