The spinal column consists of multiple blocks of bones called vertebral bodies. Between the vertebral bodies lies the disc. These discs are like rubber washers and allow movement of the spinal column. The disc contains jelly-like material surrounded by a fibrous ring. When the fibrous ring becomes diseased due to injury or any other condition then the jelly like substance is pushed out or prolapses into the spinal canal and causes pressure on the spinal cord and its accompanying nerve roots. This condition is called disc prolapse.
What are the symptoms?
Rupture of the disc or prolapse as it is usually called, can press on the spinal cord and its nerve roots leading to pain, numbness and weakness in either or both the arms and legs depending on where the prolapse occurs. If the prolapse is severe it can lead to loss of function including weakness of either or both limbs and may also affect the control of bowel and urinary bladder.
How is it diagnosed?
Usually the symptoms of a patient who presents with back and leg pain, or neck and arm pain with associated weakness are enough to help the doctor identify the problem. However, other diseases of the spine like infection, tumour and fracture can also present with similar symptoms. To rule out other conditions, various blood tests, X-rays, CT scan or MRI scans are advised. Once the diagnosis is confirmed the appropriate treatment can then be started.
What is the treatment?
Almost 90% of patients who get disc prolapse will resolve with medical treatment. This includes rest, pain relief and physiotherapy. Rest is advised for only 3-4 days after which assisted physiotherapy is required. If the symptoms do not resolve after 6 weeks of treatment or if any nerve or spinal cord related symptoms increase like numbness, weakness or loss of bowel and bladder control, then immediate surgery may be required.
How can it be prevented?
Regular care of the back with toning up exercises is the most important factor that helps to prevent further episodes of back pain. The other factors are to learn how to avoid inadvertent strains to the back. Techniques for sitting, driving long distances and lifting weights must be learnt.
How should things be lifted?
Hold heavy objects close to your body rather than away from it.
The feet must be about shoulder-width apart. A wide, solid base of support is important. Holding the feet too close together will be unstable; too far apart will make movement difficult.
Legs must be bent at the knees while lifting weights from floor level and the back must be kept straight. The stomach muscles must be pulled in. This will support the back in a good lifting position and will help prevent excessive force on the spine.
Push up with the legs. The legs are much stronger than the back muscles.
If an object is too heavy, or awkward in shape get someone to help you lift.
Avoid sudden and awkward movements while holding something heavy.
Never bend your back to pick something up
Don't twist or bend. Face in the direction you are walking.