What is a herniated disc?

 This picture shows the two main later of our vertebrae, the outer hard fibrous layer and the inner jelly-like layer 

This picture shows the two main later of our vertebrae, the outer hard fibrous layer and the inner jelly-like layer 

Receiving the diagnosis of a herniated disc, can sound scary and without the proper education, people with herniated disc's may become fearful of activity. 

Herniated disc's occur more commonly as adults age and range in severity. Many people who receive the diagnosis of a herniated disk worry how it will effect their ability to exercise or remain active. In the article below we will discuss what exactly is a herniated disk, what are the treatment options and how you can best remain active with a herniated disk. 

Your spine has 23 intervertebral discs in between your vertebrae that help absorb stress and shock from walking, running, and other daily activities. Each of these discs is made up of 2 layers: (1) an outer fibrous cartilaginous layer, or annulus fibrosus and (2) an inner jelly-like layer, or nucleus pulposus.

A herniated/ slipped/ ruptured disc happens when the cartilaginous ring of annulus fibrosus in one of your intervertebral disc either protrudes further than it should or ruptures/ tears open and lets the gelatinous nucleus pulposus inside it slip loose. The image above shows difference stages of a herniated disc over time from a bulged disc to protrustion. A herniated disc is a progressive injury that occurs over time. 

A Herniated Disc Can Heal 

The diagnosis of a herniated/slipped/bulged disc can sound scary and permanent. The good news is, with the proper treatment and management most individuals can reduce their pain and stop or reverse the progression of your herniated disc. 


How do I know if I have a Disc Herniation?

Disc herniations more often than not happen due to gradual, age-related wear and tear (disc degeneration). As you grow older, your intervertebral discs lose a portion of their water content, making them less flexible and more prone to being damaged or rupturing with even minor strains or twists.

Most herniated discs occur in the lumbar spine (lower back), although they can also happen around your cervical spine (neck). When one of your discs protrudes out, it often puts pressure on the nerves in and around your spinal cord. This pressure can cause a few symptoms at the level of the affected disc including:

Symptoms

●      Minor to severe tingling and/or numbness

●      Muscle weakness and/or lack of coordination (more common in the upper and lower limbs)

●      A feeling of electric shock

●      Chronic back pain

●      Loss of bowel or bladder control in extreme cases

On the other hand, many people with herniated discs experience no symptoms at all. Herniated discs are often found and diagnosed by standard imaging techniques (MRI). 


How to prevent a Herniated Disc

Most people find it difficult pinpoint the exact cause of their herniated disc. Herniated discs often occur due to the natural process of aging. Sometimes, lifting large, heavy objects using your back instead of your leg muscles can lead to a herniated disc, as can twisting and turning while lifting. In rare cases, a fall or blow to the back can also cause a herniated disc.

To help prevent a herniated disc, some things you can do to help keep your spine healthy includes:

Exercising Strengthening you trunk muscles helps stabilize and support your spine, giving it extra protection.

Maintaining good posture: Making sure your posture is in check can ease the pressure on your spine and intervertebral discs. This includes keeping your back straight and aligned, and lifting heavy objects with proper form, letting your legs do most of the work.

Maintaining a healthy weight: Having excess weight can place more pressure on your spine and intervertebral discs, making them more susceptible to damage and herniation.


How do I Treat my Herniated Disc?

Herniated Discs are treated in different ways depending on the severity of the herniation. Most treatments start with noninvasive therapies such as:

  1. NSAIDS - (nonsteroidal anti-inflammatory drugs)
  2. Anti inflammatory drug injection - directly into the back
  3. Rehabilitative physical therapy - exercise designed to help strengthen muscles and ligaments of the back, lessen pressure of the herniated disc on the spinal nerve, and provide additional support to the spine. 

One of the few symptoms of a herniated disc is chronic back pain. Patients with chronic back pain tend to have weaker deep lumbar region muscles, increased muscle imbalance, and decreased stability within their spines than those without back pain. 

An exercise program including both strengthing and stabilization exercises is necessary for reducing chronic pain, preventing reduced functional capability in an around lumbar joints, and helping maintain range of joint motion, muscle strength, and balance.

Studies have shown exercises that strengthen lumbar extension improve muscle function, physical stability, and range of joint motion in both individuals with herniated discs and individuals with chronic back pain. If you have a herniated disc or chronic back pain, a physiotherapist or kinesiologist can help develop an exercise program to manage back pain and improve function. 

Here are some exercises you can do to help strengthen your lower back muscles and improve your lumbar extension! 

●      Supermans

●      Heel slides

●      Lying leg raises and lowering

●      Bridge

●      Birddogs / 4 point leg extensions

●      Side Lying hip lifts / Planks


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