In a previous article, we discussed some notorious back problems, including lumbar disc disorders. Since so many suffer from that issue, it deserves a further look. Here’s an overview of the history and symptoms of lumbar disc disorders.
Lumbar Disc Disorders May Include One or a Combination of the Following Symptoms
- Intermittent or constant lower back pain and pain in the buttock,
- leg and foot pain, numbness or a tingling sensation in the leg and foot,
- Weakness in the leg and foot
- Decreased reflexes in the knee or ankle
- Changes in bowel or bladder function.
The symptoms will vary depending on if and where the disc has herniated, and what spinal nerve root is affected. Leg pain is usually greater than low back pain with disc herniations and nerve root involvement. However, if there are only annular tears without herniation, the pain will be localized to the low back and buttock. The onset of pain can be sudden or gradual after an injury. Pain may follow heavy lifting, twisting, or straining activities or repetitive stress trauma. However, patients may not recall a prior injury or a precise time the condition began because it is often preceded by frequent episodes of less severe low back pain that usually resolved.
Pain is usually characterized by sharp, shooting, or electrical pain that may be aggravated by movement, changing positions, sneezing, coughing, or prolonged sitting and standing. The pain is usually relieved with rest and a recumbent position.
Risk Factors of Lumbar Disc Disorders
- Age and Gender: the highest incidence in men between the ages of 30 and 50.
- Obesity: being overweight puts added stress on lumbar discs.
- Sedentary lifestyle: lack of exercise and poor core body strength.
- Smoking: Smoking decreases oxygen supply to the discs causing more rapid degeneration.
- Improper Lifting: using your back muscles instead of your legs to lift heavy objects. Twisting while lifting
- Posture: hyperlordotic lumbar curvature, anterior pelvic tilt (lower cross syndrome).
- Repetitive Activities That Strain Your Spine: jobs that require constant lifting, pulling, bending, or twisting.
- Frequent Driving: staying seated for long periods and the vibration from the car can put pressure on your discs.
Treatment of Lumbar Disc Disorders
Conservative care should be your first course of treatment to manage lumbar disc disorders, but treatment will depend on the clinical presentation, your age, overall health, and tolerance to therapies. With disc herniations, the first few days of care will focus on centralizing (reducing) leg pain, decreasing inflammation, and preventing further neurological loss by decompressing nerve root impingement and reducing the disc herniation. Osseous mobilization and manipulation and soft tissue therapy may be administered as tolerated.
Home care will consist of pain-relief repetitive positional exercises and lumbar stabilization exercises. We will also educate you on ways to protect your lower back, positions to avoid, and how to manage activity. In most cases, bed rest will not be recommended as the sooner you are up and moving, the better the prognosis.
Once pain and inflammation have decreased, we will continue working on lumbar stabilization and progress into proprioceptive training. We will evaluate muscle imbalances using posture and movement patterns with the goal of restoring good biomechanics and core body strength. Your home care will emphasize the progression of stabilization protocols and corrective exercises.
If you fail to respond to conservative treatment, or in cases of severe neurological loss, a referral for a surgical consultation will be recommended.