Back Pain And Sciatica Sufferers Do You Have A Disc Herniation or Bulge? Symptoms, Causes, Diagnosis, Treatment & Healing.
• Are you concerned after being told that you have a herniated or bulging disc in your spine?
• Are you experiencing back pain or sciatica and are worried that you might have a problem with a disc in your spine?
• Are you experiencing buttock, leg or foot pain, tingling or other strange sensations?
• Do you feel apprehensive about your back and want to know if you can get back to normal after a disc injury?•
How do I know if I have a disc injury?
Many people can’t identify a specific event that started the pain, or it may be a minor activity like reaching to pick something up in the morning (1). This is because changes in the disc, like a disc herniation or bulge usually happen over time rather then in one moment.
Symptoms can vary between individuals. The following may possibly be related to a disc herniation or bulge in the lower back:
• Sharp, stabbing, and intense back pain.
• Weakness in your legs, knees or ankles, e.g. difficulty pushing up on your toes, or going up stairs.
• Intense shooting pain, or deep aching pain in your buttock, thighs, calf or foot: You may have NO back pain.
• Numbness or unusual sensations in your legs e.g. tingly, burning, cold, feeling of water running.
• Pain at night in bed.
• Pain when laughing or coughing.
A disc herniation in your neck may possibly mean problems with your arms:
• Weakness in your arms or hands.
• Intense shooting pain, or deep aching pain in your shoulder, arm or hand.
• Numbness or unusual sensations e.g. tingly, burning, cold, feeling of water running.
When is back pain dangerous or medically serious?
Back pain is very rarely dangerous or medically serious. Even though 99% of back pain is not dangerous, it can still be very painful and make life very difficult and uncomfortable.
Our spine and discs are inherently strong and robust, but even a very minor strain can be agonisingly painful. Pain is not good at reflecting the physical state of our back. We can have lots of pain without significant damage. If you’ve ever had a paper cut or a bee sting you know it really hurts but there’s minimal damage.
There is an extremely rare condition called cauda equina syndrome. This is a medical emergency. This is when nerves are getting compressed within the spinal canal. Early signs are loss of feeling or pin and needles between your inner thighs, genitals or buttocks e.g. wiping after going to the toilet. Changes in your bladder or bowel, or sexual function. This is rare, but you should go to A+E immediately, because early intervention is essential.
What is a spinal disc?
Discs in the spine are tough connective tissue structures between each bone. They are very strongly connected to the bones and help hold the bones together. They allow some movement between the bones. They act as shock absorbers. They are made up of a tough fibrous outer wall (anulus fibrosus) and a viscous, gel like inner structure (nucleus pulposus).
What is a herniated disc, or bulging disc?
‘Slipped’ disc – firstly let’s clear up this misnomer. Discs do NOT slip. Unfortunately this is a commonly used phrase, which can lead to worrying images of an unstable back. Even when we do have an injury to a disc in our back, our spine remains strong and robust and in no danger of slipping, or otherwise collapsing.
A bulging disk is when the outer wall is pushed out for at least 25% of the circumference. In some cases it may be taking up some of the space nerves occupy.
A Herniated disc is a more focal change to the shape of the disc. Nearby nerves may become irritated by inflammation or by being more compressed than normal.
There are different types of herniation:
A herniated disc protrusion is when the inner substance is causing a focal poking out of the outerwall.
A herniated disc extrusion is when some of the inner substance of the disc has come through the outer wall of the disc.
What is the best treatment for a herniated or bulging disc?
Your body can heal naturally over time. The time scale for healing varies, for most people this is 12-18 weeks, but can take more than a year (2). The best treatment first involves finding out exactly what is going on, with an expert assessment. Usually this can be done with clinical testing. For the majority of cases a MRI is not needed. Getting individualised advice on any movements you should avoid in the short term, and progressive exercises to regain all your movement and activity in the long term. Treatment and advice for easing your pain in the short term whilst you heal. The vast majority of people can recover naturally and don’t need surgery (3)
Only for a very small group of people further investigation with MRI, and specialist nerve injection or surgery might be discussed.
How long does it take for a disc herniation to heal?
Can a disc herniation heal on its own?
Research looking at MRI at time of injury and one year later found that 66% of disc injuries had healed (4). The bigger the herniation, the greater the chance it is reabsorbed. However even if the herniation or bulge has not gone you can be 100% free of pain and moving and living normally again.
Does a herniated disc, bulging disc, or degenerative disc always cause pain?
No. It is normal to have changes in the discs and spine as we get older. It is common that these changes NEVER cause any pain or problems (5). Research shows that it is a normal part of ageing, even some 20 and 30 year olds have changes to the discs with no problems. These changes are due to genetics more than how much we use our back (6).
If I have pain in my leg, does that mean I have a bulging disc or herniated disc?
Even a small injury to a disc can cause local inflammation. This is a natural part of healing but the inflammatory process can make nearby nerve roots more sensitive. Normally the nerves are carrying information up from the leg to the central nervous system (sensation) and down from the central nervous system to the leg (to make muscles contract). When sensitised the nerves can start sending their own signals, which the central nervous system interprets as coming from the leg, so you experience leg pain, or other sensations like tingling or pins and needles. The location you experience pain may change and move around your buttock, thigh, calf, or foot.
Irritation can cause changes to the nerve so signals don’t travel as well. This might mean that signals travelling down to the muscles are limited. If this is happening you may experience weakness in your legs or ankles. Or signals traveling up from your leg may be limited so your leg feels numb to touch.
It is also possible for pain to refer to your leg due to other causes, so leg pain doesn’t always mean that you have a disc injury.
Do nerves really get trapped?
Nerves are tough and have a protective covering. They bend, move and stretch along with the rest of our body. Even when a disc is taking up space there is still plenty spare. Nerves are flexible and easily slide, so they are almost impossible to pinch. Rather than trapped, they are more compressed, or crowded for space. Even when nerves are not doing their job as normal, nerves can heal, repair and recover just like the rest of our body.
“What Can I Do Now To Heal My Disc Injury, Back Pain and Sciatica?”…
If you would like to know how Orson Wajih Physiotherapy can help you recover from a herniated disc injury, so you can get back to living fully and enjoying all the activities that are important to you – we invite you to start with a completely free, no-obligation, risk free appointment at our physiotherapy clinic in Knightsbridge Central London.
Note: This Free Discovery Session is something that we offer to people who are very nervous or sceptical about Physiotherapy – unsure of its benefits or if it is right for them. If that sounds like you, then please start with a free taster session so that we can work with you to find out what is wrong and what can be done – without any financial risk on your part.
How Can Choosing to See Orson Wajih Physiotherapy Help You Recover From Disc Injury ?
Our Committment To You:
• We will ensure that any serious medical problem is ruled out, and that all the factors contributing to your back and leg pain or altered sensations are explored and properly addressed.
• We will ensure that you have a clear understanding of your problem and your options for recovery. Your treatment alternatives will always be explained to you. You will be able to make an informed choice about the best treatment choices for your recovery and your life.
• We will only recommend treatments and interventions with scientifically known benefits. We will be transparent about the benefits so you can decide on your plan of care. We will not scare or coerce you into having unnecessary treatment.
• Often disc injury, back pain and sciatica has a natural course of healing that requires no intervention other than diagnosis, reassurance, and a clear self-help plan (with as much support as you feel you need to stay on track).
• Some people also choose to include treatments with short term benefits to ease their recovery journey. Others choose minimal intervention focusing only on those with long term benefits.
• We are committed to providing a place where you can have an honest conversation about your health. A conversation founded on listening to you and understanding your concerns and goals and informed by years of clinical experience and a solid understanding of the scientific research.
• Our back and discs are naturally strong structures and able to heal. Our goal is to help you to understand and experience your inherent strength and resilience and to empower you to feel confident in your body and health. We are always here to support you but always aim to minimise any need for medical intervention.
Basically, we can help you get back to living life fully without being limited by the burden of back pain or sciatica.
If you want to know what it costs – and what availability we have at our physiotherapy clinic, then please just click the button below and complete the short form.
What Other People Are Saying About Orson Wajih Physiotherapy…
Relief of acute back and leg pain. Natural healing of a protruding disc.
“I had a protruding disc. I was unable to sit down. I spent most of my time immobile on my back and took a lot of painkillers including morphine. The spinal epidural injection benefits only lasted a few days. Orson gave me exercises which helped to alleviate the pain in my back and left leg. His help and care have made life bearable and I am rapidly recovering my body, I am able to sit down and do simple things like getting out of a car without extreme pain. His holistic approach works.
I went to the consultant and we looked at the most recent scan and there is now space between back and nerve. I have noticed massive improvement since June and attribute this healing to your treatment and advice. Thanks Orson for making it possible for me to sit down and move without acute lower back pain.”
Paul C. 50’s
After physiotherapy the excruciating thigh pain and numbness have gone.
“After playing a cricket match and then a whole day of sitting I got a very severe pain at the back of my thigh. The pain made me limp I couldn’t walk normally or think about sport or the gym. I also had some numbness in my toes.
The pain was uncomfortable, frustrating and even excruciating at times, but in life most things require hard work and time to fix. After physiotherapy and doing exercises the pain and numbness have gone. I am now back at the gym and feeling confident in getting strong.”
Max S. 30’s
We know you have lots of plans that don’t include being limited by disc herniation, back pain or sciatica.
What could you be saying YES to, if your back weren’t saying NO?
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Are you unsure if physiotherapy is right for you? It could be that you’re not sure if it will help with your problem, or perhaps you’ve had a bad experience somewhere else in the past? If you’d like to come in for yourself and see how we can help then then click the button above.
References
(1) Inciting events associated with lumbar disc herniation. Suri et al. Spine J. 2010
(2) Stratified care versus usual care for management of patients presenting with sciatica in primary care a randomised controlled trial. Konstantinou et al The Lancet Rheumatology 2020
(3) Surgical versus conservative treatment for lumbar disc herniation: a prospective cohort study. BMJ Open. Gugliotta et al 2016
(4) Incidence of Spontaneous Resorption of Lumbar Disc Herniation: A Meta-Analysis. Zhong et al. Pain Physician. 2017
(5) Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations W. Brinjikji. Am J Neuroradiol. 2015
(6)The Twin Spine Study: contributions to a changing view of disc degeneration. Battié et al. Spine J. 2009