Lower back injuries
Lower back injuries are one of the most common complaints we see at Fairfield Physiotherapy and are extremely common in the general population. It is estimated that 60-70% of the adult population will experience lower back pain at some stage (1). There are many potential causes for lower back pain and while the diagnosis can sound either scary or quite minor, the pain is often not directly proportional to the nature of the injury. Severe pain can come from relatively minor injuries that can heal or recover well. 39% of lower back pain is caused by a strain to the disc while up to 30% could be caused by a “herniated disc” (2), also known as a slipped disc. Slipped discs often present as a combination of lower back pain, with referral into one or both legs and sometimes pins and needles or numbness.
What Causes Slipped Disc?
The term “slipped disc” is actually a bit of a misnomer as the disc won’t actually slip out of place at all. A disc is effectively a shock absorber in the spine and will sit between 2 vertebrae. There are 5 lumbar vertebrae and in between each pair is a disc. The disc is made up of a thick layer of ligaments with a jelly-like interior which is spongy. With trauma, repetitive movements, or prolonged postures the ligaments of the disc can get stretched which allows the disc to bulge. Once this presses on the nerve you can experience referred pain in the leg. The disc bulge will appear a little like a bubble that can become herniated if it worsens and this is what people will refer to as a “slipped disc”.
Treatment options
Typically, with a slipped disc there are three different treatment options:
- Conservative management (a combination of pain relief tablets and physiotherapy)
- Injection to reduce the pressure of the disc on the nerve
- Surgery to remove the section of the disc that has bulged and is pressing on the nerve.
Often the most suitable treatment options are numbers 1 and 2, especially for those who have constant leg pain or changes to the motor control in the leg. Physiotherapists can identify these cases and refer you to your GP or specialist. However, if your main issue is pain and physical restriction, a study was done in 2016 showed: “compared with conservative therapy, surgical treatment provided faster relief from back pain symptoms in patients with lumbar disc herniation, but did not show a benefit over conservative treatment in midterm and long-term follow-up.” (3)
Physiotherapy’s part to play
If conservative management combining physiotherapy and pain relief is deemed your best management plan, it is important to initially control your pain with appropriate medication. Make an appointment with one of our physiotherapists who will design a program to manage the stiffness, restricted movement, and some of the pain. In the early stages of your recovery, our focus will be on restoring mobility and reducing your symptoms, particularly the leg pain. Initially, leg pain may improve but back symptoms may worsen. This is due to the pressure on the nerves in your spine reducing before back pain resolves.
Once your mobility has improved and you are able to move easily, start to perform light tasks yet don’t get lulled into a false sense of security – the job is not done! Strengthening and training the core muscles to support/protect your back is important. Encouraging normal natural movement patterns without stressing the back is next. General fitness is always part of long-term success in the management of back pain. This process focusses on restoring trust in your back as well as reducing the chance of future injuries, thus allowing you to get back to the physical activities you will no doubt be missing.
If you think you have a slipped disc or are experiencing back pain however minor, call us at Fairfield Physiotherapy and Sports Injuries Centre on 94897744 for an assessment and treatment plan to get a better back.
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