This is a condition that affects the spinal nerves which exit the spine and can affect any level of the spine. It is more common in the lower lumbar and mid to low cervical spine.
The irritation may be due to the direct mechanical compression of the disc on the nerve or due to the chemical irritation caused by this. In the older population the compression may be caused by osteophytes (extra bone) that have developed as part of the degenerative process.
- The outer layer of the disc or the annulus can degenerate with age and activity, leading to its weakening. The inner part or nucleus can also disintegrate. This can eventually lead to disc material coming out of the disc and pushing on a nerve. Frequently there is a lifting or twisting activity that finally causes this.
- Spondylolisthesis or slippage of one vertebrae on another
Pain and Symptoms
- Pain is sometimes severe and will often refer into the limb i.e. leg or arm
- Can often be associated with weakness, pins and needles, numbness and loss of reflexes
- Tender over affected region with associated muscle spasm
- Significant loss of active movements pain is usually aggravated by sitting, bending lifting and often sneezing
MRI or CT scan will help provide a diagnosis along with clinical findings.
Conservative management is usually the first option and will usually include:
Activity Modification – A period of activity modification will be required to help rest the affected area. This does not imply complete rest as it is important to keep uninjured parts of the spine mobile and healthy.
Pain Medication – Early on appropriate pain medication prescribed by your GP may be appropriate in helping to control symptoms.
Physiotherapy Guided Exercise program aims to maintain movement in unaffected regions, maintain fitness, and teach correct posture and manual handling.
Surgery is sometimes required.