According to BUPA, almost 2 in 3 people will experience lower back pain at some point in their lives. The cause may not be serious and pain can often improve over a few weeks. However, some sufferers find that their episodes of pain become more frequent and take longer to resolve, affecting their lifestyle and quality of life.
If you’re struggling with ongoing lower back pain, the important thing to do is to understand what is causing it, so that you are able to decide on the right approach in targeting and resolving it. A spinal disc is one possible cause of the pain.
What is a spinal disc and why can it cause us pain?
The spinal column consists of a row of bones called vertebrae. Between each vertebrae is a spinal disc. Think of the disc as a car tyre that sits between the ground and the weight of the car. The tyre changes shape as the air inside is pushed around, depending on the road conditions and movement of the car. When we move, our discs, which attach to the vertebrae above and below the disc, transmit great pressures - distorting the disc and pushing the water-like fluid inside around.
The outer surface of a disc (called the annulus) is made of 10-20 layers of belt-like, strong, collagen material. Each layer runs in different directions to give it strength to cope with the forces acting on it. Due to various factors, a disc can become damaged and the water-like solution in the centre of the disc can slowly push out, causing a bulging disc (also called a herniated, prolapsed or slipped disc).
If the bulging disc then pushes onto the nerve exiting the spinal column, it can cause various symptoms such as:
Radiating pain down the arms/legs (sciatica)
Numbness, weakness, tingling and loss of power in the limbs
Inability to walk too far
Discomfort sitting, driving or standing still for short periods of time
Loss of bladder or bowel control (this is extremely rare and requires immediate medical attention)
What can cause a bulging disc?
There are many factors that can contribute to a bulging disc. They are most often the result of gradual, aging-related wear and tear called disc degeneration. As we get older, the discs become less flexible and more prone to tearing or rupturing with even a minor strain or twist.
Factors that can increase the risk of a bulging disk include:
A sedentary (not active) lifestyle – the inside of the disc relies on a blood supply from the vertebrae above and below and it is our normal everyday movement that keeps this supply replenished. By compressing and distracting our spine as we move around, nutrients are drawn in and out of the centre of the disc. Poor posture and lack of activity can limit this supply.
Chronic dehydration – the centre of our discs are full with proteoglycan molecules, which act like sponges and absorb water. The centre of a healthy disc contains a high percentage of water, in fact water is essential for spinal discs to function effectively. As you move, the spine compresses, placing pressure on the spinal discs. This pressure forces the discs to release some of the water-like fluid they contain. Your body will then use any excess water that is available to rehydrate the discs throughout the day. Most of your body’s efforts to rehydrate your spinal discs happen at night as you sleep, when your body is in a horizontal position. If you are dehydrated, the spinal discs may not have enough fluid available to successfully rehydrate, causing the discs to remain compressed and placing more strain on the fibrous outer layer. Having dehydrated discs can affect your mobility, as the spine cannot bend as easily.
Being overweight – excess body weight causes extra stress on the discs in the lower back.
Having a physically demanding job that involves repetitive lifting, pulling, pushing and twisting. If not done properly, these movements make your spine more vulnerable.
How do I know if I have a spinal disc issue?
Tingling in your arms and/or legs can be a common symptom of a spinal disc issue. Fibromyalgia, polymyalgia and neuropathy are sometimes misdiagnosed so it’s worth talking to us if you have been told that you have one of these conditions.
For some people, an MRI scan will clearly show a bulging disc. However, it’s also fairly common that an MRI scan won’t show any obvious disc issues. So if your MRI is all clear, this doesn’t necessarily mean that you don’t have a disc issue.
The simple reason for this is that your spinal discs compress when there is a load going through them, in other words when you are standing or sitting down. When we have an MRI, we lie down and the load through the disc is reduced, therefore the disc may not bulge. That's why many people get relief from their pain when laying down.
In most cases of bulging discs, a physical exam and a medical history are all that's needed for a diagnosis. We can tell a lot from the way that you walk and move around.
I think I have a disc issue, what should I do now?
Firstly, don’t panic. Surgery is usually not necessary to relieve the problem as there are several non-surgical solutions to treat the cause of your pain and restore normal function. We’ll talk more about these in a future blog. If you want to discuss your problem, contact Ashleigh Clinic on 0116 270 7948. We will be happy to discuss the best way forward to resolving your pain so you can live an active and healthier life.