Herniated Discs

The Malady:

Herniated Disc

The Facts:

Slipped or ruptured discs impact millions of Americans.  A herniated disc can occur in any part of your spine.  While most commonly in the lower back (lumbar spine), a herniated disc may occur in the neck (cervical spine) and more rarely in the upper back (thoracic spine).  This article will focus on the most common occurrence of herniated discs known as lumbar herniations.

Interestingly, not all cases of herniation result in pain. Studies have shown that as many as 55% of people with signs of disc herniation do not experience any pain. Those not so lucky, experience pain ranging from mild to crippling.

The Symptoms:

Symptoms vary greatly from patient to patient. While some patients feel no symptoms, patients who do experience symptoms related to this condition complain of pain in their low back.  Other symptoms can include numbness and tingling (“funny bone sensation”) in the buttocks and down the leg, and leg weakness.  This condition, identified as sciatica, is the most common symptom of a herniated disc in the low back.  When the herniation is severe, the pain may shoot down the legs as far down as the toes. While bowel and bladder changes are uncommon, they can be a sign of a very serious compression, and require immediate medical attention.

What is Happening:

Small, spongy discs sit in between each bone (vertebrae) of your spine, that, when healthy, provide padding and protection from weight bearing forces. When a disc is damaged the vertebrae can begin to squeeze on the discs, causing them to bulge, rupture or break into pieces.

Think of the discs of your spine as a jelly donut. When the “donut” is squeezed, it begins to leak its contents. This “jelly”, called the nucleus pulposis, begins to come out of the disc. In turn, this can press on the nerves of the back and cause disturbances running all the way down to your legs.

Why Is This Happening:

Herniations occur due to progressive changes in posture caused by poor/lazy posture and wear and tear due to age, or acute spinal injuries. In progressive changes in posture, prolonged slouched positions cause the vertebrae to press down on the disc, and the excessive pressure on that one spot can cause the disc to bulge out, and eventually begin to press on nearby nerves.

Similarly in an acute spinal injury (a problem that occurs after a single event), the vertebrae press down on the disc causing excessive pressure on that one spot and the disc to bulge out.  As with the affects of progressive changes in posture, the disc may begin to press on nearby nerves.

Herniations can also occur from improper lifting of a weight. If proper technique is not maintained, the back can become overly stretched, causing injury to the disc.  This results from the vertebrae crushing the disc between them. However, if you have strong core muscles and engage them while lifting, they can keep your vertebrae from compressing and crushing the disc.

Lifestyle Adjustments:

Be sure to follow proper bend and lift techniques when you lift a weight, groceries or even your child. It is critical to follow these rules when lifting heavy items:

  • Always use your legs. Bend from your hips and knees and keep your back completely straight when lifting an object off the ground.
  • Never bend and twist. Always position yourself so that the weight object is directly in front of you.
  • Engage your core.  Always keep your stomach pulled in when lifting to help support your back.
  • Keep the weighted object close to your body. This gives your arms more leverage and allows you to lift heavier weights.

Prevent It:

To prevent disc herniations you must monitor your posture when you’re sitting, standing and lifting. Sitting and standing upright, instead of slouched, keeps discs from compressing.  Identify positions and postures that cause pain, usually a flexed and hunched posture (like The Hunchback of Notre Dame), and avoid those positions and postures. Monitoring your lifting technique will ensure spinal health.

Including lower back and core exercises into your wellness routine is a proactive approach to avoiding any spinal issues.

Fix It:

If in severe pain rest is prescribed.  However, be aware that staying in bed for any more that 1 to 2 days can weaken the muscles and make the problem worse.  If possible walk intermittently throughout the day to maintain muscular strength.  Using a heating pad and/or taking a hot shower for a maximum of 15 to 20 minutes may also help to alleviate severe pain.

The only possibility of a permanent solution to the problem is to include core-strengthening exercises to your wellness routine.  Core -strengthening exercises are the best way to alleviate pain associated with disc herniation and will keep the pain from returning.  Follow my three suggested exercises to help you with your herniated disc.

Contact Info

Dmitry R. Choklin
PT, DPT, CSCS, CKTP

Cell: (917) 328-8098
Fax: (866) 282-1162
Email: dchoklin@yahoo.com

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