A common cause of lower back and leg
pain is a ruptured or herniated disc. Patients usually complain
of dull or sharp pain, cramping, muscles spasms and in some
cases sciatica and leg weakness.
In between each of the five
lumbar vertebrae (bones) is a disc which resembles a hard
fibrous shock-absorbing pad. At the end of each vertebra are
endplates which hold these discs in place. Each individual
disc has a tire-like outer casing called the annulus
fibrosus. This structure holds inside a gel like
substance which is called the nucleus pulposus.
Nerve roots exit the spinal
canal through small passageways between the vertebrae and
discs. If the disc pushes into the spinal canal or against
the nerves then you will experience pain.
Disc herniation occurs when
the annulus fibrous breaks open or cracks, allowing the nucleus
pulposus which is the gel like centre to escape. This
is called a Herniated Nucleus Pulposus (HNP) or herniated
Most disc herniation occurs
in sections L4 and L5, the L5 nerve trapped by the herniated
disc causes back pain and tingling sensations down to the
buttocks and legs.
When will the pain
Approximately 90% of people with this
condition return to normal activities within 2 months but
some patients can take as long as 6 months to recover. The
goal of the different treatment options is to reduce irritation
of the nerve thereby reducing pain so that you can quickly
return to your usual activities.
Non surgical options
for herniated disk
1. Pain control
It is advised that 1 or 2 days of complete
bed rest on a firm mattress may reduce symptoms significantly.
Some patients find lying on the floor more comfortable. It
is advised to limit sitting up in bed and bending, however
this can be quite an ordeal for active people who are not
used to staying in bed for long periods of time! Do not spend
more than 2 days in bed as it may prolong healing.
Electrical stimulation. Transcutaneous
electrical nerve stimulation (TENS)
A TENS unit provides small electrical
currents to selected areas of the nerves. This current is
not painful and reduces pain by stimulating endorphins (pain
inhibiting molecules) which help to lower the pain sensation.
This is an effective treatment for back pain.
Medication such as non-steroidal anti-inflammatory
drugs (NSAIDs) may be used to reduce pain and inflammation.
NSAID such as ibuprofen reduce inflammation of the nerve roots
and make everyday life more comfortable. You should seek advice
for from your doctor before you start any medication.
If your pain does not significantly
improve with NSAIDs then your doctor may prescribe you Corticosteroids.
The doctor may inject Corticosteroids into the spinal nerves
to reduce severe inflammation. There are obvious dangers to
inject into the spine which should be discussed with your
doctor. No more than three injections are given to a patient.
Cold or heat therapy
Reusable hot and cold packs
than can either be warmed up in the microwave or used frozen
can reduce your back pain. It is advised to use these reusable
packs rather than ice as the application of ice directly on
to the skin can cause ice burns.
You may wish to check with
your doctor before using heat in the first 48 hours of the
condition as increased blood flow can cause swelling and inflammation
in some patients.
the reusable hot and cold pack for back pain
A supportive back brace helps you maintain
a good posture and alignment which reduces spinal tension
and decreases pressure on the affected discs. The majority
of patients benefit from a back brace to reduce pain and increase
warmth to the soft tissues of the back.
supports are the Vertebrace or the Vulkan Back Brace
spinal supports are used to support the lumbar vertebrae and
the muscles of the lower back.
It provides firm, comfortable support to help relieve back
is made from a strong, elastic, woven material with built-in
spinal supports provide firm, comfortable support for the
panels in the lumbar region provide additional local support.
levels of lumbar support for those recovering from a severe
episode of back and/or leg pain. The additional support stays
in place and the compression strap helps to limit unwanted
twisting and bending movements to allow damaged structures
to recover without strain. It is ideal for those with occupations
which involve heavy lifting and carrying.
the Vulkan Back Brace
Hydrotherapy involves doing
stretching or walking inside a swimming pool. This will help
reduce pain and promote muscle relaxation. This is useful
for people that wish to start being active without aggravating
their back pain. Buoyancy jackets or other aids help you to
keep afloat in the water which reduces pressure on the back.
jackets can be used for for hydrotherapy, learning to swim
or for just additional buoyancy in the water. They are ideal
for hydrotherapy exercises to recover from a back injury.
the Buoyancy Swim Jacket
These Buoyancy jackets can be used
for hydrotherapy, learning to swim or for just additional
buoyancy in the water. They are ideal for hydrotherapy exercises
to recover from a back injury.
2. Restore function
When the pain is significantly
reduced the patient can start the process of stabilizing and
strengthening the back.
Exercise and physical
Physical activity is essential
for a speedy recovery as it allows the patient to not only
reduce pain but also prevent any future incidences of this
A physical therapist can recommend
or perform stretching exercises that can significantly improve
your back pain. These should only be carried out when the
acute pain has subsided. Ask your physical therapist about
the McKenzie manoeuvres.
Dynamic lumbar stabilization exercises
Rehabilitation and future
prevention of this condition needs to be orientated around
strengthening both your abdominal and your back muscles. This
is known as dynamic lumbar stabilization and should only be
done under the supervision of a physical therapist.
You may be able to participate
in activities such as walking, biking, swimming or elliptical
machine workouts to help control pain. Which exercises help
your back pain will be specific to you. Start with a small
amount of activity, such as five to 10 minutes and add minutes
in the days that follow. Your goal is to comfortably work
up to 30 to 40 minutes of aerobic exercise.
When non surgical
If you try non surgical treatments
but don't experience improvement after a period of time, you
may need to consider surgery more seriously. Experts don't
agree on a specific time frame for considering surgery, but
many suggest waiting four to six weeks after the onset of
pain, unless you have the signs or symptoms listed above.
Where you fall within this range may depend on several factors,
including how much the pain interferes with your daily activities,
sleep, work and recreation.