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Recovery Tip

Did you know that your core muscles, which are the deepest layer of your tummy muscles, should work at all times to brace and protect your back? These muscles switch off due to pain and it takes 50,000 repetitions before they work automatically again to protect your back!

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Friday
Sep182015

Bulging Discs

It has become common practice in the last ten years for medical professionals to image painful low backs. Some of these styles of imaging include a plain film x-ray or Magnetic Resonance Image (MRI). However, there is powerful new evidence to suggest that this is unnecessary.

Low back pain can be caused by a variety of things. These structures include the discs, facet joints, muscles, ligaments and nerves. 

Image retrieved from www.lumbarspine.net/curve.gif, (18/09/2015)

There are many tests that physiotherapists can do to determine which structures are causing your pain. The lumbar discs are often blamed for low back pain, because they’ve been shown to appear as damaged on scans in people who have pain. However, recent research has shown that there are plenty of ‘bad’ discs in people who don’t have any symptoms as well.

This table is from the study was published in the American Journal of Neuroradiology in 2014. It shows the results of a systematic review, which is a type of study that brings together the results of a lot of smaller studies and combines them. 

In the column down the left, different types of spinal degeneration are listed, against age of the people imaged across the top of the table. Besides facet degeneration and spondylolisthesis, each of the types of degeneration are about discs.

You can see in the table, that 37% of 20-year-olds have disc degeneration. That’s one in three people!

Learning from this, we now know that disc degeneration can cause pain, but it occurs in people who have never had pain. Degeneration is a normal process of ageing and begins from a very young age. Therefore, we can deduce that in people who do have pain and a disc bulge, the disc bulge may not be the main driver of their pain.

If you have lower back pain, come in and see us. We’ll be able to assess your individual situation and let you know which treatment and management options are best for you. We like to treat the person, not the picture! 

 

- Isabelle