DISC BULGES, HERNIATED DISCS AND SCIATICA
Bondi Junction, Eastern suburbs Physiotherapy  

A spinal disc is the natural shock absorber and also allows movement of the spine.

A bulging disc is actually a very common condition in our spine. It is natural wear and tear, the older we become, the more discs can bulge.

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DIFFERENCE BULGING DISC AND HERNIATED DISC

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The spinal disc consists of 2 parts:

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• the inner nucleus: is a jelly-like structure, a bit comparable with the liquid part inside a chocolate cake.

• The outer annulus fibrosus: the more dense part of the cartilage.

When a disc is moving out as a whole, it’s called a disc bulge. When the outer ring (annulus) is damaged and the inner nucleus is escaping from within the disc, it’s called a herniated disc.

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CAUSES

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• Spinal degeneration (wear and tear)

• Repetitive trauma such as shocks from work or sports, or poor posture can lead to degeneration of the discs.

• An acute injury with heavy lifting or in an accident (although most disc problems due to an acute injury already had some kind of degeneration)

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Initial bulging or herniation might be symptom free. A bit more chronic condition will usually give a broad ache in the area, often accompanied with muscle tightness. When the disc is heading towards the nerve root (beginning of the nerve), it can cause inflammation of that nerve.

Sciatica is a condition where the nerve gets irritated and refers into the leg. The further down the leg you feel the sensations, the more the nerve will be irritated. Early stage nerve irritation will only give different sensations (numbness, pins and needles), more inflammation or nerve compression can result in loss of strength of the limb.

DISC BULGE TREATMENT SCIATICA TREATMENT

"At Physio K, we will determine the best course of treatment for you. It is important to know exactly what you have, before moving on to a solution."

We will provide a thorough assessment to determine what specifically is causing your problems. Treatment is predominantly determined by the stage of your healing as more chronic pains will require longer and different treatment than more acute ones.

We are very experienced in the treatment of all kinds of low back pain and neck pain and will provide you with the best outcome in order to get you moving well again.

HOW CAN DRY NEEDLING HELP WITH NERVE PAIN /SCIATICA?

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When certain muscles are tight or overactive, they can cause pressure on the spine and therefore directly or indirectly cause irritation of the nerve root (which is the beginning of the nerve when it's exiting the spine). Sometimes these muscles can be overactive or underactive, and via dry needling, we can normalize the tone. Underactive muscles can be stimulated and overactive muscles will get released. As a result, the irritation around your nerve should disappear and therefore, your symptoms as well! To learn more about dry needling, click here.

In the bellow video, Kenny from Physio K is showing an exercise program for people with lower back pain, tailored for people who have disc issues or sciatic nerve problems. Numbness in the bum or further down the leg or the feeling of pins and needles could be an indication of this problem.

Please always check with your physio to know which exercises will be helpful for you. These videos are here as a guide and will contribute to your rehab, in addition to some specific manual treatment. Sometimes you'll need a different approach, so always contact your health practitioner to get the best recommendation for you.

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Watch the video with lower back pain exercises for people with disc problems or sciatic nerve issues.

1. Cat cow exercise.

On your hands and knees, in all four position, making sure that your hips are above your knees and your hands are underneath your shoulders. Try to tilt your pelvis forward and backwards. We're going to focus on the lower back, imagining tucking a tail in between your legs and then putting your tail up in the air. The curved up position is a bit like how a cat is rounding its back and the opposite, curved down position, is similar to the position of a cow. Make sure you stay mid range, don’t push all the way up or down if you have disc issues or sciatic nerve irritation. Do this for about a minute: 20 to 30 times and if possible multiple times a day.

2. McKenzie extension exercise

Laying on your tummy on a mat on the floor and putting your elbows underneath your shoulders (sphinx pose). Try to extend your lower back and look up with your head. You'll have a little bit of compression in the lower back which is great for your disc and you can also feel a little bit of stretch in the front so that's why you have to look up to have the maximum amount of stretch in the front.

Stay in that position for 20 - 25 seconds and go down again. Do that four to five times in a row. If this is too easy for you then you can go to the next step, which is trying to extend your elbows. Put your hands underneath your shoulders, extend your elbows totally and try to relax in your back and look up.

3. Stretch of the Piriformis

Laying on your back on a mat, pull up one leg and grab your knee with one hand and grab your heel with your other hand. The purpose is to try and pull your knee towards your

opposite shoulder and make sure you leave your head relaxed on the table. You should feel a deep stretch under your glutes. The piriformis is a muscle that's laying in the pelvis, underneath your glutes. That's a very important muscle for your nerve health. If you have any kind of nerve issues make sure you do that stretch. Hold this position for 20 to 25 seconds, relax, do that four or five times in a row. Make sure you have a straight angle in your knee which is 90 degrees and pull across

4. Nerve glider

Laying on your back on a mat with your knees bent and feet flat on the floor. If the problem is on the right side, then you'll do the exercise with your right leg. Put your right knee on top of your left knee and then, in this position, relax your foot and try to extend your right knee up and down. Don't hold, don't try to stretch, we're trying to get a glide in the nerve. This is a good stand alone exercise, or could be used as a warm up. The next step is the same thing but at the same time, pull your toes towards your nose while you extend the knee and then go down again, leaving your knee on top of the other one. Try to do 20 to 30 repetitions each, a few times per day.

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