Degenerative Disc Disease Causes and Treatment

Degenerative Disc Disease Causes and Treatment

Degenerative Disc Disease        

    

A very common diagnosis among people with back pain is degenerative disc disease. This is usually a disorder related to the aging of the low back and is actually quite normal. As we get older the discs in our low back get a little more stiff and have less fluid in them. This is what ultimately causes some of the “stiffness” and “aches” in our low back.  Movement is often the key to fixing the pain caused by degenerative disc disease. Watch the video below to learn more.

Best Exercise for Bulging Disc and Sciatica

Best Exercise for Bulging Disc and Sciatica

Best Exercise For Bulging Disc

If you have had back pain with sciatica chances are you may have been diagnosed with a bulging disc or herniated disc. A bulging or herniated disc is a very common problem that can cause sciatica pain down the leg and pain in the low back. This sciatica pain is often caused by too much bending forward of the back during lifting and sitting slouched. In order to calm down the sciatic and low back pain, the OPPOSITE of bending forward can often give relief to the area. Many people will spend time doing various types of stretches that actually make the condition worse!

What is a disc?

The disc is a cushion in our low back that sits between each vertebrae. The purpose of the disc is to absorb shock and allow for greater movement in our spine. The disc also helps create space for the nerves in our low back to exit the spinal cord and go down into the legs. The disc is made up of two different portions. The outer ring which can be characterized as a “protective wall” encases the more fluid portion (think jelly like material). The makeup of the disc allows for shock abortion and mobility in our back and neck.

Bulging Disc and Sciatica

What can cause a bulging disc/herniated disc and sciatica?

Typically, an injury to the disc happens with either:

  1. Repetitive movements (this includes posture) or
  2. Sudden movement that usually involves lifting or transferring an object.

Many people who experience back pain or sciatica say “the pain came out of nowhere”and that it “was not caused by any particular movement”. In these cases, the likely cause of the sciatica and back pain is due to repetitive movements over time or poor posture. When we perform the same movements throughout the day (typically bending our spine forward) our body sounds the alarm (which is pain) to let us know that we need to change the way we move. The same can be applied for our postures in sitting and standing. We typically spend most of our days in a “slouched posture”. Over time our body becomes weary of this position as it can cause more pressure to be placed on the disc. One of the hallmark signs of a bulging or herniated disc is pain with sitting in a slouched posture. Once appropriate postural corrections are made then sitting can become less painful. You can read more how to fix sciatica here.

The second reason for pain with a bulging disc or herniated disc can come from the movement that occurs with lifting a heavier object or the combination of lifting and twisting at the same time. When a movement like this takes place an increase amount of pressure is placed on the disc all at once causing it to result in pain and discomfort. Again, this is another way of your body telling you that you need to be more aware and diligent about how you perform lifting tasks in order to prevent any further injury! Whatever the cause of the herniated and bulging disc might be it will still be important for you to understand the common signs and symptoms of his type of injury. You can read more Top 3 Signs of a Herniated Disc here.

Do you need an MRI or scan in order to diagnose a bulging disc?

MRI’s and other scans are not necessary for the typical low back pain or sciatica episode. There are many instances where the imaging “finds something wrong” in your low back and points to that as the reason for the pain but what researchers have recently found is that this may not always be the case.The condition can be diagnosed with an appropriate history taking and movement analysis. A good clinician will be able to assist you in understanding what is causing your pain and what you need to do about it without needing expensive unnecessary imaging. Do you need an MRI? You can learn about why spending more money for an MRI may not help your condition.

Can Bulging Disc Heal?

Yes! Discs can be healed. Movement is the key to healing and returning back to living a life pain free without relying on medications, injections or surgery. Understanding which movements make the pain worse and what movements help decrease the pain is important for healing in a timely manner. The time frame for which healing occurs depends on several factors including how long the pain has been going on for, severity of pain, nature of the injury, and work/exercise factors.

What is the best exercise for bulging disc/herniated disc and sciatica?

If the correct diagnosis has been made then appropriate exercises can be undertaken in order to begin healing and start moving pain free again. A commonly prescribed exercise is bringing your knees to chest in some form or variation

While this exercise may provide some short term relief it actually can make the condition worse because it applies more pressure on the disc. You will want to avoid any variation of exercise that involves bending your spine including the above mentioned stretch and child’s pose. (In some cases these exercises can be beneficial HOWEVER in the majority of cases they are incorrectly administered and are the opposite of what you will want to do!)Watch this video below and try the exercise to help decrease your sciatica and low back pain.

What else can I do?

If you are experiencing bulging disc, herniated disc, or sciatica pain then first thing you MUST do is avoid panic and fear. Understand that back pain will occur in 80% of the population at some point in their life and will go away with appropriate treatment. Recent research suggests that in general you want to avoid bed rest and stay as active as possible (within pain limits). Taking the appropriate steps to change your movement patters, adjust your posture, and performing the right set of exercise can allow you to heal and return to pain free movements.

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 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.