Back on Track: Part 1 What is a Disc Herniation? - Fighting Fit Physiotherapy Nerang Gold Coast

If you are experiencing pain in your lower back

And have symptoms such as deep aching in the spine plus a burning, electric, and/or radiating pain down the leg.

It could be from a herniated or bulging disc.

Ouch!

Let’s get to understand what a disc herniation is and how physiotherapy can help.

A bulging disc is often referred to as a herniated or protruding disc and can cause significant pain and discomfort in an acute back injury.

It occurs when the nucleus pulposus in the middle part of the intervertebral disc (which lies between the vertebrae) is displaced out from the intervertebral space.

When the intervertebral discs become damaged, the integrity and flexibility in the spine is lost.

This can cause compression of a nerve root.

This compression can cause a number of symptoms such as:

Back pain
Sensation changes down the leg
Numbness in areas of the lower limb and feet
Burning or hot sensations
Sharp electric like pains
Radiating or referring pains
Weakness or loss of power in the leg or legs
Even bladder or bowel issues

It’s also important to be educated on some of the facts that are related to disc herniations in people:

Incidence: Herniated discs occur in up to 20 cases per 1,000 adults each year, most commonly in those aged 30 to 50, with a male-to-female ratio of 2:1.
Most Common Level Affected: 95% of lumbar disc herniations involve the L4-L5 and L5-S1 discs.
Prevalence: Lumbar disc herniation is 15 times more common than cervical herniation and is a significant cause of lower back pain, with a symptomatic prevalence of 1% to 3%.
Age Factors: Most herniated discs (95%) are in individuals aged 25 to 55 at the lower lumbar levels; herniations above this level are more common in those over 55 due to age related changes in the disc.
Rarity in Children: Herniated discs are very rare in children, these injuries primarily affecting young and middle-aged adults.
Recurrent Herniation: Recurrent lumbar disc herniation is a common complication after primary discectomy.
Cervical Herniation: Cervical disc herniation occurs in about 8% of cases, most often at the C5-C6 and C6-C7 levels..

Curious to know more about what a disc is?

Let’s dive a bit deeper.

A key part of a disc bulge is the intervertebral discs.

These discs are what is between two adjacent vertebral bodies and link them together.

The disc consists of the annulus fibrosus, nucleus pulposus, and two cartilaginous endplates. The nucleus pulposus is a gelatinous substance that lies in the middle of the intervertebral body and serves to provide shock absorption during movement for the spine.

The annulus pulposus surrounds the nucleus pulposus and keeps it intact when forces are applied to the spine.

The cartilaginous end plates lie on top and below of the nucleus pulposus and annulus pulposus and function in sustaining nutrition of the disc and preventing the disc from bulging into the vertebral body next to it.

The most common causes of disc herniation is from aging as the nucleus pulposus becomes less hydrated and weakens with time, unfortunately a normal part of getting old.

Kind of like getting grey hairs.

Trauma is the second most common cause followed by connective tissue disorders and congenital disorders.

The most common disc herniations are located in the lumbar or lower spine followed by the cervical or upper spine.

The thoracic or middle spine has the lowest rate of disc herniations.

Activities that can damage the intervertebral discs are usually repetitive movements where recovery is impaired like twisting and bending which increases with more force applied to it. Even living a sedentary lifestyle, obesity, tobacco abuse, poor and inadequate nutrition, sleep all can increase the risk of a disc herniation.

There are also 3 different types of disc herniations:

Posterolateral Disc Herniation: Typically protrudes to the back and side into the vertebral canal, compressing the nerve root of the next lower level (commonly L5 affects S1 nerves, pain down the back of the leg or what can be known as sciatica).
Central (Posterior) Herniation: Less common, can compress the spinal cord or lead to Cauda Equina Syndrome if above the second vertebra. Can lead to bladder or bowel issues.
Lateral Disc Herniation: Causes nerve root compression above the herniation level, with the L4 nerve root being the most frequently affected.

Disc herniation can also be classified into 4 different stages which are bulging, protrusion, extrusion, and sequestration.

1.Bulging: This means that the outer edge (annulus pulposus) of the disc is sticking out beyond the edges of the bones above and below it.

2. Protrusion: This means the inner part of the disc (nucleus pulposus) bulges out and presses against the outer layer, but the protective posterior longitudinal ligament at the back is still intact.

3. Extrusion: This happens when the inner nucleus pulposus part of the disc pushes through its outer layer, but the protective posterior longitudinal ligament at the back stays unbroken.

4. Sequestration: This occurs when the inner part of the disc breaks through the outer layer and the protective ligament at the back is damaged. Some of the inner material then moves into the space around the spinal cord.

Now this blog isn’t there to scare you.

It is here to inform you about what can go on inside.

But the most important thing is not what is or has broken, but what to do about it to fix your problem.

In part 2, we will dive into exactly what our approach is to treating people with disc bulges and back pain.

I’ll see you over in the next blog soon!

Dean Phelps

Dean is a registered Gold Coast Physiotherapist with undergraduate and postgraduate studies in Human Movement and Exercise Science. His background has developed his vision for Fighting Fit Physiotherapy to focus on optimal health and peak physical performance for every single patient. Utilising his many qualifications, in depth knowledge of the body and passion for exercise he can provide a holistic approach to your treatment and exercise prescription to get the best outcome.

Brenda Samosa

05:52 07 Nov 24

I had a really bad shoulder and had been seeing a different physio for 3 months (from a different place) I got told Tyson was good. After just a few sessions the movement was coming back. I’m 66 and was worried I would have to stop surfing. But with a lot of help from Tyson I’m back in the waves ( thank you so so much)

Cyana Ferguson

08:16 30 Oct 24

Steve Harris

22:33 15 Oct 24

Great team, all friendly, super helpful and first class clinical advice and a big shout out to my Physio Noah with my shoulder issue

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05:33 19 Sep 24

These guys are the best in the biz 🎉

Ryan Brockett

04:20 18 Sep 24

Shout out to Max from fighting fit physio. He helped me out massively straight after shoulder surgery and back into work and sports in no time. Couldn’t recommend anyone better!

Scotty

08:31 31 Jul 24

Five star service from Max & the team!
Professional & very thorough, you know that patient outcomes are of the highest priority.
I highly recommend this business.

Riley Wilson

08:27 14 Jul 24

Be AWARE they’ll immediately try to commit you to multiple follow up sessions after your initial consultation. This happened to me and then I later found out that as it just so happens, they have a cancellation policy that says you have to pay 100% of the consultation fee for cancelling. They failed to tell me this when they were pushy in committing me to 6 sessions after my consult, so that was a really nice little surprise.

I was already uncomfortable with how pushy they were in having me commit to so many sessions, so when I heard about the policy I just cancelled all together. So, I can’t speak further to the quality of their service throughout therapy phase. FYI this was also a few months ago now, it’s possible (though unlikely) they may have changed the policy. Just ask the question.

Megan Shelley

06:51 03 May 24

Fighting Fit Physiotherapy is hands down the best physio I've encountered. Having tried multiple physios for various injuries, I always find myself coming back to them. Their expertise consistently exceeds expectations, helping me get back to my sport faster than I thought possible. Their personalized approach and attention to detail make all the difference. I could not recommend a better or more exceptional physio team!

Gina Matthews

08:41 24 Mar 23

Can't recommend this place high enough. I was in so much pain with my knee an had been for months through advise an exercises I'm now looking forward to returning to gym an back riding my horses in endurance thank you so much

Courtney Halse

01:36 29 Nov 22

Kyle was knowledgeable, personable and professional. He saw me through my second pregnancy and continued to work with me until 6 months post partum on issues with my back. Would recommend anyone to go and see him.

Also shout out to Georgia on the front desk. She makes you feel welcome and brings a sense of warmth to the place!

Alli Davenport

08:07 04 Nov 22

After hip replacement surgery in February I wanted toget back into weight training legs, I started with Mitch 18 weeks ago and after a lot of hard work and sweat I am able to safely train again, I cannot thank Mitch enough for his support,encouragement and knowledge. The staff are friendly and helpful and I always looked forward to my session's

Robert Parkinson

10:50 15 Aug 22

This is the second time I have been treated by the team at FFP.
As a health professional myself I have been impressed with the level of care I have received from all members of the team.
The personalised treatment and rehabilitation programs have produced excellent results and I have completed both programs pain free and feeling stronger than before my injuries.
During the program there was constant communication and follow up and they were very accommodating with my work schedule.
All in all it was a very holistic experience and I would highly recommend the service.

Kiri Canavan

07:30 08 Jun 22

Tyson was amazing! We came up with an 8 week plan at my first consultation with weekly check ins and updates to exercises. 8 weeks later, I am pain free and able to train harder than ever. Highly recommend and the staff are all fantastic and super accomodating!

If you are experiencing pain in your lower back

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