Many people are familiar with the term "bulging disc" in regards to lower back pain. It can feel like an intense, sharp, stabbing sensation that can often travel down your leg through your hips and bum, sometimes as far as your feet.
This is a common diagnosis when you start to develop back pain. You get a scan which shows changes in the disc, and the pain matches the effected nerve area. It can be a scary diagnosis.
But you may be surprised to know that a lot of people who don't have pain have also been found to have changes in their discs. I find this study to be really encouraging, because it shows that people who have significant changes to their disc structure can still live a painfree life. It suggests that the disc changes may have already been there for some time before any painful symptoms even began, and gives hope that even if the structure doesn't change, that the pain can change.
Lets have a look at this interesting literature review, particularly in regards to the findings around disc degeneration, disc bulges and disc protrusions.
This is a literature review of 33 separate studies that investigated the imaging of spinal degeneration in painfree people ranging from their 20's to their 80's. It was published in the American Journal of Neuroradiology in 2014.
In total, the review takes into account MRI and CT scan imaging on 3110 individuals with no painful symptoms.
As you would likely predict, the number of findings increased with the participants age group, showing age-related degeneration occurs even in people who aren't experiencing pain.
Lets have a look at the imaging results for the disc degeneration, bulge and protrusion categories:
Disc degeneration - changes to the disc and surrounding vertebrae that result in loss of cushioning and support, may include signs of osteoarthritis at the joint.
Disc degeneration in painfree participants was identified in:
Disc bulge - changes that alter the shape of the disc and can make portions of it "bulge" out of place, which can apply pressure to nearby nerves.
Disc bulge in painfree participants was identified in:
Disc protrusion - changes to the annular membranes around the disc allows the disc nucleus to protrude and apply pressure to the nerves.
Disc protrusion in painfree participants was identified in:
What does this mean for your bulging disc?
It means that theres a good chance that your structural changes were already present before your back became painful. The area may be irritated or flared up right now, but these findings are a good indication that even if your scans don't change, your back pain still can settle down.
It means that a scan showing disc changes doesn't have to be a life sentence of pain.
Does this mean bulging discs DON'T cause pain, then?
Don't get me wrong, bulging discs can be painful, and for some people it can be severe. This study just helps to show us that theres more to back pain that what shows up on MRI or CT scans. Structural changes are just one layer in the complex onion that is back pain.
We can help!
There are lots of ways we can change your experience of back pain through massage and myotherapy techniques like dry needling, taping and support, strengthening the surrounding muscles with exercises that are appropriate for you, and supporting your understanding of how your back functions.
Book a time to come see us to talk about your back pain and creating a treatment plan to reduce it.
You might be familiar with that sharp, shooting pain sensation in your lower back, hip and leg. It can also be felt as numbness, pins and needles, tingling or burning type of sensations. Whatever way the pain or symptoms present, it runs along the Sciatic nerve - which is why this is referred to as Sciatica.
But did you know theres more than one potential cause behind this pain?
Often this pain can be linked to muscle tension in the glutes and hips. The Sciatic nerve runs underneath the muscles of your glutes, and when it gets compressed there it can be a real pain in the bum - literally!
Because this nerve runs all the way down to your feet, the jolts of nerve pain can sometimes be felt anywhere from just localised in your buttocks and hip, to the back of your thigh, behind the knee, straight down your lower leg and even into the base of your foot.
The Sciatic nerve can be impacted at the root of the nerve near the spine, however this doesn't always mean there will be pain. Often this is called a Bulging Disc or Herniated Disc, but you might be surprised to learn that even though "Bulging Disc" sounds pretty awful, studies have shown that more than 50% of people over 40 with no pain symptoms at all can have a disc bulge show on scans.
Irritation or compression of the Sciatic nerve can be common after serious trauma to your leg or lower back. Things like car accidents, falls, and horse riding accidents are all common high impact incidents that can aggravate the nerve. If you've had an injury like this, its wise to seek treatment for it.
Do you have Sciatic nerve pain or nerve symptoms of numbness, tingling and pins and needles? Book an appointment with us to have an assessment and treatment. If we can resolve the issue, we'll create you a treatment plan that includes manual therapies and a take home exercise program.
More serious causes do exist, so if treatment of the muscles and joints is not relieving your pain, we'll refer you to see your GP to rule out any serious structural or pathological conditions.
We all know that our bodies are full of these things called nerves, but have you ever wondered how they work to control your body?
Lets have a look at two important types of nerves in your body - the ones that tell you sensory information like touch or taste, and the ones that move your muscles and joints.
Sensory nerves are responsible for everything you feel or sense. The five senses - sight, sound, touch, taste and smell - all fall under this category.
Any awareness you have of the feeling or sensation of your body comes from the sensory nerves.
The main sub types of these nerve receptors are mechanoreceptors, chemoreceptors and thermoreceptors.
Mechanoreceptors respond to pressure and touch. When you feel muscles stretch out, or when you're aware of the chair you're sitting on, thats all thanks to mechanoreceptors.
Chemoreceptors send information about chemical changes. This could be like the warming feeling of rubbing Deep Heat over your sore shoulder, as well as internal biochemical changes, like lactic acid build up after doing a big workout.
Thermoreceptors tell us about temperature. They respond when you touch something hot or cold, and are the reason you'll quickly pull your hand away from a hot stove to avoid a serious burn.
Then we have your Motor nerves, these are the ones that control movement.
Every time you make a movement, its because these Motor nerves are sending a signal from your brain to the muscle they activate saying "Move!"
Fun fact - muscles can only ever pull, they can't push! So when you activate your biceps to bend your elbow the biceps muscle contracts and gets shorter which pulls your forearm upwards. When you want to stretch your elbow back out straight, your Motor nerves activate your triceps which then pull your forearm back down to straighten the elbow.
Everything in the body is controlled by nerve signals. The brain is like the control centre, and the nerves move out from the brain into all the tissue of your body - muscles, joints, organs, the lot.
Some nerves can be over a metre long, like the ones that send signals to and from your toes.
The nerves in your arms and hands all connect in via your neck, which is why we like to assess and treat your neck if you're having any pain, or tingling or other "nerve-y" symptoms in your hands and arms.
The same goes from the nerves for your feet and legs - they extend out through your lower back, which is why we consider your back when you come in for treatment for your foot, ankle or leg.
How can you tell if your pain or symptoms are nerve related?
If a Sensory nerve is involved in your pain it can feel like sharp, shooting pains, tingling, pins and needles, numbness, or just feeling "weird" (we call that parasthesia)
If its a Motor nerve thats involved, the muscle groups that nerve activates can be weak, or in extreme situations might not be able to activate at all.
If you think your symptoms may be nerve related, book in with your Myotherapist for a full assessment and treatment plan.
Mel is a Myotherapist based in Ferntree Gully.