Bulging discs – A pain in the butt!

Almost all of us will at some point in our lives experience lower back pain. Chronic  lower back pain is a condition that drives people straight to the nearest clinic to find out  what can be done. Often the doctor will prescribe physical therapy. If this doesn’t do the  trick, cortisone injections, or ultimately surgery is suggested. 

Injections or surgery “may” reduce the pain but will not address what is causing the pain.  We must begin to recognize that in most cases chronic back pain is a symptom of  musculoskeletal dysfunction. We can attempt to fix the “symptom” by getting an  injection, removing a disc, or fusing vertebrae, but this will not deal with the underlying  cause. This is why many people experience pain relief only to have the symptom  reoccur. I’m not anti-surgery or injections in all cases, although I do advocate trying  other solutions first, but I believe it’s imperative to address alignment instead of just treating the symptom. There is a reason the disc bulged and the dysfunction is still present even after an injection or surgery. Ultimately, we must remove the cause to  assure pain symptoms won’t reoccur. 

When you address WHY your back hurts only then can you alleviate pain long  term. Basically the back is a series of curves. You have a lumbar and cervical curve, which should be in mild extension, and a thoracic curve, which should be in mild  flexion. The muscles surrounding the spine should support these curves for a healthy  spine. 

Muscles only follow orders, and if they are not being told to move, they learn to stay  where they are. In our society we spend a great deal of time sitting at a desk at school or  work, on a computer, in a car, or in front of a TV. Due to this more sedentary lifestyle,  the spine loses its structural curves and flexibility becoming more rigid. Sometimes we  have the weekend warrior who after sitting most of the week decides to play a game of  golf or tennis. The body is unable to handle the excessive strength and rotation these  sports require on a rigid and often flexed lumbar spine and this can lead to disc issues and  back pain.

There are many terms that are thrown around in the medical world describing this condition: Ruptured disc, torn disc, slipped disc, collapsed disc, disc protrusion, bulging  disc or herniated disc. Don’t let all these terms scare you, these are just terms diagnosing  a symptom. This condition CAN be alleviated, the body just needs the right stimulus to correct whatever is causing the disc to bulge and push on the nerve. It’s not the disc  that’s actually causing the pain, but the nerve that’s being pinched. This radicular pain  that comes from the nerve root can be referred to other parts of the body. If the nerve  being pinched from the disc bulge is the sciatic nerve then one may experience pain  running down the leg. For example, if someone has an elevated left hip, the sciatic pain  from the herniation may be on the right leg because the disc is being shifted and  compressed to the right. Surgery can remove the piece pressing on the nerve, but it will  not address the elevated hip and potentially rounded lumbar spine that is causing the  herniation, so you can see how symptoms are likely to reoccur.

The disc is the tough pad that acts as a cushion between the vertebrae. With a disc  herniation it is being squeezed by the bones until it ruptures or comes in contact with a  nerve. As I mentioned earlier, the doctors want to remove the piece pressing on the nerve.  Here’s the issue – I believe the back is designed to use all of that disc! Sure it’s currently  pressing on a nerve and that is causing severe pain, but the important question to ask is  how did it get there? The only thing that shifts bones is muscles, so if muscles moved the  spine into its dysfunctional state, they should be able to shift it back to its functional  alignment. 

The majority of disc herniations will occur in the lumbar spine at L4-L5 or L5-S1. In  most cases if the pain caused by the herniation persists for over 6 weeks, doctors may  recommend surgery. A microdiscectomy is designed to take the pressure off the nerve  

root. In this surgery, a small portion of the disc that’s pushing on the nerve is removed.  Although the surgeon will tell you the success rate of this surgery is about 95%, what  they are not telling you is that a smaller percentage of people will experience another disc  herniation within a few months! And a larger percentage will experience symptoms  again within a year. Why is this? Once “again,” the symptom has been dealt with, (being  the disc pushing on the nerve), but the cause (being incorrect curvature of the spine and  possible rotation and pelvic misalignment) remains the same. In many cases if these disc  herniations occur multiple times a lumbar fusion surgery will be recommended. 

Some people say you may not completely heal the ruptured disc; however, it has been  proven that the discs can shift back into place if provided with the right stimulus and by restoring proper structural alignment and there are MRI’s to prove it. When restoring  

alignment it is possible to prevent the disc from leaking onto the nerve root and this may resolve the pain symptoms, which is typically the main concern. Therefore, it makes  sense to attempt to restore the body’s alignment before rushing into surgery. As  previously stated, even if you do opt for surgery, the problem is likely to occur in the  future with another disc if the musculoskeletal problems that caused the herniation have  not been addressed. 

Although the symptom is not our main concern, it is important to understand what is  causing the pain. The treatment for back pain due to a disc herniation for example can be  quite different than that for other symptoms of back pain such as stenosis, spondylosis,  spondylolisthesis, spinal arthritis, or disc degeneration. Therefore, what exercises you  may prescribe to alleviate one form of back pain may exacerbate another. This is why  customized exercise menus that address each individual’s specific alignment issues are  very important when dealing with lower back pain. 

So in summary, remember that the spine with its correct curves intact is a natural shock  absorber. Therefore, to alleviate pain symptoms, we must first restore the proper spinal  curves and joint alignment. This allows us to strengthen on a more stable frame, and  ultimately regain functional mobility, stability and biomechanics. In order to achieve this, we must regain awareness and control of our body. Pain symptoms will come and  go, but it’s important to remember that by continuing to focus on correcting dynamic  alignment and posture, these symptoms will become less prevalent and can ultimately be  resolved. 

Lisa Decker M.S. 

PAS, CES, PES, CPT, CAMQ 

www.alignedfit.com

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