What Is A Lumbar Disc Bulge?


Hi there. So have you been told that
you’ve got a problem with the disc in your lower back, and you’re not even sure
what that means? Well my name’s Karen Finnin and I’m a
physiotherapist and the director of Online.Physio and I’m here to
explain to you all about the discs in your back in simple terms without all
those big scary words. So our spine is made up of a series of
blocks of bone and they’re called vertebra and the bottom five of those
make up our lower back as George is clearly showing us here. Now in between
all of those vertebra, you can see in light brown here, these are the discs. So
where bones are hard and rigid, discs are a little soft and cushioned and squishy, and
that’s what allows our vertebral column to absorb shock and to also bend and
flex and move. So let’s have a look at the anatomy of a disc a little more
closely. OK so as we saw on George here the discs sit between two vertebral
bodies, so if they’re the vertebra, then the disc sits in the middle. Now the disc
is actually made up of rings and rings and rings of fibrous tissue and there’s
a pocket of jelly that sits right in the middle of it. So if we have a bit of a
more of a bird’s-eye view of the disc, it looks a bit like this. So this would be
the front of the body and all your abdominal contents here and this would
be the back of your body with your spinal cord here. Now it’s rings and
rings concentric rings of fibrous tissue and a pocket of jelly like substance in
the middle. So when we’re upright and straight, the spine can absorb shock, but
when we bend forwards and backwards we see something interesting happen with
the jelly in the centre of the disc. Let me explain. So when you bend forwards, one
vertebra bends forward on the next, if this is the front and this is the back.
So what happens is the disc gets compressed at the front and this sends
that jelly nucleus towards the back of the disc, OK, and if we bend backwards
it’s the opposite, but unfortunately a lot of what we do is flex these days. We
sit, we bend, we lift, we eat. A lot of it is bent forwards, very little of our
natural movement takes us back the other way. So what you have
then is a lot of time spent where the jelly nucleus is pushing onto the back
wall of the disc, as in this picture here. Now over time, this can create little
fissures or little tears in the back wall of the disk, OK, because the jelly
keeps pushing backwards onto the back wall. Now you can be developing this this
little bit of damage without having any pain at all because the nerve supply is
only to the very outer rim of the disc. So this can be building up without you
even knowing it until a day where maybe something even seemingly cryptic happens
like bending over to pick up a pen and that is the day when the disc swells a
little bit because the contents of the nucleus keep pushing backwards, pushing
into these tears and they finally create some swelling in the back of
your disc, OK? That is the day where you start to feel pain and sometimes it’s a
very sudden onset of pain so when that happens our brain registers that there’s
something wrong it sends a signal to our brain and that is often to spasm all
the muscles and hold it because something’s wrong, we don’t know quite
what’s going on but we don’t want you to move. That’s our body’s primitive defense
to there suddenly being pain in that area. Now when we break it down and we
want to get someone going and moving again, there are certain things that we
need to do to help the disc to recover and your health professional will guide
you through those, but it basically revolves around asking ‘how can we get
this jelly moving back away from the back wall of the disk to give it a
chance to settle down?’ In general terms what that means is, it’s a lot of flexed
activity and bending forwards that has caused the jelly to injure the back wall
of the disc, so if we can bend back the other way that’s often a great way to
help it to settle down. Medication can help with advice from your health
professional or pharmacist, exercises can certainly help from your health
professional, and overall movement and activity is the right thing to get going within the limits of your pain. So I hope
that’s helped to explain the mechanics of the disc in your back. When this back
wall of your disc does sort of swell it can sometimes show up on imaging or a
scan and be called a ‘disc bulge’, so that is where that terminology comes from. iIn
extreme circumstances that bulge gets big enough to press on a nerve. If this
is your spinal cord here, and there’s nerves exiting here, if that swelling
gets big enough and encroaches on that nerve that’s sort of a new level of
injury, that’s why we often ask about symptoms in your leg, pins and needles,
weakness. If that’s the case that’s obviously something that we really have
to take note of and tread very carefully but in the majority of people it’s just
a minor bit of swelling that will settle with the right things. So follow your
health professional’s advice and you’ll be feeling better in no time. I hope
that’s helped you to understand a little bit more about the discs in your lower
back. I’ll see you next time

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