08 Feb Back pain – disc prolapse : Advice sheet

What is disc prolapse?

A disc injury is not an injury that occurs in one go. A disc prolapse is caused by cumulative micro-traumas to the inter-vertebral disc over a long period of time, until the disc can no longer handle the stresses placed upon it. (Extremely high forces are required for an acute single-trauma prolapse to occur – i.e. a severe car accident.)

The most common area for a disc to prolapse or ‘slip’ is in the lumbar spine (lower back) or cervical spine (neck). The discs are weakest around the 4–5 and 7–8 o’clock portions, commonly referred to as the ‘postero-lateral’ portions.

The position that places the most stress and pressure on the inter-vertebral discs is when flexion (bending forwards), side bending and rotation are combined. (Imagine someone sitting on a chair and then attempting to tie one of their shoe laces.) Add the effort of trying to pick something up while in this position, and you have a recipe for disaster.

The position that places the least amount of stress and ‘decompresses’ the discs is lying on your back with your lower legs resting up on a foot stool or chair – ideally with 90 degree bends at the hips and knees.

Throughout the average working day, each of us can lose as much as 2cm in height, as the weight of our upper body and forces travelling up through our lower body compress the discs in our spine. The discs are 80% water, and this is what gets squeezed out! Keep hydrated to make sure your spine is shock absorbing to its fullest potential.

How will you be treated for back pain with disc prolapse?

Ice packing and anti-inflammatories are effective treatments. Soft tissue manipulation in the form of massage and stretching to regulate tone and length to help decompress the lower back area and help normal movement are also beneficial. Acupuncture and taping can complement this nicely, depending on the individual and their injury location/severity/cause. Initially, treatment is very effective, with pain levels dropping considerably within two weeks. However, full recovery can take a further 6 to 8 weeks from there, with full rehabilitation taking more time afterward. It must be kept in mind though that everyone has different healing potentials, and without a scan we cannot be sure what severity of damage there is to the tissue, and results will hinder greatly upon these variables.

What can you do to help yourself when you have disc prolapse?

Keep hydrated. Think about how you are moving and the position in which you pick up things. If you play sport or go to the gym, make sure you stretch regularly to keep flexible and keep your core strong to support your lower back.

Please remember, if you need any further advice then you can email us at advice@pbclinic.com.