signs

your disc bulge

Here is a list of warning signs that indicate your disc bulge problem may be deteriorating. You can discuss this at you intake exam.

Severe or progressive bilateral neurological deficit of the legs, such as major motor weakness with knee extension, ankle eversion, or foot dorsiflexion.
Recent-onset urinary retention (caused by bladder distension because the sensation of fullness is lost) and/or urinary incontinence (caused by loss of sensation when passing urine).
Recent-onset faecal incontinence (due to loss of sensation of rectal fullness).
Perianal or perineal sensory loss (saddle anaesthesia or paraesthesia).
Unexpected laxity of the anal sphincter.

Sudden onset of severe central spinal pain which is relieved by lying down.
History of major or minor trauma, or even just strenuous lifting in people with osteoporosis.
Structural deformity of the spine (eg, a step from one vertebra to an adjacent vertebra).
Point tenderness over the vertebral body, or pathological fracture.

Significant muscle weakness or wasting.
Loss of tendon reflexes.
Presence of a positive Babinski reflex (toes extend and fan outwards when the lateral part of the sole of the foot is stimulated).

Onset in people older than 50 years, or younger than 20 years of age.
Pain that remains when supine, aching night pain that disturbs sleep, and thoracic pain.
Past history of cancer (breast, lung, gastrointestinal, prostate, renal, and thyroid cancers are more likely to metastasise to the spine).
Fever, chills or unexplained weight loss.
Recent infection (eg, urinary tract infection).
Intravenous drug misuse.
Immunocompromise such as HIV infection.

Neurological:
- Patient with arm pain and neurological signs, from two nerve routes
  Disturbance of bladder and bowel function, or perineal anaesthesia
  Spinal cord symptoms
Radiological changes:
- Patients with rheumatoid arthritis and osteoporosis are contraindications to forceful mobilizations.
  Any pathology leading to significant bone-weakening such as tumours, infections, long-term corticosteroid medication, fracture
- Patients with vertigo need close supervision
Hypermobility:
- If a vertebra in the spine was hypermobile compared to the other vertebra, care must be taken to avoid putting excessive strain on the hypermobile joint
Vascular
- Aortic aneurysm, bleeding into joints, e.g. severe Haemophilia
Pregnancy
Musculoskeletal deformity
- Spondylolysis, spondylolisthesis