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Disc Injuries & Sciatica Cause and Treatment

The spine is made of bones (vertebrae) that are separated by discs. These discs have a number of important tasks to perform including;

  • Absorbing the loads of walking, sitting and twisting
  • Permitting the vertebrae to move on top of each other so that we can turn, reach and bend
  • Create a space between each vertebrae to give the height required for the nerves to leave the spinal cord at each disc and innervate the body

The disc itself is soft in the middle and surrounded by a tough outer ring and is sometimes likened to camembert cheese with its firm outer and soft inner areas. There are 7 discs in the neck (cervical), 12 in the chest (thoracic) and 5 in the lower back (lumbar).

Any one of these discs can become a problem. The most common disc injury location for people 25-55 years is in the lower back between vertebrae L4 and L5 and between L5 and S1. Disc injuries above this level are more common for people over 55 years. The most likely age to get a disc injury is between 30 and 50 with males getting the injury at a ratio of 2:1 compared with women.

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How did I get a disc injury and sciatica?

  1. Major Trauma; A single major trauma such as heavy lifting, hard falls, large efforts in sports or even a sneeze or cough while in a bent over position.
  2. Minor Trauma; Prolonged or repeated minor loads such as sitting (especially with poor posture), motor vehicle driving, bending and leaning. Often this leads to the “all l did” shock when a minor event such as picking up a child’s toy triggers significant back pain.

The disc will now occupy more space than it should and so have the potential to touch pain sensitive structures around the spinal canal and where the nerves exit the spinal column.

Spinal nerves L4, L5, S1, S2 and S3 join together to make the
Sciatic nerve so if any of the spinal nerves have abnormal pressure applied to them (such as a disc bulge) then pain can be experienced in the structures innervated by the nerve. This is known as sciatica.
It is very important to understand that the causes of sciatica can be complex and varied and are not just about the loss of disc integrity;

  • Slow changes with Degenerative Joint Disease and arthritis
  • Narrowing of the spinal canal known as stenosis
  • Fracture of vertebral structures called spondylolisthesis
  • Weight distribution shifts with weight gain or pregnancy
  • Piriformis Syndrome where the passage of the sciatic nerve around a muscle is the issue
  • Tumour or infection
Disc-Injuries

How can disc injuries and sciatica present?

You can have a disc injury with lower back pain only. The pain can be right across the base of the spine and extend into one or both buttocks.

If the disc injury touches one of the exiting nerves then you can get sciatic pain that travels into certain locations in the lower leg(s) as well.

Some of the common symptoms of sciatica you may experience are;

  • Sharp, shooting, electric or burning pain in the leg and foot
  • Numbness or pins and needles in leg and foot
  • Weakness when moving the leg, ankle or foot ,
  • Burning or prickling sensations
  • Pain and/or numbness on top of the foot, particularly between the big toe and second toe.

With sciatica most patients will find ;

  • Pain that is worse when sitting or standing due to increased disc pressures
  • Pain improves when lying down or walking with decreased disc loads
  • Difficulty in getting from sitting to standing to walking
  • Pain is aggravated by sneezing or coughing
  • Difficulty getting a full night’s rest

How Chiropractic and Myotherapy can help you

  1. Examination

    The first and most important step is to evaluate if we can help you. We are well trained to conduct a thorough history followed by an orthopaedic, neurological and physical examination.

    If you have any imagery studies already performed these are valuable. If you don’t these may be requested if the history and examination deems this important to your case.

  2. Provide a diagnosis

    At the end of our examination we will be able to provide you with an accurate diagnosis of what the problem is.

  3. Plan a Course of Action

    If after the examination we determine that we can help you we will plan a Course of Action to get you back to where you want to be. We will be able to give you

    a) A timeline of how long the process will take
    b) The techniques we recommend
    c) What you need to modify at home and work
    d) Give you any necessary exercises and advice that assist recovery

  4. How we will help you

    Poor biomechanical function in the lower back is a common cause of sciatic pain. Spinal manipulation, mobilisation and myotherapy aims to restore normal balanced movement to the spine which to remove the irritation of the sciatic nerve and stop the sciatica.

    It is typically combined with specific flexibility and strengthening exercises to surrounding musculature to achieve the best long term improvement possible. Chiropractors and myotherapists are the highly trained in performing this treatment.

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