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Back pain - disc problems

Intervertebraldiscsarespongycushionsfoundbetweenthevertebraeofthespine.Thesediscs haveanumberofimportantfunctionsincludingshockabsorption,keepingthevertebralcolumn stableandofferingthevertebraepivotpointstoallowmovement. Adiscismadeoftwoparts:theelasticoutershell(annulusfibrosis)andthejelly-likecontents (nucleuspulposis).Commondisc-relatedproblemsincludedegenerativediscdiseaseandruptured (orslipped)disc. Symptoms Thesymptomsofadamageddisccanvaryaccordingtoitslocationandseverity,butgeneralsigns include: Severe,localisedpain Painradiatingdownthelegs Worseningpainassociatedwithbendingoverorsittingdownforalongtime Worseningpainassociatedwithactivitieslikecoughingorsneezing Numbnessorpinsandneedlesinanarmorleg.

Ima ge des crip

Risk factors Somepeoplearemoresusceptibletodiscproblemsthanothers.Riskfactorsinclude: Obesity Poormuscletone Lackofregularexercise Cigarettesmoking Advancingage Poorposture Incorrectliftingtechniques.

Oftenthereisnorecognisableriskfactorpresent. Degenerative disc disease Thediscsofayoungchildareplump,butthewatercontentreduceswithageuntilthediscsare comparativelythinandhard.Bonygrowthscalledbonespursmaydeveloparoundthediscs.In manycases,theseage-relatedchangescausenoproblems,butsomepeopleexperienceapainful conditioncalleddegenerativediscdisease.Themostcommonsymptomisbackpaincausedby holdingthesameposition(eithersittingorstanding)fortoolong. Ruptured disc Thetermslippeddiscsuggeststhatadischasmovedoutofposition;however,thisisnotcorrect. Thediscsareheldfirmlyinplacebyvariousstructures(includingligaments,musclesandthe vertebraethemselves),sothetermslippeddiscismisleading.Termslikeruptured,herniatedor prolapseddescribethesituationbetter.Acrackinthetoughoutershellofthediscallowsthesoft jelly-likecontentstooozeout. Themostcommonsiteforaruptureddiscisthelowerback,andchroniclowerbackacheisthe usualsymptom.Aswegetolder,theriskofrupturingadiscdeclinesbecausethediscsdryoutand thecontentsarelessabletooozethroughanycracks. Sciatica

Backpain-discproblems

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Sciaticaisnervepainfromthesciaticnervethatrunsfromthespineintothebuttockanddownthe backoftheleg.Acommoncauseofsciaticaisaruptureddisc.Thespinalcordhasroomtoslideup anddowninsidethespinalcolumnwheneverthebodymoves.However,abulgingdisccan protrudeintothespinalcolumnandpressagainstthespinalcord,hamperingitsmovementand causingpain. Diagnosis Diagnosisofdiscproblemsgenerallyinvolves: Takingamedicalhistory(todetermineriskfactorsandpredisposingconditions) Physicalexamination.

Otherinvestigationsaregenerallyreservedforpreoperativeassessment. Treatment Themajorityofdiscproblemswillresolveregardlessoftreatment.Bedrestmaybeindicatedfor initialmanagementofseveresciatica,butmostpeoplecankeepactivewithsomerestrictions accordingtothelevelofpain. Somecommontreatmentsinclude: Heattreatment Regularmassage Exerciseprogramdesignedtoimprovestrengthandflexibility Non-steroidalanti-inflammatorydrugs Pain-killingmedication Uncommonly,inseverecasesofruptureddisc,anoperationmaybeneededtotrimthe protrudingbulge(laminectomy) Alsouncommonly,inseverecasesofdegenerativediscdisease,anoperationmaybe neededtoremovethediscandfusetogetherthetwovertebraeoneitherside.

Self-help suggestions Giventimeandtherightconditions,aruptureddisccanhealitself.Ongoingmaintenancecan reducetheriskofdiscproblemsinthefuture.Beguidedbyyourdoctororhealthprofessional,but generalsuggestionsinclude: Trynottositstillforlongperiodsoftime. Avoidliftingheavyobjects. Rememberthatmovementssuchasbendingandtwisting(especiallyatthesametime)can increasepressureonyourdamageddisc. Workonincreasingyourabdominalstrength.Strongstomachmuscleshelptosupportthe back. Payattentiontoposturewhilesitting,standingandwalking. Flexibilityexercises,performedregularly,canimprovemobilityandhelpreducemuscle tensionandbackpain. Includeagentleprogramofback-strengtheningexercises. Yogaisrecommendedbysomepractitionersasanexcellentformofstrengtheningand stretchingforpeoplewithbackproblems.

Where to get help Yourdoctor Physiotherapist

Things to remember

Intervertebraldiscsarespongycushionsfoundbetweenthevertebraeofthespine. Commonproblemsincludedegenerativediscdiseaseandruptured(orslipped)disc. Riskfactorsfordiscproblemsincludeobesity,advancingage,lackofexerciseandincorrect liftingtechniques. Mostdiscproblemssettlewithoutneedforintervention.

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AustralianRheumatologyAssociation(VicBranch)

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Backpain-discproblems

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