Lumbar Disc Bulge

INTRODUCTION

In between the bones of your spine (vertebrae) lies a structure designed to absorb shock and help to make your spine flexible. These are called intra-vertebral discs and consist of a gel-like centre (nucleus pulposus) surrounded by an outer layer made of robust, criss-crossing fibres (annulus fibrosus). Sometimes the outer layer can degenerate or tear, due to age-related deterioration, employment or an injury. This causes the gel-like centre to bulge against the weakened outer layer and potential contact a nerve as it exits the spinal cord (refer to the picture for an illustration of this).

PRESENTING SYMPTOMS

A lumbar disc bulge can cause low back stiffness, pain, muscle spasms, pins and needles, numbness, pain or weakness in your buttocks or down your legs and potentially into your toes (sometimes called sciatica) . In some cases bowel and bladder function can be affected.

Symptoms can appear suddenly during the causative activity but it is also common for patients to experience pain and stiffness after the activity, especially the next morning. Generally symptoms are made worse by activities involving bending forwards, lifting, prolonged sitting or going from sitting into standing. Coughing, sneezing and twisting may also aggravate symptoms. The skin and muscle around the lower back is often tender to touch in patients with a lumbar disc bulge.

HOW PHYSIOTHERAPY CAN HELP

Depending on the severity of your symptoms and the level of pain-free movement you can achieve, out physiotherapists will tailor a rehabilitation plan that suits where you are and the goals you have.

Our physiotherapists will first aim to get your symptoms under control. This can be done via massage to ease muscle tightness and pain and increase your pain-free movement. We can also mobilise the vertebrae of your neck which can help with stiffness and pain. Light movements and stretches will be prescribed that you can do at home to help reduce symptoms.

Once symptoms are controlled, we will start you on an exercise program designed at improving the strength, endurance and coordination of your lower back and core muscles. This stage is very important as it will ensure the long-term health of your back and decrease the frequency and severity of pain flare-ups, which are common with lumbar disc bulges.

We also provide advice on sleeping position, pillows and work ergonomic guidance to help you get through the day as pain-free as possible. If need be we can use other treatment options such as taping, dry needling, traction or bracing depending on your situation.

If you have a lumbar disc bulge that is impacting your quality of life, book an appointment with one of our physiotherapist's so we can help you get back to your best!