One of the most common problems associated with a disc bulge or herniation in the lower back is sciatica. The pain from sciatica can be anything from infrequent to annoying, severe and debilitating. Often people think they have sciatica if they have any pain in their leg at all, if the pain is not felt down the back of the leg it is not sciatica. That is not to say that you do not have a disc problem or a nerve impingement, it just means that another nerve such as the femoral nerve, which would be felt down the front of your leg, may have been irritated.
- An ice-pack may help at the acute stage
- Anti-inflammatory drugs and painkillers as prescribed by your GP.
- Once the spasm begins to ease, osteopathic treatment can be helpful in restoring mobility and reducing pain, as opposed to bed-rest.
The exercise programme your osteopath recommends is important to ensure that the underlying problem is addressed and the risks of recurrence are reduced to a minimum.
The majority of disc bulges occur in a posterior lateral direction (backwards and outwards). If you suspect a disc problem then it is advisable to avoid flexion (bending forward) especially loaded flexion (bending forward and picking up a heavy object) until tests have been carried out. An osteopath will perform many tests to help them come up with a working diagnosis, however the only definitive way to know if you have a disc bulge is to have an MRI scan. An osteopath can refer you to have a scan privately but only your GP can refer you for a scan on the NHS.
Some symptoms may arise as a result of an underlying problem that is not of a musculoskeletal origin. It is advisable to schedule an appointment with a GP if the following applies:
- Patient is under the age of 20 or over the age of 55.
- Pain symptoms are constant, and are not alleviated by either lying down or resting.
- Pain runs through to the chest, and originates from the upper back, just behind the chest.
- Pain began gradually, and progressed to severe symptoms through the course of days or weeks.
Other symptoms may include:
- Weak leg or foot muscles.
- Numbness experienced within the region of the buttocks, around the anal area, or in a leg or foot.
- Bladder or bowel disorders, like inability to urinate or incontinence.
- Fever, loss of weight, and general feeling of poor health.
- Recent occurrence of violent injury or trauma to the back.
- An existing cancer diagnosis.
- Steroid use for more than a month
Cauda Equina syndrome
Cauda equine syndrome is a very serious type of nerve root problem that is classified as an emergency case. Although uncommon, this syndrome leads to lower back pain, inability to urinate, numbness within the anal area, and a feeling of weakness in one or both legs. The disorder, which requires urgent medical attention, is caused when the nerves at the end of the spinal cord are subject to constriction. If left unattended, cauda equine syndrome can permanently destroy the nerves connecting to the bladder and bowels. As soon as these symptoms are noticed it is a medical emergency and you are advised to consult a doctor immediately.