1. What is it?
Intervertebral discs are the shock absorbers of the spine. They consist of a tough outer fibrous layer (annulus fibrosis) and an inner jelly like layer (nucleus pulposis). Injury can occur to the outer layer (tearing) or involve the inner layer (herniation/protrusion).
2. What are the causes/predisposing factors of injury?
Usually repeated stress over time is the cause of this injury – especially lifting, bending and twisting activities. However, an acute tear of the annulus can result from a flexion (forward bending) trauma.
3. What are the symptoms?
Most often increased pain and limited mobility with forward bending is seen. You may also notice that you appear “crooked” or antalgic as your body tries to move away from the irritated area. In cases where a lumbar nerve root is involved there may be a sudden change from back pain to predominantly leg pain.
4. What can be done to prevent or treat this injury?
There are some studies to suggest that there is a lower incidence of this injury in cardiovascularly fit people and people who do not smoke. The hypothesis is that increased blood supply to the area around the disc promotes a healthier disc.
Treatment is varied and usually consists of icing the area, short term use of anti-inflammatories, ultrasound, electrical stimulation, McKenzie exercises, spinal manipulation, core stabilization and strengthening exercise, and aerobic conditioning. I recommend that people suffering from this consult their health care provider for assessment and treatment as these conditions can last for a long period of time. Also, if progressively worse neurological symptoms are seen (i.e. loss of bowl or bladder control) surgery maybe immediately indicated.