Slipped Disc – The do’s and dont’s of Rehabilitation
A slipped disc in the lower back (lumbar spine) is a common problem and can often be overlooked, mis-diagnosed and treated with exercises that may worsen the problem rather than help it. It is extremely important to have a correct and specific diagnosis for your low back pain in order to treat and advise any rehabilitation.
A pelvis being ‘out of line’ or having ‘Sciatica’ is not a real diagnosis because they don’t tell us what it is about an ‘out of line’ pelvis that is causing pain or what is causing the Sciatica.
What are Discs?
The Discs in the spine are basically our shock absorbers with several outer layers of tissue (fibro-cartilage) and a thick fluid in the centre. A slipped disc is caused when the thick fluid within the centre works its way through the layers of tissue and bursts out. This mostly happens slowly over time and then suddenly the fluid pushes through the final layer and hits the nearest nerve – often the ‘Sciatic nerve’.
Generally speaking, if you bend forward, the vertebrae in your back squeeze together at the front and push the fluid in the disc backwards, a bit like squeezing a toothpaste tube at one end and watching the paste come out the other. Sitting down and stretching the leg out will often have the same effect and if it gets worse, coughing, sneezing and even laughing may also push that fluid onto the nerve and cause pain.
Now, there may be other reasons for sciatica of course, and coughing, sneezing and laughing are not definitive ways to diagnose a disc problem. But without having x-ray vision Osteopaths and other practitioners have to go on what makes sense. We ask ourselves, what is logical and most likely depending on the symptoms and specifics of the person. We then test and make a diagnosis followed by specific treatment and sound advice.
Can exercises make it worse?
So let’s get to the nitty gritty.. if you have been diagnosed with a disc bulge (slipped disc) or you suspect you have one, you can see that bending forward may actually push the disc further onto the nerve. So logically, makes sense to avoid anything that bends the spine forward, such as stretching the back by bringing the knees up, picking anything up from the floor, slouching on the sofa, or leaning forward on the seat in front of your computer.
What might be more beneficial is sitting straight and perhaps gently arching the back (tilting the pelvis) which should encourage that fluid to move away from the nerve and reduce the pain. Breast stroke swimming could also be advantageous and perhaps laying face down with your arms in front and gently lifting one arm and the opposite leg off the floor, we used to call this exercise ‘Supermans’ for obvious reasons I think..
How long will it take?
Disc problems can take some time to heal so you will need to be patient. Having an MRI scan early on won’t necessarily change anything so it isn’t always worth rushing into. If the pain increases over time and the symptoms worsen, then of course a scan will be needed to assess what is happening.
The simplest problems often cause the most pain and worry, but rest assured, the majority of disc problems do resolve over time with the correct treatment, advice and rehabilitation. However, try to remember you really need a correct and specific diagnosis, so ask the right questions. What is it about the pelvis being ‘out’ that is causing the pain? or what is causing the Sciatica? When you have a specific diagnosis, you can then do the right rehab to help resolve the problem.
I hope this gives you a little more info about back pain, thanks for reading.
For more information see www.jhoughtonosteopath.co.uk or call me:
Thorpe End Clinic – Norwich: 01603 291925
Text or Call Mobile: 07736 449603
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