About lumbar disc prolapse and disc bulge
The cartilage discs between the vertebrae work as shock absorbers during movement and consist of a ring of hard cartilage surrounding a softer core material. In these intervertebral discs you can get injuries such as disc prolapse (disc herniation) and a variant of disc prolapse often called a disc bulge (disc protrusion).
A disc prolapse occurs when the hard cartilage ring cracks open so that core material is pressed out of the disc itself. If it presses on or irritates a nerve root, you can get radiating pain in the legs, often called “sciatica”.
A disc bulge occurs when the ring of cartilage partly cracks open, but the outer layer is intact. The cartilage ring is then weakened so that a bulge occurs, which can press on, or irritate, a nerve root.
Some risk factors for lumbar prolapse and disc bulge are strenuous and one-sided work, smoking, and severe overweight. However, family history is the biggest cause. If family members have had it, you have a greater chance of getting it yourself. It is most common to get a disc prolapse when you are between 35 and 50 years old.
Common symptoms of disc prolapse and disc bulge:
- Radiating / aching / shooting pain in one or both legs, and often lower than the knee
- The pain is greater in the leg than in the back
- Reduced sensation in the skin over a given area, most often on the lower leg and around the foot/toes
- Weakened muscle strength in some muscles
- Pain is provoked in certain positions
- Local back pain
- It can hurt to stand, sit or move around
Some prolapses can be so serious that you need urgent medical help. You should seek a doctor/hospital quickly if you:
- Feel weakness in your legs
- Lose control of your bladder or bowel
- Feel numb in the buttock region and genitals
These symptoms can mean that a disc prolapse is pressing on the nerves that go to the bladder. You then need emergency treatment in hospital.
A thorough history and clinical examination are important when you come to us at Behandlerverket. The examination is important to find out between which vertebrae the prolapse is and whether it affects muscle strength or sensation. The examination is often sufficient, but if further imaging is needed, chiropractors and manual therapists can refer for it. They can also refer to medical specialists if a surgical assessment is needed.
Most prolapses and bulges do not need that and often get better by themselves over time, but a thorough examination and an adapted treatment plan are a sensible thing in any case. It is important to try to keep moving, and in some cases treatment can be pain-relieving, for example traction and exercises adapted to your symptoms. After all, our concept is based on easy access to treatment and exercise.