As an exercise physiologist specialising in workers compensation one of the most common injuries I come across is lower back and gluteal pain caused by herniated inter-vertebral lumbar discs. This is often referred to as a bulging or slipped disc. Intervertebral discs sit between each vertebrae in our spine and consist of a strong outer layer called the ‘annulus fibrosis’ which houses a thick jelly like substance known as the ‘nucleus pulposus’. One way to picture it simply is to think of 2 biscuits sandwiching a marshmallow. The biscuits are the vertebrae and the marshmallow is the disc. The marshmallow is soft and spongy and when you place pressure on the biscuits by squeezing down, the marshmallow’s spongy consistency absorbs the force while temporarily squashing out of the biscuits. When the force is released the marshmallow springs back to shape. This is the same principle for our intervertebral discs as they act as a shock absorber to protect our vertebrae when placed under load. Unfortunately as we age these discs gradually loose fluid, become rigid, thin and their ability to absorb shock decreases. This process is known as disc degeneration.
When pressure is placed on the spine these degenerated discs do not have the ability to adequately absorb the force and instead crack, bulge or loose excessive fluid, which aggravates the nearby nerve root. As a result the injured person experiences sharp shooting pain radiating down the leg and buttock. In a physical job role such as a trade assistant it is usually a result of heavy lifting or performing tasks requiring twisting through the lower back.
Initially it is very painful and debilitating, however, when managed conservatively symptoms usually resolve within approximately 6 weeks. A progressive exercise program aimed at improving lumbar flexibility and increasing the strength of the muscles surrounding and supporting the spine can assist in conservative management. If symptoms become persistent surgery may be recommended, the surgery involves removing the section of herniated disc that is aggravating the nerve root. Following surgery exercise rehabilitation under the guidance of an exercise physiologist plays a crucial role in safely regaining function, returning to work and activities of daily living. If you have experienced a herniated disc and are interested in partaking in structured exercise program to aid your recovery book an appointment with an exercise physiologist at Absolute Balance.
Phoebe Trolio (BSc – ExHealthSc, GraddipSc – ExRehab)
Senior Accredited Exercise Physiologist (AEP) (ESSAM)