INJURY & REHAB
MANAGING
DISC INJURIES
A couple of simple questions and some pressure-reducing
amendments to exercises can put clients with disc injuries on the
path to recovery, writes physio and exercise scientist, Merrin Martin.
itting at work, happily researching
this article, I come across so
much information about disc
injuries. It seems that ‘Dr Google’ is
extremely good at defining what a disc
herniation is, how it happens and when to go
to a doctor, but not so good at providing
helpful information regarding management
of the injury. As I look further into what advice
is accessible for management of a disc
injury, the majority of websites veer towards
the recommendations of bed rest, NSAIDS
(anti-inflammatory drugs) and cortisone
injections, with a visit to your GP if pain
persists. In a nutshell, rest and drugs!
There are very few sites that encourage
people to seek some hands-on treatment,
and even fewer that provide any information
about specific exercise programs for disc
injuries to help keep clients active and strong.
So, let’s remedy that by focusing on
some screening questions to ask your
clients regarding low back pain, exploring
exactly how discs behave when we exercise,
and taking a look at how to provide a better
program design to those clients at risk of
disc injuries. If your client currently has a
disc injury, remember to always refer them to
a health care professional (such as a physio)
for diagnosis and advice prior to starting
their exercise program.
S
What are discs?
First up, a quick anatomy refresher: the
spine is made up of many bones called
vertebrae. Between each of these vertebrae
lies a circular disc (intervertebral disc), which
collectively act as shock absorbers and
allow our spine to move. They are made up
of a strong fibrous outer surface and a soft
jelly-like middle part.
What happens when the disc fails?
A disc bulge, or herniation, occurs when
the softer middle part of the disc bulges out
through a weakness in the outer layer and
presses on surrounding structures. The
area around the bulging disc also becomes
inflamed. Any disc in the spine can bulge,
but the most common area is in the lumbar
spine. Bulges vary in size and location and
symptoms can vary.
What are the symptoms of disc-
related lower back pain?
Firstly, perhaps unsurprisingly, back pain.
This can be acute or come on over a period
of time. However, the pain can also manifest
in other ways, such as nerve root pain: when
the bulge presses on one of the nerves
exiting the vertebrae, you may experience
leg pain as well as, or instead of, back pain.
The most commonly affected nerve is the
sciatic nerve. The pressure on the nerve can
also cause numbness, pins and needles or
weakness in areas of the leg supplied by the
affected nerve (buttock, leg or foot).
What are the risk factors?
A number of things affect the likelihood of
somebody experiencing a bulging disc:
• Ageing. The natural process of growing
older results in an ongoing loss of water
and proteins from the disc, increasing the
risk of disc injury.
• Genetic. An inherited predisposition can
cause accelerated degeneration of disc
materials.
• Obesity. Excessive body weight places
added stress on the spine.
NETWORK WINTER 2018 | 41