Top 3 Signs of a Herniated Disc and What You Can Do About It

Top 3 Signs of a Herniated Disc and What You Can Do About It

Top 3 Signs of Herniated Disc and What You Can Do About It          

        Top 3 Signs of a Herniated Disc and What You Can Do About It        

Chances are that if you have back pain your doctor, or maybe even a friend, has told you that you may have a herniated disc. An MRI can confirm this, but this expensive imaging technique may not be necessary as herniated discs can be diagnosed quite easily with a comprehensive history taking and physical exam. I am not talking about a short 5-10 minute visit with a doctor or neurosurgeon in which you are given a label of “herniated disc”, “stenosis”, or “disc disease”. Typically an hour-long examination is necessary to either rule-in or rule-out other potential causes of your back pain. 5-10 minutes just won’t cut it, and often can leave you wondering what’s next. Below I will talk about the top 3 signs that you may have a herniated disc.

1. Your pain is usually worse when you are sitting.          

When we sit for long periods of time more pressure is placed on our discs than when you stand. If a disc has already been herniated or has been predisposed to a herniation this pressure can often cause an increase in pain in our low back. Often times, as sitting time increases the pain gets more intense and can often refer into the buttock/hip area. Many times this type of pain affects us at work and during social outings such as going to the movie theater. If you suffer with this type of pain you will want to avoid “slouching” when sitting and instead sit with a backward bend, or slight arch, in your low back. If you find this difficult to do you may want to consider placing a rolled up towel or foam roller (about 6—8 inches in diameter) and place it behind your back while you sit in order to keep you upright.

2. Bending forward often causes an increase in pain              

Bending forward or flexing your spine will be one of the more provocative positions for you if you have a herniated disc. Back to the same concept of placing “pressure on the disc”.  Each time you bend forward you increase the pressure on the back end of your disc (think of a balloon that you squeeze on one end and the opposite end bulges getting bigger). Now bending forward isn’t necessarily bad in general, but if you have a herniated disc then bending forward too much can delay your recovery. People with this type of pain usually have a hard time picking up small children/grandchildren and find it difficult to reach down for low objects. To avoid putting pressure when bending forward, perform the “hip hinge” technique. You can do this by keeping your spine straight and only bending at your hips when you reach down. This can also be performed when you go to stand up from a chair as well.

3. You often get numbness, tingling, or pain down your leg.

Herniated discs are the number #1 cause of sciatica. Chances are if you have sciatica it is likely related to your disc problem. If your pain is severe enough, your sciatic pain most likely can be set off by the above-mentioned postures/movements as well. Sciatic pain/numbness/tingling can be caused by irritation by the herniated disc.  This sciatic pain is often described as a “burning” that can make exercise and social outings very uncomfortable. The key to keeping your sciatic pain under control is to know what movement/postures turn the pain on. From there you can do the “opposite” of those irritating movements to help reduce the pain. For instance, many people find relief if they get up and walk while stretching tall. Lying on your tummy can also help reduce your sciatic pain (although this may increase your low back pain slightly, that is okay). These are the hallmark signs of a herniated disc.  Can a herniated disc be healed? Yes, it can! Often times it can be done without expensive surgery (medications and injections just mask the pain and do not fix the true source). Physical therapy is a natural and low cost proven line of defense against herniated discs. You will be given exercises and taught how to move throughout the day to prevent those painful ”flare-ups”.  The key to recovery is getting help FAST before the situation gets worse. If a herniated disc is left untreated it likely will progress to more intense sciatic pain. Do not delay treatment thinking your symptoms will get better. Find a good Physical Therapist that can get to the root of your pain and help you get back to the activities that you love.   

Do you need an MRI for your low back pain or sciatica?

Do you need an MRI for your low back pain or sciatica?

Do you need an MRI for your low back pain or sciatica?Why you may not need an MRI for your low back pain or sciatica.

Often times we look to MRI scans and CT scans to help determine an appropriate diagnosis for someone that is suffering from low back pain or sciatica. Doctors will throw out terms such as “degenerative disc disease”, “stenosis”, “bulging disc”, “herniated disc”, or one of those crazy words like “spondylolisthesis”. But the question remains do these fancy medical terms tell you everything that is going on with your back pain? Do they help you find an appropriate treatment so that you can move pain-free and return to an active lifestyle?

Recent research has shown that these scans may not be helpful at all in understanding your pain. It is likely that they do not assist you in getting the proper treatment. This study published in 2015 in the American Journal of Neuroradiology demonstrated that these degenerative changes are more normal than you think, and are often seen in people WITHOUT pain. Studies have also found that MRI scans are not helpful when determining if stenosis is the cause of low back pain. I will list some of these shocking statistics about the findings on your MRI/CT scan and discuss how this may not correlate with your low back pain or sciatica.

Here are the results you get when you put a person WITHOUT back pain through an MRI or CT scan:

  • 27% of 20 yr olds have disc degeneration but have no pain
  • 80% of 60 yr olds have disc degeneration but have no pain
  • 96% of 80 yr olds have disc degeneration but have no pain

Results of the scans done on people with disc bulge showed:

  • 30% of 20 yr olds have a bulging disc but have no pain
  • 60% of 50 yr olds have a bulging disc but have no pain
  • 80% of 80 yr olds have a bulging disc but have no pain

So what does this tell us?

As we see, the number of people with disc degeneration and disc bulges rises as we age but the key finding is that these people DO NOT HAVE PAIN. This demonstrates that disc degeneration and disc bulges are a normal process of aging and should not always be seen as the cause of your sciatica or low back pain. Also, the link between an MRI picture and the severity of symptoms remains controversial with studies indicating a high number of disc herniations ranging from 20%-76% in people without back pain. Just as aging on the outside (grey hair, wrinkles) is a normal process, so is aging on the inside.

There may be some underlying negative effects of getting that MRI/CT Scan as well:

People may become less active once they are given a label such as “disc degeneration” or “bulging disc” for their back pain. This inactivity can feed into negative thoughts about the health of their spine and decreased mobility as they age. It can also trap people in the vicious cycle of seeing doctor after doctor and getting scan after scan in order to determine what is wrong with them causing them even more frustration! This can all be avoided by understanding the limitations of the diagnoses that MRIs and CT scans provide.

The results of your scan may also lead to unnecessary interventions including pain medications, injections, or even surgeries. Would it make sense to get surgery just based off a picture of your back? Now in some cases, scans are necessary, but this includes a small portion of the back pain and sciatica sufferer population. On occasions, scans are necessary to rule out any fractures, tumors, or serious conditions such as cauda equina syndrome.

Let’s also consider the cost of MRIs and CT scans and how they may not even be useful. Does it make sense to undergo a procedure that will cost between  $500-$2,000, which won’t even with certainty be able to determine how you will get rid of your pain? Healthcare costs are rising, meaning consumers will have to pay more out of pocket. This is something to consider when you are told you need an MRI.

What should you do?

Some questions you should be asking your Doctor if he/she recommends you get an MRI or CT scan include: “ If I get the scan how will it help me feel better” or “If I undergo this test and it shows “X” result are you confident that it actually will aid in my recovery?” The fact of the matter is long wait periods for Doctors and general diagnoses of what “may” be causing your back pain or sciatica just doesn’t cut it, and it certainly won’t help you move pain-free and remain active.

A good physical therapist will be able to treat you without an MRI because you are a PERSON and not a PICTURE. They will be able to determine the cause of your pain and treat you based on your individual presentation of symptoms. A good therapist will be able to LISTEN to you and perform a comprehensive physical exam in order to determine what treatment is right for YOU. If you are an active person with back pain and want to move pain-free without medications, injections or surgery check out my Free Report “7 Simple Steps to Naturally End Your Back Pain (and Stiffness) ”  

Resources:

https://www.ncbi.nlm.nih.gov/pubmed/16813774

https://www.ncbi.nlm.nih.gov/pubmed/25430861

https://www.ncbi.nlm.nih.gov/pubmed/21382687

https://www.ncbi.nlm.nih.gov/pubmed/19139672

https://www.ncbi.nlm.nih.gov/pubmed/20798647

Do you need an MRI for your low back pain or sciatica?