‘We Need to Be Aware of Silent Lower Back Disc Pain’
We commonly let lower back pain progress to the point of where it becomes debilitating before we seek help. I have met many Patients in my clinic who present with Lower Back Pain that gets worse as the day progresses. Commonly the Patient report the pain is ok in the morning time with the lower back feeling stiff, however they are overcome with achy or sharp lower back by evening time.
So what is going on in the Lower Spine that is causing this pain? Well once we have ruled any boney degenerative conditions of the lower spine, the answer to this question points loudly as Lumbar Disc irritation. So if we take the analogy of the Jam Donout again and visualise the jam surrounded by the hardened dough, well this equates to our lumbar disc which has a soft nucleus gel like centre and is surrounded by a hard annulus. If someone presses the edge of the donout the jam squirts to the opposite side, similarly when we bend forward the soft gel-like nucleus squirts backwards and when done repetitively can lead to the nucleus gel protruding out through the hard outer annulus layer.
Signs & Symptoms of a ‘Silent Disc Problem’
Lower Back stiffness in the morning time, ongoing for months/weeks.
As the day progress, there is achy or occasional sharp pain
Bending forward can be difficult due to restriction & increased Lower Back Pain
There can be relief with lying down on the couch, extending the spine backwards or even sitting down on a kitchen chair in an upright position.
Possible sharp pain when coughing or sneezing or when going to the toilet
Driving, sitting and Standing for long durations is an ordeal and distinctly uncomfortable
So What is the Action Plan?
Well a program of progressive exercise strengthening is required immediately to strengthen the lower back muscles of erector spinae & Multifidus, Glutes and Transverse Abdominis. By targeting these important lumbar & pelvis muscles we create a ‘Corset like’ support around the Lower Spine. Treatment would target 2 areas, the tender & excessive mobile vertebra in the lower back and the stiff and restricted vertebra.
Tomás Ryan is a Registered Physical Therapist with The Irish Association of Physical Therapy (MIAPT) and is based in Thurles. Contact Number: 0504 26672 Email:firstname.lastname@example.org