What is a Lumbar Disc Herniation or Slipped Discs?
Lumbar Slipped Disc Injuries or disc herniation is a condition that affects the spine where a tear in the outer, fibrous ring of an intervertebral disc allows the soft, central portion to bulge out beyond the damaged outer rings. Disc herniation can be age-related degeneration of the outer ring, known as the anulus fibrosus, although trauma, lifting injuries, or straining have been implicated as well. Tears are almost always postero-lateral (on the back of the sides) owing to the presence of the posterior longitudinal ligament in the spinal canal. This tear in the disc ring may result in the release of chemicals causing inflammation, which may directly cause severe pain even in the absence of nerve root compression.
Types of Lumbar Slipped Disc Injuries
There are 4 typesof disc hernation that can occur in the spine as shown in the picture above. You can see that severe of the disc injury increases going from left to right in the picture
Can a Slipped Disc Cause Sciatica?
Depending on the severity of the discal herniation, Yes it can, but not always
What Treatment does the National Institute of Clinical Excellence Recommends for Low Back Pain and Sciatica?
NICE (2016) recommends manual therapy (spinal manipulation, mobilisation or soft tissue techniques such as massage) for managing low back pain with or without sciatica, but only as part of a treatment package including exercise, with or without psychological therapy. Which Osteopaths are perfectly qualified to offer in a clinical setting.
How can Osteopathy Help?
The manual therapy approach of osteopathy can be applied either reduce the severity of discal pain by treating the surrounding soft tissues (muscles, tendons, ligaments and facet joint capsules)
How Can Prescriptive Exercise Help?
Exercise maybe required either to increase core stability or lengthen the muscles that attach to the spine and intervertebral discs in an attempt to either stabilise the disc herniation or reduce muscle loading on the discs.
Will I need to be referred to the GP or Specialist Doctor?
If the lumbar disc hernation is severe then the osteopath you would need to be referred to GP for either further investigation (MRI scanning) or Orthopaedic surgery (i.e. a Diskectomy) or spinal injections maybe required to treat the disc hernation.
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National Institute of Clinical Excellence (2016). Low back pain and sciatica in over 16s: assessment and management