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.   

How Can You Understand Your Pain?

How Can You Understand Your Pain?

                          Are you having trouble describing your pain?                      

Can you rate your pain on a scale of 1-10? We all dread that question when we go to see the doctor. What does it even mean? As a Physical Therapist, I do not enjoy asking that question (in fact I avoid it as much as possible) because most of the time people feel that they have to be EXACT and maybe their pain isn’t so exact as a number. It can be frustrating to pick a number that represents our pain because pain is more than just a number; it affects our lives, our ability to exercise, perform our jobs, and enjoy time with family and friends.             

I myself have dealt with pain involving back and sciatic pain.  What I found through my rehab process is that it was more beneficial to focus on what I could do and how I did it, as opposed to my levels of pain. The more I focused on my “pain” the negative thoughts that came with it would creep into my head. I worried about if there was any end in sight. It made all the difference when I switched my view from focusing on “pain” to focusing on what I could do. When the focus was placed on my pain the thoughts would creep into my head…. ‘Will I need surgery?’ ‘How much longer will this last?’  Even as a Physical Therapist I questioned whether I would get better.        Understand Your Pain   

What Is Causing Your Pain?              

What’s more important than rating our pain on a scale of 1-10 is to know what “causes” our pain. Whether it be sitting, standing too long, running, or exercising, this information can give us good intel into how to handle our pain. From there we are able to determine what can help alleviate our pain, which may include moving more often, performing a certain stretch, or resting from exercise.  All of this information is key to finding out the solution on how to fix the problem.           

Many people have a fear of explaining or discussing their pain because it’s so hard to describe that they may not think its believable. I find that using common descriptions can be helpful in this situation. I’ve often heard patients tell me “it feels like an ice pick” or ” it feels like there is a block that won’t let me move further”.  These analogies can give good insight into whether the pain is coming from a muscle, joint, or nerve.

Pain can often be complex, we all may have experienced it at some point in our lives, but each of us experiences it differently. It may be time that we shift our focus from the “number” of the pain and more towards our pain experience. From there we can assess what areas of our lives it affects and how we can go about changing it. Once you find a health care provider who listens and understands your pain, it can make all the difference in the world in helping you return to the activities you love.

How Should You Handle Your Low Back Pain?

How Should You Handle Your Low Back Pain?

Take Care of Your Back Throughout the Day

 

You floss and brush your teeth for good oral hygiene. Your goal is to prevent disease, delay decay, and help avoid expensive dental procedures that neglecting your mouth health might bring about.  By performing this daily maintenance routine, you ensure that you do not run into any future issues with your gums and teeth. This helps avoid costly dental bills. You also take good care of your skin by applying sunscreen to help prevent damage to your skin cells and any further medical issues down the line. So what are you doing for your spine? Are you practicing good spine health techniques to help limit your discomfort and pain? Do you perform “routine” exercises to help improve spinal mobility and muscle performance? There are several techniques you can perform throughout the day to help ensure good spine health. Best of all, these techniques do not require any fancy equipment or expensive products.

1. Engage your spinal stabilizing muscles.

Often times when people hear this they think of participating in Pilates, getting in a plank position, or performing some sort of rigorous workout targeting core muscles. While there is nothing wrong with partaking in these tasks, they are not always readily available or easy to do throughout the day. There are simple techniques you can do often throughout the day without anybody really noticing. First, sit towards the edge of your chair. Pretend there is a string on the top of the back of your head that is pulling you toward the ceiling. You should feel your stomach tighten a little. You should also have the sensation that you are “holding” yourself in place. Congratulations, you are now in a neutral spine alignment and relying on your “muscles” to do their job and support your spine.  You will want to hold this position for at least 10 seconds. Perform at least 4 times an hour. (The recliner and couch prevent us from keeping this alignment.) A                                                                                          B

Picture A demonstrates sitting without activation of the core muscles.

Picture A demonstrates sitting without activation of the core muscles.

Picture B demonstrates sitting with good activation of the core muscles in neutral alignment. 

Picture B demonstrates sitting with good activation of the core muscles in neutral alignment.

 

You can also perform this in standing when you walk. You will want to again pretend there is a string on the top of the back of your head that is pulling you toward the ceiling. You should feel your stomach tighten as if there is a “natural corset” surrounding your spine. This will help you engage those muscles when you are in more functional walking and standing positions.

2. Perform regular Low Back/Pelvic mobility exercises.

Sitting is often a position where a lot of back pain can be experienced. This can appear a lot with people who have a typical desk job or need to sit for extended periods of time. Try this technique out: Next time you are sitting down, try to perform pelvic rocking periodically to keep the spine nice and mobile. (It will often stiffen up after sitting for a while.) Follow these steps to perform a correct and safe pelvic rocking.

  1. When you are sitting down, slowly rock your hips back so that your low back slouches a little. This will put you in a flexed posture.
  2. Next rock your hips forward so that you begin to arch your low back. You will now feel that you are bending your back backwards.
  3. Now rock back and forth between these two motions in a slow and controlled manner.
  4. Note: If you have pain going into either of these positions you will need to stop just short of that pain in order to perform the movement in a comfortable pattern.
  5. Perform 15 repetitions each way several times a day as tolerated.

A                                                                                       B

Picture A demonstrates hips rocked forward with your spine slightly bent backwards.

Picture A demonstrates hips rocked forward with your spine slightly bent backwards.

Picture B demonstrates hips rocked backwards so that your back is slightly slouched.     

Picture B demonstrates hips rocked backwards so that your back is slightly slouched.

     

 

 

 

3. Standing Spine Stretch.

Often times people will focus on bending forward to stretch their spine, but is that what we should be doing? At times it will be necessary to do this, but for some conditions, the spine may prefer to bend backward more often than forwards.           Standing Spine Stretch, reduce low back pain

To perform a different kind of spine stretch, raise your hands above your head while they are locked together. Now reach your hands and arms high towards the ceiling. This should create a natural backward bend in your spine. The goal here is to not get too aggressive but to work out any stiffness that may be present. Hold this position for 10 seconds. Perform 1-2x an hour to take breaks from sitting.

If you have back pain that makes it difficult to sit, stand, or participate in the activities you love, then you may want to start putting a little more attention on your “spine health”. Much like maintaining good healthy habits for our teeth and gums to prevent any disease, we should also be focusing on a nice healthy spine regiment throughout the day. This will help you to feel less pain and stiffness while gaining more confidence about your back throughout the day.

Does Stretching Help Your Pain?

Does Stretching Help Your Pain?

Should You Stretch to Get Rid of Your Pain?   

  

Just keep “stretching”…….does that sound familiar? Often times it’s a phrase used when you have been seeing a medical professional for some kind of musculoskeletal pain and you haven’t seen the results that you’d like. You may have come across an article on the Internet or been given advice from a friend that tells you to “stretch” whatever body part is painful. There lies the problem though. Most of the time “stretching” just isn’t enough to solve your problem. Sure, it is a part of the solution (but most of the time its <10% of the solution!). Think about it for a second. When is the last time you had persistent pain and was able to “stretch out” the pain for it to go away (without it coming back).  That clinically doesn’t happen very often. I see it on the faces of frustrated individuals who are still in pain despite their persistent stretching. While stretching can help improve the flexibility of your muscles, it does not address underlying deficits in muscle strength, endurance, stability, and motor control (the ability of your muscles to move efficiently within a certain range).  Deficiencies in these areas are more likely the cause of your musculoskeletal pain and stretching does not help improve those deficiencies. For instance, those tight muscles you are “stretching” are often muscles that are tensing up because they are being “overworked” due to weakness in other surrounding muscles.                 Should You Stretch to Get Rid of Your Pain?    Let’s use an example of the “low back”. When you have muscles that constantly tighten up in your low back and you experience a “stiff” feeling, then that is likely due to weakness in the stability muscles of your back. Those stability muscles are not performing their job very well causing the muscles around them to work overtime. What happens when you yourself work overtime? You become tired, maybe a little irritable, and not pleasant (think about what your muscles go through!). Same goes for the neck. This day and age, with computers, the amount of people with neck pain has definitely spiked in numbers! One of the most common occurrences with neck pain is a feeling of tightness in the neck down into the shoulder area. Stretching won’t help this condition, at least not unless you address the weak muscles that aren’t doing their job of supporting the spine and other joints.

Does Stretching Work?

Now, by no means am I saying that stretching is bad for you or that you shouldn’t stretch. I am just discussing how stretching alone is often not the solution to your musculoskeletal pain. Many people who have come to see me say they have been through a “stretching” program and it hasn’t worked.  People often think of exercises as being a series of stretches, and while stretching is considered a form of exercise, it is certainly not the only form. There can be much confusion out there on what form of exercise can help decrease pain and get the body to move pain-free again. This is usually done with a combination of tactics including hands-on techniques to help relieve pain followed by strength and stability work on the muscles. Research supports comprehensive programs when it comes to addressing our pain. While stretching can be a component of these programs, it by no means should be the only form of exercise used to address your pain. It is important to be able to target the specific muscles, nerves, or tendons that may be causing your pain. This can be done with a proper assessment of the area where your discomfort is to determine the source. Then by figuring out what the source of the pain is you will be able to understand what type of exercise will be most appropriate for that specific problem. So if you have been in pain lately (maybe even for quite a while) I would ask, “has just ‘stretching’ been able to help solve your problem?”