This helpful article on a herniated disc comes from the website About.com. Many herniated discs can be managed conservatively, but some require surgery. Post-operative recovery from surgery has changed due to pilates. Pilates is an exercise method designed to prevent back problems and allow us to use our backs appropriately.

However, Professor Stuart McGill`s research into the biomechanics of the spine has found that pilates should definitely be avoided by anyone experiencing any nerve irritation or recovering from surgery.

The reason for this is because when someone is recovering from surgery, it can take up to two year for the collagen fibres to repair. See Professor Tim Watson`s website for more information.

Many patients with back pain, leg pain, or weakness of the lower extremity muscles are diagnosed with a herniated disc. When a disc herniation occurs, the spinal disc, a cushion that sits between each vertebra of the spine, is pushed outside its normal position. A herniated disc wouldn’t be a problem if it weren’t for the spinal nerves that are very close to the edge of these spinal discs.

Spinal discs become more rigid with age. In young people, the disc is soft and elastic, but like so many other structures in the body, with age the disc gradually looses its elasticity and is more vulnerable to injury. In fact, MRIs show evidence of disc deterioration in about 30% of people as young as 30..

What happens with a ‘herniated disc’? As the spinal disc becomes less elastic, it can rupture. When this happens, a portion of the disc pushes outside its normal boundary and this is called a herniated disc.

When a herniated disc bulges out from between the vertebrae, the spinal nerves and spinal cord can become pinched. There is normally some extra space around the spinal cord and spinal nerves, but if enough of the herniated disc is pushed out of place, then these structures may become compressed. This results in pinching of the nerves.

A herniated disc may occur suddenly after a fall or other form of accident, or it may occur gradually with repetitive straining of the spine. Often people who experience a herniated disc already have spinal stenosis – narrowing of the space around the spinal cord and spinal nerves. When a herniated disc occurs, the space for the nerves is further diminished, and irritation of the nerve results.

When the spinal cord or spinal nerves become compressed, they don’t work properly. This means that abnormal signals may get passed from the compressed nerves, or signals may not get passed at all.

Common symptoms of a herniated disc include:

* Electric Shock Pain
This is pressure on the nerve which can cause abnormal sensations, commonly experienced as electric shock pains. When the compression occurs in the cervical (neck) region, the shocks go down your arms. When the compression is in the lumbar (low back) region, the shocks go down your legs.

* Tingling & Numbness
Patients often experience abnormal sensations such as tingling, numbness, or pins and needles. These symptoms may be experienced in the same region as painful electric shock sensations.

* Muscle Weakness
Because of the nerve irritation, signals from the brain may be interrupted, causing muscle weakness. Nerve irritation can also be tested by examining reflexes.

* Bowel or Bladder Problems
These symptoms are important because they may indicate cauda equina syndrome, a possible condition resulting from a herniated disc. This is a medical emergency. If you have problems urinating, having bowel movements, or if you experience numbness around your genitals, you should see your doctor as soon as possible.

All of these symptoms are due to nerve irritation caused by the herniated disc pressing against the nerves.

How is the diagnosis of a herniated disc made?
Most often, your doctor can diagnose a herniated disc by physical examination: testing sensation, muscle strength, and reflexes.

Only in conjunction with a physical examination, should an MRI be used to help diagnose a herniated disc. This is because it is normal for a MRI of the lumbar spine to show abnormalities, especially as people age. Patients in their 20s may show early signs of disc wear. In people of 40 and older, this type of wear would be expected.

Diagnosing a herniated disc, and coming up with the correct treatment plan depends on the symptoms experienced by the patient, the physical examination findings, and the x-ray and MRI results.

Previous posts on this blog discuss the dangers of prolonged sitting. There’s refererence to a video on how sitting in the forward position dramatically increases lumbar disc pressures, sometimes, in combination with other factors causing a disc to herniate.

I strongly recommend anyone who suffers from low back pain and any leg pain to look at this excellent video which was made in Singapore.

Helen How
Registered Osteopath
14 Craighall Gardens
Edinburgh EH6 4RJ

0131 551 1044