Disc Related Lower Back Pain | Therapy | Coventry

What is disc pain?

Up to 80% of the UK population suffers from lower back pain. Lower back pain is a common cause of pain and there are many causes. When suffering from lower back pain it is important to understand what structures or tissues are involved because this will have an impact on the direction of treatment and rehabilitation.

Generally, lower back pain will involve a number of tissues in the surrounding area such as muscles, facet joint (joints between neighbouring vertebrae), bony pathologies, discs and other conditions such as infections are all contributing factors of low back pain.

However, a common factor of lower of back pain is discogenic (involves the discs). Disc pain can be due to ‘degeneration’ or wearing out of the lumbar intervertebral discs or trauma. Degeneration can occur due to normal ageing processes or repetitive strains (postures or work related). The discs are located between each vertebra and each disc consists of a tough outer fibrous layer that surrounds a gel-like nucleus.

image

Figure 1: Lumbar Disc.

Repeated overuse, during bending, lifting, work or sporting activities can lead to wear and tear or degeneration of the outer layer of the disc. If this degeneration is sufficient, the gel-like nucleus can prolapse or herniate (push outwards) from the disc. Occasionally, a single specific incident can cause the disc to prolapse.

Often this ‘prolapsed’ nucleus can impinge or put pressure on nerves and other structures, which can cause significant pain. Disc injuries occur most commonly in the lumbar spine, at the bottom of the back. The reason for this is that the spine is a mobile structure. Where the base of the spine attaches into the sacrum (upper tailbone area) it is quite rigid. There this area tends to suffer from greater forces the the areas above that are more mobile.

 

herniation causing nerve compression

Figure 2. Disc compressing onto nerve root

 

What causes disc pain?

The exact cause of lumbar disc pain is not well understood. There are differences that can be seen between a normal lumbar disc and a degenerative lumbar disc. Most often these ‘differences’ can be seen on an MRI scan. However, lumbar disc degeneration is part of the normal aging process and most people who have degenerative discs that may be seen on a scan or x-ray do not necessarily suffer from pain. Therefore it is important to see a health professional before considering a scan or x-ray to get an official diagnosis first.

 

stages of disc_herniation

Figure 3. Stages of disc herniation

In less severe cases, lower back pain can be managed by accomplishing lower back mobility exercises. Please see our list of generic exercises below. If you are uncertain about your back pain needs please consider getting professional advice before accomplishing them.

Our team of physiotherapists and sports therapists will take you through a full assessment that involves, initially, some questioning to allow you to describe your pain so we can understand your needs. Secondly, we then go through a full physical assessment that will narrow your pain needs down in order to direct treatment and rehab.

Simple Pain Relieving Back Movements- these exercises can be accomplished as pain permits

Lumbar rotations (rotate knees together 10 X to each side)

lumbar rotations 2

Lumbar Flexion (pull one knee to chest 10 X each leg)

knee-to-chest-stretch

Lumbar Extensions (place elbows under chest and press up with arms/shoulders to arch the back 10 X)

 

prone extensions

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