One of the most common causes of lower back pain in professional truck drivers that I encounter in my clinic is lumbar spine disc herniation. In order to understand this type of injury, it’s a good idea to review the anatomy of a spinal disc.
I always tell my patients that a disc is built similarly to a jelly donut. It has a softer, jelly-like center, surrounded by layers of tougher exterior fibers. A herniated disc occurs when some of the jelly pushes out through a tear in the outer fibers.
In most cases, disc herniations are due to everyday wear and tear on the disc, called disc degeneration. As part of the normal aging process, spinal discs tend to lose their elasticity due to decreased water content. This in turn makes the disc more prone to tearing or rupturing under stress. Although some disc herniations are caused by a single catastrophic event such as a fall, the vast majority occur gradually.
There are several risk factors for disc herniation, the first of which is excess body weight. This causes increased compression and stress on the spinal disc.
Secondly, physically demanding driving occupations may increase your risk. Even for long-haul truck drivers, prolonged hours in a seated position put stress on the disc. Finally, some people are genetically predisposed to developing a herniated disc.
The symptoms associated with a disc herniation largely depend on the location of the injury. The lower back is the most common location for a disc herniation to occur. However, they can occur in the mid-back and neck on rare occasions.
Lower back disc herniations generally cause pain and stiffness in the lower back and buttocks region. If a nerve is compressed by the disc herniation, pain may radiate in the leg and foot. Similarly, pain may radiate into the arm and hand if the disc herniation is in the neck.
Numbing and tingling in the upper and lower limbs are also a commonly reported symptom of disc herniations. In more severe cases, muscle weakness may be experienced in the areas supplied by the affected nerves. It is important to note that not all disc herniations are symptomatic. In some instances, individuals have disc herniations without knowing it.
It is important to seek medical attention if you suspect you have a herniated disc. Your doctor will usually be able to diagnose a disc herniation by taking a detailed medical history and performing a physical examination.
During the examination, your doctor will check your reflexes, muscle strength, and your sense of touch. If necessary, your doctor may recommend more sophisticated tests such as an MRI or CT scan to better visualize the affected disc. These tests will allow your doctor to determine the severity of the herniation, as well as whether it is contacting a spinal nerve.
In addition, a nerve conduction test may be performed to assess the level and location of the nerve injury.
The good news is that most disc herniations resolve within a few weeks with conservative treatments. Treatment usually consists of rest and over-the-counter medications such as Ibuprofen. Your doctor may also prescribe a muscle relaxant and pain medication. If the disc herniation does not heal within a few weeks, physical therapy may be recommended. In rare cases, surgery is required to fix a herniated disk. The most common type of surgery involves removing the small portion of the disc that is protruding. Patients tend to recover from this type of surgery quite well.
As I always say, prevention is the best treatment. As far as discs are concerned, maintaining good spinal flexibility and strength is key. This can be accomplished by performing a regular stretching and strengthening exercise routine. Also, utilizing proper lifting techniques that focus on lifting with the legs and not the back is very important.
Keep these simple tips in mind and you will be well on your way to maintaining a healthy, pain-free spine. Until next month, drive safely.
Dr. Christopher H. Singh runs Trans Canada Chiropractic at the 230 Truck Stop in Woodstock, Ont. He can be reached at 519-421-2024.