Lower back pain and lumbar disc bulge

By Megan Storey | March 6, 2020

Hello readers! This month we are going to talk to you about a common low back complaint. Let us paint you a picture. You’re a busy mum that tackles the same daily challenges of getting the kids through their morning routine, school drop off, housework and a day job. It’s hard work, not to mention having this niggly, nagging low back pain to deal with at the same time. Sound familiar?

It’s a scenario we are all too familiar with here at Physiotherapy for Women. We see so many busy mums who are struggling with low back pain, but are just so caught up in the daily grind that they don’t find the time to come get checked out. Usually the pain carries on for some time, then one day they’ll bend down to tie up a shoelace and bang… Crippling pain! It’s often at this stage that people come to the clinic barely able to move and in a very distressed state.

So what has happened?

The scenario of long-standing low back pain followed by a single episode of acute pain (often following a seemingly trivial movement) is common with a lumbar disc bulge. Let us explain what it is, how it happens, and what we can do to help get you back to being super mum again.

The spine is broadly made up of bones called vertebrae and discs that sit between them. The discs are responsible for allowing movement, whilst being strong enough to hold the vertebrae together. They also act as shock absorbers for the varying forces that our body must withstand on a daily basis when we move. Each disc has an outer and inner section. The outer section is a tough and fibrous material (aka the ‘Anulous Fibrosus’ or AF), whilst the inner section is more gel-like (aka the ‘Nucleus Pulposus’ or NP).

A lumbar disc bulge occurs when the NP pushes through the AF and the disc material moves into a space in the spine that it would not normally reside in. This causes inflammation and depending on the severity of the bulge, can press on nerves that run down to the legs. It’s important to point out that discs don’t just spontaneously bulge for no reason. The NP will slowly push through the AF over a long period of time (hence the long standing niggly pain), usually because we have spent this time doing lots of bending and lifting (who doesn’t with kids, right?!), which places high amounts of stress on the discs. Then there is the ‘straw that broke the camel’s back’ moment when things turn worse suddenly (in the example above, it was the tying of shoelaces).

Signs and symptoms

The signs and symptoms of a disc bulge will depend greatly on the level of the spine that is affected. Most commonly, it affects the lowest two discs in the spine. The nerves that exit the spine at each level have a specific role and will run down to serve different parts of the legs. Broadly speaking, you may experience any or all of the following:

  • Low back pain (especially when bending and sitting)
  • Pain that travels down one or both legs
  • Pins and needles, tingling or numbness down the legs
  • Weakness with certain leg movements

A severe disc bulge can lead to more serious signs and symptoms which include problems with your bowel, bladder and sexual function. These are rare but can occur.

Treatment

Recovery from a disc bulge usually takes 3-6 months, depending on the severity. That doesn’t mean you’ll be in pain for that long. Generally speaking, the acute pain from a disc bulge will start to settle within a few days to a week. Inflammation is a process the body goes through when injury occurs and it is vital for our recovery. So the early stages will definitely be the worst, but the good news is things will start to feel better quite quickly with some treatment and by following some simple rules. Coming to see us early on is important because we can educate you from the word go. It is normal in the early stages of an injury like this for people to want to stop everything, including moving, through fear of injuring themselves further. However, it is very important to keep moving! The worst thing you can do is to lie down on a lounge and do nothing all day. They say motion is lotion, and that’s true when it comes to disc bulges. Doing things like heavy lifting and bending is off the cards to begin with, but walking and mobilising the spine regularly is allowed and encouraged.

The injury will have left you with restricted joints and muscle tightness. We will use massage and joint mobilisation techniques to free you up and get you moving again. We will also give you some exercises to start following which we will progress slowly. These will aim to restore full movement to your spine and limbs, muscle tension to normal levels, and strength to the trunk and limb muscles that have been affected.

Many mums we see with this issue have poor core stability, most likely stemming from pregnancy and poor movement and breathing over the years. Being unable to stabilise through the trunk and pelvis during movement will have been the main reason the disc has bulged in the first place. So, it is natural for there to be some core strengthening needed for full recovery and to reduce risk of re-injury in the future. Over time we will start to re-introduce full movement, including bending and lifting. But this time round you’ll be moving well and safely.

If you have low back pain, we recommend you come to see us at the earliest possible convenience. Don’t wait for the big bang as recovery will be longer. Give us a call today on 08 8443 3355.