So you slipped\/popped\/herniated a disc.\u00a0 Nope nothing sipped or popped really. But this sucker hurts.\u00a0 Like a lot.<\/p>\n
Let’s back up a minute. What the hell is a herniated disc and why does it cause so much back pain?<\/p>\n
Ok here is a bit of a small anatomy lesson.\u00a0 The spine is made up of bony vertebrae and in between them sits a disc that is made of connective tissue with a gel filled middle.\u00a0 Picture a jelly donut with the donut part actually made up of concentric rings layered like an onion.\u00a0 Are you with me so far?\u00a0 Ok, so then really close to these discs are nerves on either side of the spine at each disc level (kind of).\u00a0 Now that you have that picture in your head I can explain what happens to the discs sometimes when we injure them.<\/p>\n
Sometimes with repetitive movement, lots of flexion, sitting, moving, lifting, standing (and just life in general – because these things are cumulative) the jelly in the disc starts to make its way through the concentric rings causing the outer layers of the jelly donut to bulge outwards.\u00a0 If this bulging is anywhere near the nerve the nerve gets ANGRY. Nerves do not like pressure. Nerves. Do. Not. Like. Pressure.\u00a0 In fact it only takes 8 mm of pressure to cause the nerve to have altered function and possibly cause pain, numbness or a whole host of other symptoms.\u00a0 8 mm of pressure is the amount of pressure you feel on the back of your hand if you place a dime on it. So not much pressure on the nerve and you get back pain. This is just mechanical pressure but the nerve can also be irritated by chemical mediators released in the area such as inflammation… ok lets not get too complicated.<\/p>\n
Where were we?\u00a0 Ok, we have a bulging jelly donut and this is causing pain in the nerve.\u00a0 This could translate into back pain, back pain with leg pain or even numbness and tingling in the leg.\u00a0 This can get even worse if the jelly makes its way all the way out of the\u00a0 donut rings and we call this a herniated disc.<\/p>\n
Right so what do we do?<\/p>\n
Firstly most herniated discs do not like flexion of the lower back or increased intra abdominal pressure.\u00a0 That means sitting, bending and often coughing and sneezing too.\u00a0 These things will cause increased symptoms and should be avoided if possible.\u00a0 Because of the common course of herniation bending forward at the waist\u00a0actually forces the jelly in the donut backwards causing the bulge or herniation to get worse.<\/p>\n
For this reason those with a herniated disc may respond really well to the McKenzie protocol which I prescribe to patients in my clinic.\u00a0 I am going to upload a video with a simple exercise below but you have to promise me that if you suspect you have a herniated disc to please go check with your health care professional to make sure that this is the thing for you to do. If you do try it on your own and symptoms worsen – STOP.<\/p>\n
Ok now that that is out of the way\u00a0 – the easiest (but not always the correct) McKenzie exercise to show you are simple back bends or extensions.\u00a0 All I want you to do is stand up and put your hands on your lower back. Then bend backwards keeping your neck in neutral and arching only your back then stand up again.\u00a0 I want you to do that 5-6 times in a row – all of this should take less than 15-20 seconds.\u00a0 That is it. If you are doing this right and you do have a herniated disc the pain or numbness in the leg should feel better a little bit better.\u00a0 If it feels worse please discontinue the exercise!!!<\/p>\n
****Important note – if you have bowel or bladder changes such as a loss of control you need to seek emergency care – as in go to the Emergency Room.\u00a0 Do not pass go, do not collect $200. Ok?<\/p>\n
Good.<\/p>\n
Right, so if this exercise does make the leg pain or numbness less but increases the lower back pain that is actually ok and expected… If it does some of all of these things you can do this up to once an hour.<\/p>\n
You still need treatment and fast so please contact me or another health care provider so that we can help you\u00a0 – hope this helps!!!<\/p>\n
Exercise video listed below (underlined: “McKenzie Exercise” please click it and it will take you to the video)<\/p>\n