A disc prolapsed is often referred to as a slipped disc, however please do not worry as your disc cannot “slip” anywhere. Think of your discs as shock absorbers between the vertebrae of your spine. What actually occurs, is the thick gel-like nucleus in the middle of the disc bulges out through a tiny fault in the fibrous disc wall. This small bulge of nucleus can therefore irritate and compress the nerve root causing pain, which may radiate down the leg. There are different types and severities of disc prolapse, which can be seen in the diagram below.
What causes a disc prolapse?
Generally a disc prolapsed will occur if there is already a weakness in the fibrous wall of the disc, which often only requires a small amount of pressure to be placed on the spine for a prolapse to occur. For example:
- lifting a heavy object in an awkward way
- direct injury such as a fall or a whiplash accident
- bending forward
- moving awkwardly
- coughing or sneezing
What are the symptoms/effects of a disc prolapse?
Disc prolapses typically present with:
- acute low back pain
- leg pain / sciatica
- muscle spasm
- shifting of the pelvis and back
- numbness and/ or pins and needles
- weakness in the lower leg or foot
Pain is often aggravated when:
- coughing and sneezing
Pain often eases:
Pain often eases when lying down, particularly on the non-painful side. The back pain and leg pain is often less in the morning after a nights rest.
Diagnosis of a disc prolapse
Both doctors and physiotherapists are able to assess and diagnose a disc prolapsed. During a consultation, a physiotherapist is able gain an understanding from your symptoms, work and social history, medical history and then a physical assessment. Depending on your symptoms it maybe necessary to refer for an MRI or for a consultation with a surgical specialist. If this is required your physiotherapist will discuss this thoroughly with you.
Physiotherapy treatment for a disc prolapse
Physiotherapy treatment for disc prolapses is very effective and aims to reduce pain, stiffness and muscle spasm, as well as sciatic leg pain. Once your disc prolapsed symptoms ahave been reduced your physiotherapist will help to improve your muscle strength and flexibility. Your physiotherapist at Edinburgh Sports & Spinal will develop an individually tailored exercise plan, which will help relieve pain, keep you strong and flexible and help prevent any further problems being caused to your back. In the acute phase, physiotherapy treatment will involve being given plenty of advice on how to modify activity, how to reduce pain, as well as guidance on the use of painkillers. As the acute episode settles, physiotherapy treatment for disc prolapse may include:
- soft tissue massage
- joint mobilisation
- extension exercises to relieve nerve root irritation and pain
- lower back exercises and techniques to help restore normal pain-free mobility and stability of the spine
- electrical stimulation such as TENS to help with pain
- postural advice
- strengthening exercises to help reduce the recurrence of another disc prolapse
Your physiotherapist at Edinburgh Sports and Spinal Physiotherapy will provide specialist support through your exercise program, ensuring correct posture and strengthening the core stabilising muscles and lower back muscles in a safe and effective way. Our ultimate aim is to reduce your pain, allow you to return to work and sporting activities as soon as possible.