“Doing” a disc

It’s moving day and you’ve been running around packing, unpacking, lifting boxes and awkward furniture all day. You can’t stop though because there’s still more to do. It’s onwards and upwards with another load in the back of the Ute. You bend down to pick up the umpteenth box of the day and bang and you’re hit with excruciating low back pain and a shooting pain down the back of your leg. It’s crippling and you’re struggling to catch your breath and stand up straight. It’s a scenario unfortunately a lot of us are familiar with, but what has caused this searing pain? One possible and relatively common cause for such pain is a lumbar disc prolapse. Sit back with a coffee and let us take you through the ins and outs.

What is a disc and what just happened when I bent down?

Your spine is made up of many vertebrae spanning from the neck all the way down to the tailbone. Between each vertebra sits an elastic-like structure called a disc. The disc is made up of a tough outer section called the ‘annulus fibrosus’, and a gel-like inner section called the ‘nucleus pulposus’. The discs work to separate the vertebrae to allow movement, as well as provide shock absorption to forces acting on the spine during movement.

Common causes of disc prolapse include trauma and degeneration of the disc tissue as a result of poor posture (for example lots of slouching or slumping) and repetitive bending movements. When we bend forward, particularly when we bend forward under load (like with our house mover above who had been repetitively picking up and putting down heavy boxes), the forces acting on the discs, and especially the inner nucleus, increase drastically. Over time these repetitive movements may cause small micro-tears in the layers of the outer annulus, which weakens the overall structure of the disc. Slowly, the nucleus gets forced out and a small bulge may occur (there is often no pain at all at this stage). If these movements continue, or if you go to pick up that box which is just too heavy for you, the force is too much and the bulge can progress into a larger protrusion. Like with any injury, the initial response of the body is inflammation. The presence of inflammatory chemicals alone can cause irritation to the surrounding nerve tissue as it exits the spine, or you may get actual contact of the disc on to the nerve itself, causing impingement. This is when you feel pain and know that all is not well.

‘What should I expect to feel when this happens?

The signs and symptoms of a disc prolapse can vary greatly depending on the type and severity of the prolapse, and where the spine is affected. A prolapse may happen slightly out to one side of the disc affecting only the nerves on that side of the body (this is most common). Or it may occur in a backwards direction, potentially affecting nerves on both sides of the body. A small bulge may only yield mild symptoms, whereas a large prolapse may cause more severe symptoms. Interestingly, this is not always the case though.

Some of the symptoms you may experience include:

  • Low back pain
  • Pain running down the front, side or back of the leg
  • Pins and needles or tingling down the leg
  • Numbness down the leg
  • Muscle weakness (this may manifest as losing the ability to lift your foot)

The most common disc prolapse affects the L5/S1 disc (the lowest disc in the spine) and will give symptoms down the side and back of the leg. Your practitioner will ask you lots of questions and do lots of tests to determine exactly what area is being affected.

How do we treat disc prolapses?

Initially you may be in a lot of pain and simple movements may be very difficult to perform, like standing up straight, for example. This is because the body is trying to protect you from doing further damage. Once inflammation occurs, the body needs a few days to deal with what has happened. So, if you come to see your Osteo straight away, don’t expect to feel better after one visit. In fact, it is quite possible you will feel worse in the coming days before you start to feel better. The advantage of seeing your Osteo early on is that they can educate you on the do’s and don’ts, tell you what to look out for and inform you what to expect going forward. Often the unknown is scary, but your Osteo will be able to ease your mind, even if not the pain immediately. Us Osteos like inflammation. It’s the body’s way of protecting the injury and getting organised for repair. So, although it may be painful, it is good to see it through without intervening too much.

Early on, we’ll get you moving better. We will also give you breathing, relaxation and core activation exercises to help the body better cope with the pain. A disc will often prolapse because of poor core stability, so getting you on the path to rehabilitating your core is good early on. When it is possible, we will relax the tight muscles and reinstate movement to joints that may have seized up and become restricted following the injury. Our focus is to ensure the fluids of the body (i.e. blood, joint fluid, and lymphatic fluid) are moving freely around the body. When injury occurs, these fluids can become congested and a bit stuck around the area, and sometimes need a little help to get moving again. This will ensure a speedier recovery. The injury site will need lots of fresh blood to the area, while the lymphatic system will need to be flushed – ridding the area of all the bad stuff. Depending on the severity, discs generally take around 3-6 months to fully recover.

Your Osteo is trained to help you through the injury process, so you can rest assured you are in safe hands. We know when and how to treat and know what to look for to ensure you are seen by the right people if it’s required (this might include your GP or a specialist if necessary). If you think you have a disc prolapse or have previously been diagnosed with one and need help managing it, then look no further. Call us today to book your appointment.

References:

  1. Brukner, P. et al. 2017. Clinical Sports Medicine. 5th ed. Australia: McGraw-Hill Education
  2. Kim, Y. et al. 2018. Differences in the Incidence of Symptomatic Cervical and Lumbar Disc Herniation According to Age, Sex and National Health Insurance Eligibility: A Pilot Study on the Disease’s Association with Work. International Journal of Environmental Research and Public Health. 15 (10) 2094.
  3. Reiman, M. et al. 2016. Return to sport after open and microdiscectomy surgery versus conservative treatment for lumbar disc herniation: a systematic review with meta- analysis. British Medical Journal of Sports Medicine. 50. 221-230.

ATTENTION ALL NEW MUMS!

May!!! We agree…. How is it May already? Well, May allows us to celebrate those very special people in our lives – our Mums. Being a parent can be very challenging at the best of times. And especially if you’re a new mum. It doesn’t matter whether it’s your first, second, or fifth child, being a new mum comes with a whole host of daily challenges. Your new little human requires all your attention – feeding  constantly, changing eight nappies a day, bathing… Throw in another child, other family members, work, groceries (and the list continues) into the equation and it’s easy to see how life can be taxing on you and your body.

The good news is, we’ve devised a little self-help guide for new mums! Below we give you tips on how to be kind to your body and not put yourself at risk of injury, so you can give your little munchkin the attention they need.

FEEDING

You’re going to be doing a lot of this. Your new recruit requires constant nourishment to ensure they grow strong and stay healthy. And it doesn’t matter whether you breast or bottle feed, it’s likely you are going to be seated for long periods, looking down at your baby. This all leads to extra strain through your neck, back and shoulders. So, try some of these little gems of advice to help keep this process pain free:

  1. Get a comfortable, supportive chair – pick a chair that is going to feel good to sit in, but one you can easily get up and down from. If it’s too low, allowing you to slouch right back into, you’ll struggle to move yourself and your baby around without compromising your back.
  2. Keep your neck moving – feeding is a great time to bond with your baby. Eye contact is important but try not to spend the whole time looking down at a funny angle. Once your baby is comfortable feeding, it’s OK to break that eye contact every now and then to move your neck. Doing some light stretches will ensure you don’t end up with sore, overworked muscles.
  3. Consider a feeding pillow – these are great for taking the weight of your baby, so your shoulders and arms don’t have to. And they still allow you to have that important close contact.
  4. If you have a partner who can help feed, allow them to help regularly to give you a break. This tip is more for the bottle feeders of course, but it can make a huge difference.

CHANGING

It’s going to be nappies galore! This can mean a lot of bending over, so it’s important you look after your posture so your lower back doesn’t take all the strain. Try to avoid changing your baby on the floor in these early days. Ideally, get yourself a changing table. It means you can place your baby down on the table and change them at a height where you don’t have to bend forward and hold an awkward position. And of course, the same advice can be followed when changing your baby’s clothes. Look after that back, you’re going to need it!

OTHER USEFUL TIPS

The following tips are by no means any less important, so try to take these on where possible:

  1. Sleep when your baby sleeps: Getting those extra hours in when your baby is taking a nap is important to conserve your energy and reduce the risk of fatigue.
  2. Eat and drink well: It’s easy for the focus to turn to your baby, and rightly so, they are little and dependent on you. Remember though, you can’t look after your baby if you aren’t well. Eat for the health of you and your baby – lots of water and good nutritious food such as fruit and vegetables!
  3. Stretch: Especially your shoulders, neck and chest. Once baby comes along, our arms are always in front of us. Whether it’s holding, feeding, changing or playing, we’re usually a little slumped in our shoulders. Build stretching into your routine (like every time after baby feeds for example). We want to reverse the ‘slump’ position, so take your arms out wide, open up your chest and hold for 30 seconds (and repeat). Aim to do this three times a day (or whenever you get the chance!). Gentle shoulder shrugs and neck stretches can also help.
  4. Take time to relax: When the opportunity arises, get your partner, grandparent or friend to look after your newborn while you take a bath, read a book, or close your eyes for a little while. You deserve it, and it helps keep you sane and grounded during a very busy period in your life.

We hope you’ve found our list of tips interesting and helpful. If you are ever unsure, have a niggle or need some further advice, please do not hesitate to call us and book an appointment! Happy Mother’s Day to all you lovely Mums and mother-figures out there!!!

References:

  1. Everymum – https://www.everymum.ie/baby/expert-advice-5-practical-posture-tips-for-new-moms/
  2. Womens Health Australia – https://www.womenshealth.com.au/prenatal-postnatal-posture

WHAT’S IN A CURVE?

YOUR CERVICAL SPINE EXPLAINED

Acupuncture Yarraville - Inner West Health Clinic

Your cervical spine (c-spine) is classified as your top seven vertebrae (or more commonly, your neck). Here at Inner West Health Clinic, we think the cervical spine is pretty important. Not only does it house the delicate spinal cord, which sends messages from your brain to your body (and back again), and important arteries that provide blood flow to the brain, but it is also strong and flexible, allowing movement in all directions.

It has a lordotic curve, which means the spine curves into the body, before curving back out again through the thoracic spine (upper to middle back), and then curving back in again (lordotic curve), in the lumber spine (lower back). These curves are important as it helps us evenly distribute force through our spine, while helping us move, twist and bend. When one of our curves start to change or move, or if we experience some kind of damage or injury, it can set off a chain of events in our body – literally from head to toe!

Given the cervical spine’s important function in the body of holding the head centred and straight, it gets a lot of trauma. Not just severe trauma like from car accidents or injuries (a blog for another time), but daily trauma, which just about everyone experiences.

“So what is this daily trauma that I’m giving myself?” you ask. It’s a multitude of activities but sitting or standing with bad posture is a very common one. Do you:

  • work at a desk?
  • drive a car?
  • use public transport?
  • sit on the couch and watch TV?
  • use your mobile phone, tablet or laptop?
  • hold a baby in your arms, or feed a baby regularly?

If you answered yes to any of these, you’re likely to be experiencing trauma to your c-spine, which could result in:

  • forward head placement, putting extra strain through your spine and other parts of your body
  • eventual disc irritation, bulges or herniation
  • headaches, including migraines
  • nerve tingling or pain
  • referral pain to other parts of your body such as the shoulder
  • potential to progress into more severe or chronic issues.

To give you an idea of how trauma is caused, the human head weighs about 4.5-5.5kg. When it flexes forward 15 degrees, the force through the spine grows to about 12kg. At 30 degrees, it’s 18kg, and at 45 degrees flexion, our spine sees about 22kg. To deal with that, the spine and muscles around it start adapting, setting of that chain…

Correct sitting at desk posture ergonomics: office worker using a computer and improving his posture

How do I prevent further trauma?

  • Notice your posture: Try to keep your shoulders back and your head above your shoulders. You can do some simple exercises like chin tucks. Basically, dance like you’re an Egyptian and retract your head backwards, so it’s sitting above your neck. Try not to give yourself too much of a double chin (don’t tilt your head down). Also try some stretches that open up your chest and elongate your neck.
  • Shoulder retraction: Roll your shoulders back and down, then pull your shoulder blades together, like someone has put tape from one blade to the other. While doing this, make sure your core is engaged, by drawing your belly button into your spine – try to keep a natural curve in your back.
  • Check your workstation: You should be sitting with your elbows at right angles or just wider, your knees should be level with your hips, or slightly lower – prop your feet up onto a foot rest if you need. The top of your screen should be at eye level. Check out our graphic for more information.
  • Take regular breaks when sitting: Simply stand up, do a couple of stretches or go for a quick walk. If your workplace has standing or walking desks available, use them regularly.
  • Parents with babies: Be conscious of your posture. Try to relax your shoulders and use a pillow or support when feeding or holding bub for extended periods of time. If you have a baby that loves long cuddles, try baby-wearing (chest to chest) using a well-fitted carrier, rather than holding.
  • Visit your Inner West Health Osteo for a posture check and regular maintenance treatments. Your practitioner will be able to see where your imbalances are, find out what is causing your pain if you have any, and work through a plan to meet your goals.

Your cervical spine is important, so make sure you look after it! Think about your posture, get your Egyptian dance perfected and show off those beautiful (spinal) curves.

References:

1. Spine Health: https://www.spine-health.com/conditions/spine-anatomy/cervical-spine-anatomy-and-neck-pain

2. Assessment of Stresses in the Cervical Spine Caused by Posture and Position of the Head: https://motamem.org/wp-content/uploads/2016/06/spine-study.pdf