DISC HERNIATION

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One of the most com­mon causes of lower back pain in pro­fes­sional truck driv­ers that I en­counter in my clinic is lum­bar spine disc her­ni­a­tions. In or­der to un­der­stand this type of in­jury, it is a good idea to re­view the anatomy of a spinal disc. Let’s get started. 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 a tougher ex­te­rior fibers. A her­ni­ated disc oc­curs when some of the jelly pushes out though 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, phys­i­cal de­mand­ing oc­cu­pa­tions such as con­struc­tion may in­crease your risk. In the case of the pro­fes­sional truck driver, it is the pro­longed hours in a seated po­si­tion that puts 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 low 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 herniation with­out know­ing it.

It is im­por­tant to seek med­i­cal at­ten­tion if you sus­pect that you have a her­ni­ated disc. Your doc­tor or health pro­fes­sional 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 MRI or CT scans 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 nerve in­jury.

The good news is that most disc her­ni­a­tions re­solve within a few weeks with con­ser­va­tion treat­ment, which usu­ally con­sists of rest and in­fla­tion con­trol with over the counter med­i­ca­tions such as ibupro­fen. Your doc­tor may also pre­scribe a mus­cle re­lax­ant and pain med­i­ca­tion. If the disc herniation does not re­solve within a few weeks, phys­i­cal ther­apy may be rec­om­mended. In rare cases, surgery is re­quired to fix a her­ni­ated disc. The most com­mon type of surgery in­volves a sur­geon re­mov­ing the small por­tion of 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 the key com­po­nent. This can be ac­com­plished by per­form­ing a reg­u­lar stretch­ing and strength­en­ing ex­er­cise rou­tine. To add to this, uti­liz­ing proper lift­ing tech­niques that fo­cus on lift­ing with the legs and not the back are very im­por­tant.

Keep th­ese sim­ple tips in mind and you will be well on your way to healthy pain free spine.

Un­til next time, drive safely!

Toronto Hy­dro joined GFL Excavating and the Elec­tri­cal Safety Author­ity (ESA) at an event last month to re­mind dump truck driv­ers about the dan­gers of hit­ting over­head powerlines.

Dump trucks are the num­ber one cause of pow­er­line con­tact in the con­struc­tion in­dus­try and the big­gest risk hap­pens when un­load­ing. Given the height of the bucket, if the job site is close to powerlines, the metal can make con­tact and be­come a di­rect con­duc­tor of elec­tric­ity. Trucks that have their boxes raised can also take down wires and — in some in­stances — hy­dro poles.

Safety ex­perts from Toronto Hy­dro and the ESA helped to hand out safety stick­ers to driv­ers as they left the work site. Driv­ers were asked to com­mit to work­ing safely around powerlines.

Ar­eas like Toronto can pose an in­creased risk, as there are a large amount of wires in a con­gested area. And Toronto is cur­rently a hot spot for dump trucks due to the large amount of ex­ca­va­tion hap­pen­ing as a re­sult of un­prece­dented growth in the city.

QUICK FACTS

• There are more than 15,000 kilo­me­tres of over­head wires in Toronto • GFL Excavating is one of the largest excavating com­pany op­er­at­ing in Toronto.

Dr Christo­pher H. Singh Chi­ro­prac­tor, runs Trans Canada Chi­ro­prac­tic at 230 Truck Stop in Wood­stock, Ont. He can be reached at 519-421-2024 E.mail: chris_s­ingh@sym­pa­tico.ca

(CNW GROUP/TORONTO HY­DRO COR­PO­RA­TION)

REP­RE­SEN­TA­TIVES FROM TORONTO HY­DRO, ELEC­TRI­CAL SAFETY AUTHOR­ITY AND GFL EXCAVATING SPOKE TO DUMP TRUCK DRIV­ERS IN DOWN­TOWN TORONTO ABOUT POW­ER­LINE SAFETY.

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