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

Are You Suffering With A Golf Injury?

Don’t let your pain hinder your golf game!! Golf injuries affect 15-20% of golfers annually, with backs, elbows, shoulders, and wrists the most common areas. Recreational golfers sustain more golf injuries than professionals and the rate of injury increases with advancing age. If you are carrying a golf injury or have a problem that it is aggravated when you play you may need to be assessed at Archview Physiotherapy Clinic by a Chartered Physiotherapist.

The Most Common Golf Injuries

Low Back Pain: The lower back is the most commonly and frequently injured area of the body in golfers. The golf swing requires flexibility and rotation in the back. Back pain can me due to many different factors and can appear as pain in the lower back, muscle stiffness, spasms, or pain radiating down into the leg.

Golfer’s Elbow/Tennis Elbow: Pain, tenderness and inflammation on the outside (Tennis Elbow) or the inside (Golfers Elbow) of the upper arm near the elbow. Tennis Elbow is at least four times more likely to occur than Golfers Elbow. Overuse during excessive practice or decreased forearm muscle strength can be part of the cause of these injuries.

Shoulder Pain: Shoulder or upper arm pain can catch at various phases of the golf swing, at night time, or with overhead activities. Rotator cuff tendinitis, tearing or impingement in the rotator cuff, AC joint arthritis, and joint instability can all lead to shoulder pain. Additionally shoulder soft tissues can become aggravated with repetition. Older golfers may have pain due to bursitis or rotator cuff injuries with reduced circulation to the shoulder muscles. In younger golfers joint laxity or a high-velocity swing can cause micro-trauma to the rotator cuff.

Knee Pain: Knee pain, clicking, swelling of the knee aggravated by twisting, squatting, and walking can present in golfers. This can be caused by any of numerous underlying issues involving the meniscus or cartilage, knee osteoarthritis, or kneecap pain.

Carpal Tunnel Syndrome: Golfers may experience numbness and tingling of the fingers (especially at night), decreased grip strength and clumsiness. Carpal Tunnel Syndrome is a repetitive stress injury that occurs in the nerves of the hands.

De Quervain’s Tenosynovitis: This causes pain, swelling, and tenderness in the wrist near the base of the thumb and due to inflammation in the tendons that control the thumb. Typically pain can present in the left wrist at the top of the backswing.

Fractured Hamate Bone: Pain and tenderness in left palm, numbness in ring and little finger can be due to a fracture of the hamate.This is a small bone on the little finger side of the wrist. If like many golfers you grip the club by putting the butt-end of the club right up against the hook of the hamate during the swing a fracture can develop.

Trigger Finger: Trigger finger can cause a finger to lock up and I can become stuck in a bent position. Your finger may straighten with a snap like a trigger being pulled and released. This is caused when the area through which the finger tendons run is damaged.  Repetitive gripping actions used in golf increase the risk of developing this injury.

If you think you are suffering from any of the above injuries or want to learn how to avoid injuring yourself while playing golf contact Archview Physiotherapy Pain and Sports Injury Clinic on 01 4913228/01 2963490 or at info@archviewclinic.ie for an appointment.