Disc issues and Back pain

Many people suffer from backpain due to disc issues, these spinal disc problems are often misunderstood. This may be due to the many different issues that can occur to the disc. Along with the many different terms used to describe each of these issues, such as herniated disc, slipped disc, pinched nerve and bulging disc.

Carol Hopkins one of our physiotherapists aims to break down these issues and make them easier to understand and gain an insight into how these issues can be treated and managed.

What are discs and their function?

A disc is the structure which lies between each vertebrae. Each disc has a thick outer layer (annulus) which surrounds the soft gel-like centre (nucleus). These discs act like a cushion, absorbing shock between the vertebrae. The spinal canal, which contains the spinal nerves, lies directly behind the disc and body of the vertebrae.

Types of disc problems

  • A Degenerative disc – a disc that is described as being degenerative simply means that the disc shrinks and loses its height. This can cause the disc to bulge out into the spinal canal. The alignment of the spine may become altered and patient’s posture may also become altered.
  • A Bulging disc – this occurs when the disc becomes degenerative and starts to lose its height a bulge out into the spinal canal. In this instance the nucleus (inner portion) of the spinal disc remains contained within the annulus (outer portion). Nerve roots can also become pinched by the disc bulge and compress the nerve roots, or due to the loss of disc height.
  • A Herniated/Prolapsed/slipped disc (all three terms are often used to describe the same issue) – This is a condition whereby the annulus (outer portion) of the vertebral disc is torn, enabling the nucleus (inner portion) to herniate or leak through the fibres. This too can cause the nerve roots to become pinched.
  • Disc degeneration with osteophyte formation – Often bony spurs referred to as osteophytes grow in conjunction with degeneration of the disc. Osteophytes are an indicator that degeneration is occurring and are an enlargement of the normal bone structure.

Physiotherapy treatment for any of the above issues is hugely beneficial and often necessary. Treatment times differ from person to person and injury to injury. The treatments generally consist of a combination of manual therapy including, joint mobilisations, soft tissue/trigger point release, the McKenzie approach (mobilisation and exercises in lumbar spine extension), along with, advice and education on the condition, a home exercise programme and clinical Pilates. These will all help to improve and maintain range of movement as well as building strength and stability around the weakened areas.

Image of the spine with a number of disc issues
Image of anatomy of spine and disc

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