Herniated Disc in Happy Valley
What is a Herniated Disc?
An intervertebral disc acts as a spacer between our vertebrae. In total, there are 23 discs in our spine – 6 in our cervical spine, 12 in our thoracic spine, and 5 in the lumbar spine. The disc structure is comprised of a tougher outer layer and a softer gelatinous inner layer. They function to reduce vertical pressure or load on our spine from gravity, jumping, etc. The discs also assist in passive stability while we move our torso during activity.
If pressure on the disc exceeds the tension of the surrounding structures, the inner portion, or nucleus, can bulge through the outer fibers like when you squeeze a balloon and a portion suddenly swells outward. If the pressure is large enough it can cause tearing of the outer fibers.
Common Risk Factors:
- Age – Most people begin to experience some level of disc degeneration beginning at age 30 with progressive loss of: disc height, flexibility, and the gelatinous inner nucleus. We don’t get taller as we age, right? Therefore, the prevalence of a symptomatic disc bulge, or herniation, over the age of 50 becomes increasingly rare.
- Weight – Increased body mass creates larger loading forces on the discs which may contribute to a bulge or herniation.
- Work Duties – Jobs that require physical labor typically involve more lifting, pushing, pulling, and carrying types of tasks which increase strain on your discs. Most disc injuries occur from lifting or carrying a load and then twisting through your back. It could happen from something as simple as tying your shoes though.
- Recreational Habits – On the other hand, having an overly sedentary, or low physical activity, lifestyle can also put you at increased risk. Having low level of activity leads to muscle atrophy, especially our core, which can influence stresses and strains on our backs while we move.
Recent imaging studies (MRI) have identified that some of the disc degenerative processes are quite prevalent in society, with most being asymptomatic – without pain. So, having a disc herniation or bulge does NOT mean you will always have pain, or necessarily need a surgery to resolve your symptoms. Many times, physical therapy can assist in full recoveries back to your normal activities.
Is My Pain Caused By My Disc?
The symptoms of disc bulges and herniations can vary widely from person to person. As stated above, there are many among us with these conditions and have no idea!
For the unlucky who DO have pain, it is thought to come from the pressure of the bulge on nearby structures – primarily your nerve roots. The pressure will cause symptoms (depending on if in the neck or low back) of numbness or tingling sensations to the arms or legs, electrical/burning pain down the arms or hips and legs, and/or weakness in the arms or legs. Typically, in cases of disc herniations only one side of your body is affected. If you experience these symptoms on both arms or both legs, or if you unexplainably lose control of your bladder/bowels, call your doctor immediately.
Common Pathologic Disc Pain Patterns:
- Symptoms are worsened by sitting, bending over at the waist, twisting, and/or reaching to the side.
- Symptoms are worse with prolonged positions/postures.
- You largely prefer standing over sitting for relief of symptoms.
A thorough examination by one of our doctors can identify the likely source of your symptoms. During the examination, your provider will be asking questions and exploring:
- Quality, nature, and area of your symptoms.
- When/what make your symptoms better/worse.
- How your symptoms began.
Your physical examination will include:
- A movement and posture assessment – identifying how you stand, move, squat, and perform other day to day activities.
- Measure your flexibility in your spine.
- Assess the strength of proximal and distal muscles to note level of nerve involvement, if any.
- Tests to confirm or rule out the source of your symptoms.
If your symptoms are at an appropriate level to begin physical therapy, we will begin working on pain relief immediately. While we cannot diagnose, if we see a concern of a moderate to large herniation, bulge, or rupture; a request to return to your primary care doctor or an emergency room will occur.
Treatment of Disc Related Symptoms
Assuming the source of your symptoms was deemed to be from disc related dysfunction, a plan of care will be created to jump start your path to recovery. Specifics of a plan of care will vary due to the individuality of care, but here is an overview of what a plan could look like:
- Exercises that assist in restoring and correcting muscle imbalances.
- Specific stretches to address any regions of increased tension or spasm.
- Spine stabilization activities focused on increasing core strength and dynamic control.
- A safe aerobic program to maintain tolerable activity levels. In general, walking is one of the best activities for low back pain.
Aside from the gold standard aforementioned strategies:
- Hands on mobilization of spinal joints in the region can assist in gentle restoration of movement.
- Body mechanics and posture training can facilitate huge relief of pressure on your discs.
- Pain reduction and management through passive modalities to improve tolerance to activities.
The skills and strategies you learn from us are lifelong in their value and can assist you in handling and even preventing future back pain.
Prevention Is Possible!
Remember – many people have bulging discs right now but don’t have symptoms. However, here are some tips to try and minimize your risk of developing a painful disc related condition:
- Sustaining a healthy weight can reduce significant strain on your spine and discs.
- Awareness of your postures can stave off unnecessary weakening of the passive support structures around your spine.
- Strive to utilize good body mechanics when at all possible.
- Stay active with exercise to strengthen your spinal support structures.
If this sounds like a problem you’ve been experiencing and has been interfering with your life, call us today to get started on a plan of care that works for you. Ascent Physical Therapy is conveniently located off Sunnyside Road in Happy Valley. We also love treating our neighboring communities of Damascus, Gresham, Clackamas, and Sandy at our top rated physical therapy clinic!