What is it?
There is a disc between each of the vertebras. They are like a pillow made to absorb shocks. The discs are surrounded by a ligament (annulus fibrosus) and at the center of the disc is the nucleus.
Many people confuses the prolapsed disc with the bulged disc.
A bulged disc is when there is pressure on the intervertebral disc making it wider, exactly like if you apply pressure on a balloon.
The prolapsed disc is when the nucleus is ejected into the spinal canal with the potential of nerve compression.
This always happen when the annulus fibrosus breaks, due to either one specific trauma or several micro-traumas.
The best case scenario is if the nucleus goes out without touching any nerves but often the nucleus exits and compresses a nerve root causing a typical symptomatology;
First there is inflammatory pain but there is also nerve symptoms such as numbness or loss of sensibility, radiating pain (in the leg if the prolapsed disc is in the low back, in the arm if it is in the neck), loss of functions (incontinence, no more strength in the leg/the arm). The loss of function is what we call a ´red flag´ and therefore a scan is needed to evaluate the prolapsed disc.
The osteopath can help you to evaluate the state of your back and will let you know if you need further examinations at the doctors before you can approach an osteopathic treatment.
Depiction of a normal and a prolapsed disc
Treatment of the prolapsed disc
By releasing the nerve pressure, osteopathy can help you with a prolapsed disc symptoms.
I like to first do a symptomatic treatment to decompress the nerve and to reduce the pain and the inflammation. These treatments are very gentle and respectful of the body's structures. We don't want to activate the inflammation more than it is already and hence the gentle mobilisation and decompression techniques.
We then need to understand why this prolapse has happened. Is it because of a certain trauma or is it more complex, like a misalignment of the body causing unbalanced pressure on the spine causing the disc to slip?
Again, the osteopath is very aware of that and can help you to understand and treat a prolapsed disc.
Training and physical exercise after a prolapsed disc?
After more than 10 years experience with patients with prolapsed discs and protrusions, I have gained important knowledge of how to approach physical exercise after a prolapsed disc. During the acute phase of the prolapse, there is high inflammation. The body is like an engine. The inflammation is when the engine has been getting too hot because of the work we have asked of it.
So first of all it is essential that you give your body some rest!
Resting doesn't mean not moving at all. Moving is important and will keep your joints functional. It will also help to drain the liquids produced by the inflammation. But I always ask my patients NOT to exercise during the acute phase.
Keeping a sleep pattern of 6 to 8 hours per night is also very important. It is indeed during the night that the body repairs itself the most.
After 3 - 5 osteopathic treatments (approx. 6 weeks), the pressure reduces and the pain slowly goes down. Patients then are entering in what I call, ´the orange zone´. It is a dangerous zone because as the patient starts feeling better, he/she still has to be very aware of how he/she uses the lower back. This "orange zone" varies from patient to patient but I advice to take it easy for another month with specific releasing exercises given during the sessions at the clinic (these exercises vary from one patient to another so I won't describe them here).
After around 2-3 months, depending on the state, the patient can start training the core to give more stability and flexibility to the spine.
Last but not least: NO TORSIONS (twisting)
Torsion is the most dangerous thing you can do to your low back (prolapsed disc or not).
The annulus fibrosus is very sensible to torsions and can therefore be damaged during excessive rotations.