Is it disc or a muscle spasm ?

You bend down awkwardly, you pick up something heavy, you twist on an awkward angle and next thing you can't stand up straight and your lower back is killing you. There can be a range of causes, and sometimes more than one cause for your pain. Two of these are commonly your lower back muscles or the lumbar spine discs. Unfortunately these, when hyper acute can present exactly the same. Although some symptoms can indicate one over the other is more likely.

Symptoms:

- Unable to stand up straight

- Pain can be localised to the lower back or spread down the legs or up the back

- Pain with coughing, laughing and sneezing

- Pins & needles in your leg

When to seek urgent medical help

- Bilateral (both sides) pins and needles or numbness

- Loss of control of your bowel or bladder

- Numbness around your pelvis

- Sudden loss of sexual function

These symptoms relate to caudal equina syndrome and require urgent medical attention and surgery. This is when the spinal nerve root are compressed and if not treated early, can lead to long term problems. These may include incontinence, permanent paralysis of your legs. This is a rare disorder and doesn't occur commonly. 

Diagnosis:
During your initial assessment your osteopath will get you to do a range movements and they will preform a range of orthopaedic tests to try distinguish if it is a disc or muscular spasm (or other cause). If the muscle spasm is hyper acute (very very sore) then some of the orthopaedic tests for a disc will give a false positive. To completely distinguish a disc from a muscle spasm, imaging must be done to identify the cause. Also the rate at which you recover will also indicate whether it is a disc or muscle spasm. A muscle spasm will recover quite quickly, where a disc take a lot longer to heal. 

Osteopathic treatment:

Your osteopath will send you for imaging if they think it is necessary. The first treatment is just aimed at reducing your pain levels. As treatment progresses, your osteopath will aim to improve your lower back mechanics (mobility, decrease muscle tension), improve local blood flow to help reduce inflammation and address the upper back & pelvis + lower extremity (legs) mechanics. Tailored advice will be given, which may include; ways to get up without causing your pain to increase, sleeping posture, stretches, exercises and so on. 

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