Between 60% and 80% of people will experience low back pain at some point in their lives. Not all of these people will have a problem with their discs as the majority of back pain comes from muscle strains, which sounds simple but can still cause severe pain.
What is disc pain?
Our spine is made up of bones called vertebrae stacked on top of each other. Between each of these bones, we have discs that act like shock absorbers and help to maintain the stability of the spine. People with a disc problem are often told that they have a “slipped disc” However this is a poor choice of words as nothing has moved or slipped out of place as luckily for us, the discs are held in place tightly between the vertebrae.
Instead, the discs can bulge and the correct term to be used when this happens is a disc herniation or prolapse, depending on the severity. If the disc bulge irritates or puts pressure on the nerve roots in the lower back you will experience pain and/ or numbness along the affected nerve which can run down your leg. Although this may sound (and feel) very serious it is most often not and responds well to a variety of treatments.
How do I know if I have a disc herniation?
Common symptoms include lower back pain, pins and needles, numbness and pain in one leg or foot and/or muscle weakness. The pain is sometimes described as shooting or burning. Moving may cause sharp bouts of pain.
What treatment should I have?
Your GP will be able to prescribe you some pain relief if you feel you need it.
Going to see a physiotherapist is a great idea to get advice on what to do or not do. A physiotherapy assessment will include taking a detailed history of what may have brought the problem on and a physician exam. This will include getting you to move in certain ways, checking the nerve function and muscle strength and palpating the painful area. From your assessment, the physio will be able to tell you if they think the disc is involved. They will give you some treatment to help with your symptoms, prescribe exercises that can help you recover and give you advice on activity modifications to help you move better. They will then gradually build you back up to your previous level of activity.
Will I need a scan?
For most people scans are not needed. This is because the result of the scan is not likely to change the course of your treatment. However, if your problem does not resolve after a few months or symptoms are progressively getting worse you may be then referred for a scan.
What can I do to help the pain?
- The most important thing you can do to help your pain is to try and keep moving. Gentle exercises and activity can help to ease the symptoms as it keeps the back moving and helps to deliver blood and nutrients into the area to aid recovery.
- If you usually undergo contact sport, impact exercise or weight lifting you will have to reduce this until the pain subsides to protect the back.
- Try to avoid being in any positions or postures for a prolonged period, especially sitting. If you have a desk job ensure you have a good chair and desk set up and get up to move around regularly ideally every 20 minutes.
- Over-the-counter pain relief or visit your GP if you feel you need something stronger
How long does it take to resolve?
Everybody is different and there is no straight answer to this question. However, typically your symptoms will start to reduce after 2-4 weeks and by 3-4 months you should be pain-free.
Is there anything I should be worried about?
In general no. Most low back pain caused by discs will resolve without any major intervention.
Very rarely a disc problem can cause a serious problem called cauda equina syndrome, which needs immediate medical attention. Keep the following symptoms in the back of your mind:
- If you experience any loss of control in your bowel or your bladder (either being unable to tell that you have voided or being unable to empty your bladder),
- numbness/ loss of sensation around your groin, inner thighs or buttocks
- a loss of control of the movement in one or both legs
If you experience any of these then you need emergency medical attention and should go straight to A&E.
