Back behind the wheel: Exploring disc injuries – are you at risk?
December 1, 2006
Through my work with truck drivers, I have found disc injuries are one of the most frequently injured spinal structures among truck drivers. In this article I want to clear up some of the mystery asso...
Through my work with truck drivers, I have found disc injuries are one of the most frequently injured spinal structures among truck drivers. In this article I want to clear up some of the mystery associated with this type of injury by discussing the different terminology used to describe a disc injury as well as risk factors and treatment options.
Have you ever had a slipped disc or a bulging disc? What exactly do these terms mean? There are many different terms used to describe spinal disc pathology, and all are used differently by different health care providers.
Unfortunately, this tends to confuse most people because they hear their diagnosis referred to in different terms by different practitioners and are left wondering what exactly is wrong with them. In order to comprehend the different terminology you must first understand the anatomical structure of the disc.
I usually describe a spinal disc to my patients as a jelly-filled donut. The inner aspect of the disc contains a gel-like substance called the nucleus pulposus. Surrounding the nucleus are tough fibrocartilagenous fibers called annulus fibrosis. These annular fibers contain the inner nuclear material preventing it from spilling out.
Due to the fact that there are so many terms used to describe a disc injury such as a ruptured disc, degenerative disc disease and disc protrusion, it is best to focus on what the specific structure within the disc is damaged. There are three main classifications of disc injuries.
The first type of injury consists of annular fiber tears, which do not extend into the outer aspects of the disc.
Thus, the nuclear material is prevented from completely escaping the disc. The second type of disc injury, which is commonly referred to as a disc herniation, consists of annular tears which extend from the innermost aspects of the annulus to the outermost aspects of the annulus.
Often in this situation, the pressurized nuclear material can squeeze through the tears in the annulus and escape to the outside of the disc.
When this occurs, the nuclear material may come in contact with nearby spinal nerves and even the spinal cord resulting in pain. In the third type of injury, the inner nucleus loses hydration due to prolonged spinal stress and increasing age.
This results in a “bulging” of the disc which resembles a tire which contains an inadequate amount air. Just like a herniated disc, a bulging disc may impinge the nearby spinal nerves and spinal chord.
Now that we know the three main types of disc injuries, let’s talk about the common symptoms. When tearing of the annulus occurs within its inner portion only, generally pain is not experienced because there is a lack of pain receptors in this region.
When tearing of the annulus occurs in the outer annular fibers, mild to excruciating pain may be felt in a generalized manner.
In the case of a disc herniation or a bulging disc that is compressing a spinal nerve of the spinal cord, people may experience symptoms such as pain, numbness, tingling and/or weakness within their limbs.
In rare cases, people may lose control of their bowel and bladder functions.
This is a medical emergency which requires emergency medical attention.
Now, can you prevent disc injuries from occurring? The answer is maybe. There is no way to completely prevent disc injuries, however avoiding the common causes will greatly reduce your chances. Things that you should avoid include:
* prolonged sitting;
* poor postural habits;
* poor lifting habits;
* improper truck seat position;
* improper lifting technique;
* extended exposure to vibratory forces (i.e. tuck drivers, jack hammers, etc.)
Other risk factors which have been shown to increase the susceptibility of disc injury include:
* lack of physical activity;
* poor diet and nutrition.
As you can see, truck driving exposes you to many of the risk factors associated with disc injuries. This is the reason why many truck drivers will sustain at least one, if not more disc injuries during his or her career.
Although most disc injuries are not severe, some can end a truck driver’s career. However, by paying attention to things like driving posture and lifting technique you will be well on your way to a career on the road with little or no back pain due to disc injuries.
Until next month, drive safely!
– Dr. Christopher Singh, B. Kin., D.C., runs Trans Canada Chiropractic at 230 Truck Stop in Woodstock, Ont. He can be reached at 888-252-7327, or email TCC@transcanadachiropractic.com