Low Back Disc Injuries

Low Back Disc Injuries and Treatment Options

Overview:

Classic symptoms of a low back disc injury include intense pain that may travel down one of the legs. These injuries have been shown to happen to  5% of the population and are most common during the ages of 30-50. The normal timeline for a disc injury is for the pain to come on on suddenly and get progressively worse over the next 5-24 hours. A low back disc injury often occurs from poor posture while lifting objects, sitting slouched over for prolonged periods, and playing sports. There are also many other day to day movements that when done incorrectly can cause wear and tear on the spine. Common treatments for a low back disc injury include chiropractic care, rest, and reducing inflammation. 

When a low back disc injury occurs, In Home Chiro is here to help. During the first visit each patient will receive a diagnosis, management recommendations, and treatment (if indicated). As a mobile chiropractor in San Diego, Dr. Goldeen has seen countless disc injuries and has helped patients through the entire process: from initial injury to full recovery. 

The Structures Involved: 

A spinal disc is a fluid filled sac “nucleus pulposus” that is contained by tough fibers called “annular fibers”. The annular fibers form the outer ring of the disc.  The annular fibers are not uniform in thickness. Located on the the back corner of the disc is the thinnest section of annular fibers. As a result, this is where most disc injuries occur. Unfortunately, this region of the spine is also where the spinal nerves live. Therefore, when the disc is injured it may push on the nerves causing pain to travel down the leg.

How a Low Back Disc Injury Occurs:

The fluid-filled center of the disc applies outward pressure on the outer protective layer “annular fibers”. Over time this pressure can start to stretch out and weaken the fibers. Unfortunately, because the outer corner is the thinnest portion this is often the first spot to be injured. 

The weakening of the disc does not usually occur all at once. There are several factors that usually cause minor damage over time. For example, sitting in a slouched forward position causes the disc to compress the front and weakens the fibers on the backside. Years of sitting like this make it much more likely for a disc injury to occur.

Other factors that that cause the disc to weaken is lifting incorrectly. When a person bends their spine to pick up an object this causes pressure to build up on the disc and can lead to stretching and tearing of the annular fibers. This is why it is recommended to lift by bending the hips and knees and not the spine. Both sitting slouched and lifting with by bending the back back are habits that many people do for years on end. With this chronic and repetitive stress on the disc it becomes stretched over time and makes it more likely to be injured. 

How Long Does a Low Back Disc Injury Take to Heal?

A low back disc bulge usually starts to feel better within the first 1-2 weeks after your symptoms began. Pain free movement can take anywhere from 1-3 months to achieve. The spinal discs take a prolonged time to heal because there is very little blood supply to the area. Wound healing occurs when nutrients and immune cells are able to travel through the bloodstream and into the injured area. Therefore, the discs are at a disadvantage and often need extra care to help heal. Chiropractic care is designed to decompress the disc, restore normal alignment, and reduce inflammation. Having this extra care speeds up the healing process and reduces the pain.

Other factors that impact the healing time include age, health status, and receiving treatment. Most healing processes are slowed with increased age. Next, health status such as: diet, body weight, alcohol consumption, and smoking all impact the quality and speed of the healing process. Lastly, treatments that reduce inflammation and pressure around the torn fibers help to decrease pain and accelerate the healing process. 

Holistic Treatment Options:

There are generally three phases that a patient will progress through to have their disc injury treated. 

  • Phase one: Inflammation Control

During the initial 1-3 weeks of a low back disc injury there are several keys to recovery.

  1. Rest
  2. Reducing inflammation with ice and Omega 3
  3. Avoiding positions that bulge the disc
  4. Chiropractic care
  5. Breathing exercises 
  6. Light muscle therapy

  • Phase two: Regaining Movement

During weeks 3-5 of the low back disc healing the treatment starts to progress.

  1.  Chiropractic care
  2.  Therapeutic exercise
  3.  Muscle therapy 
  4.  Ergonomic assessments
  5.  Ice 

  • Phase Three: Strengthening and Future Injury Prevention

Phase three is when low back pain is minimal or gone.

  1. Chiropractic care
  2. Lifestyle changes 
  3. Core strengthening
  4. Anti Inflammatory Diet
  5. Ergonomic changes

Re-injury: 

Once a disc is injured it is likely to happen again. Listed below are four of the most common ways that this can happen.

  1. In the morning the disc is most likely to be injured because throughout the night the disc becomes filled with fluid. This causes more pressure on the outer fibers and can lead to retearing. 
  2. Flexed forwarded positions cause more pressure on the healing portion of the disc and can reopen the healing wound .
  3.  The fibers are weakest with twisting motions and this can result in tearing additional fibers. 
  4. Rushing the healing process by getting back to daily activities before the disc has healed.  

Types of Low Back Disc Injuries:

The two most common types of low back disc injuries are bulges and herniations. These types occur within different stages of the injury. 

The first stage of most low back disc injuries occurs over months to years. This stage involves daily activities  that cause degeneration and weakening of the disc. 

Stage two can happen during a cough, workout, or randomly. During stage two the disc bulges/prolapses into the outer protective layer due to the degeneration that occurred during stage one. 

Stage 3, a disc herniation/extrusion is when the outer fibers tear and no longer contain the fluid. This stage can happen before stage two if the person is overweight, smokes, or it occurred while lifting an object. A herniation/extrusion involves more damage to the disc and often requires more treatment than a bulge/prolapse.     

Conclusion:

The two common types of a low back disc injury are a bulge/prolapse and  herniation/extrusion. Both most commonly affect people between the ages of 30 and 50. They are very painful injuries that usually start to feel better in 1-2 weeks but can take anywhere from 1-3 months to become pain free. 

The In Home Chiro approach to treating disc injuries is designed around years of clinic experience and successful patient outcomes.  Furthermore, Dr. Goldeen has had his own disc injury during football accident giving him firsthand knowledge about what people are going through. He is passionate about making sure each person gets the right care. Please feel free to call or book an appointment today to help prevent or treat a disc injury.    

Resources 

https://mayfieldclinic.com/pe-hldisc.htm

https://www.ncbi.nlm.nih.gov/books/NBK441822/

Images taken from google

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