Chronology of an Injured Disc
The burning pain of a herniated disc is a centralized attack on the spine. The lower back, known as the lumbar vertebrae, begin at the top of the lower bend of the back and five vertebrae later end where the sacral vertebrae begin. The lumbar area is the most common area to experience back pain.
It doesn’t matter which one of those five discs are causing problems, the one common denominator is the debilitating pain. If the pain is located in your lower back, you’re apt to sense some significant pain in your buttock, hip, or leg, with some numbing in your ankle, shin, or foot. This condition is commonly known as sciatica. In most cases, it is caused by a bulging or herniated disc. It can also be caused by degenerative disc disease which is a condition where the disc releases proteins that inflame and irritate nearby nerves.
It is a fact that as aging progresses some level of degenerative disc disease is common in 85% of the population. As the disc weakens through the degenerative process, it becomes more vulnerable to injury. It is possible to herniate a perfectly healthy disc by lifting something too heavy.
Spinal vertebrae compress the disc unevenly through normal activity such as sitting, the manner in which you rise from your chair, or by doing anything that involves the spine. Such as certain types of exercise. Muscles and ligaments that are not warmed up and stretched have the potential to bind up at a time when you need them the most and could pull your spine out of alignment. A disc could herniate lifting a 500-pound gorilla or grabbing a 20-pound dumbbell. It's not the amount of weight you lift but the mechanics of how you lift.
Your spine is in serious peril if your daily routine is to rise from bed, dress, grab a quick cup of coffee, and then dash out the door and head off to work. If your spine is out of alignment and you are suffering from lower back pain, a routine of therapeutic exercises - in many cases - will provide back pain relief. But first, let's take a look at some exercises that if not done correctly might cause a disc to rupture.
Exercises that executed incorrectly could herniate a disc:
- Exercises or stretches that require some type of toe touching, especially in the morning
- Some types of yoga could cause a disc injury such as sun salutations or downward dog
- Many types of Pilates exercises are not recommended for people with lumbar issues
- Crunches – this is an abdominal exercise that provides little benefit because crunches are especially hard on the lower back and do very little for toning up your core
- Bent over rows while not keeping the lower back arched. Any type of strength training performed with improper form can cause a disc to rupture
- Bike riding is hard on the lower spine. We don't want you to stop riding your bike unless you have an injury and are doing physical therapy. But be aware that proper bike riding form will help you maintain a healthy spine. Try to keep your lower back in a neutral position when bike riding
Exercises to stay away from when you have a herniated disc:
- Don't do sit-ups with legs straight or bent
- Stay away from machines that isolate your abdominal muscles. The problem with many machines in the gym is that they do not mimic natural skeletal movement. Too much twisting and unnatural movement associated with machine workouts
- Running will aggravate a herniated disc but no two spinal injuries are the same. Be sure to ask your physical therapist or your doctor before you resume running as a form of exercise
- Squatting with any weight will place unbearable strain on your spine causing the vertebrae to unduly squish your discs out and into sensitive nerve roots
- Lower back extensions could exacerbate an already painful condition
- Stay away from most forms of resistance training such as squats, deadlifts, and bent over rows
Exercises that help manage back pain:
The goal of the following exercises is to improve flexibility through the stretching and strengthening of your abdominal core. Forget about the 6-pack; we want to get you back on your feet again. Don't forget to check out the link that includes an infographic showing how to do the following exercises.
- Begin with a 5-minute low-aerobic warm-up exercise with a stationary bike. It is nearly useless to try to stretch muscles that are not warmed up
- Hamstring stretch – Lie down on your back with both legs extended. Lift one leg as close to 90 degrees as you can get. Use a stiff strap, a towel, or place your heel up against the side of a wall to support your leg. Hold each stretch for 3-minutes. Repeat with the other leg.
- Hip flexor stretch – Lie down on your back with legs extended and arms by your side. Lift one of your legs off the floor and bring it as close to your chest as possible. Don’t stretch into or beyond your pain threshold. Hold the stretch for 3-minutes. Repeat with the other leg.
- Planks – Lie down on your belly with arms positioned in front and your legs extended. Place your elbows and forearms under your shoulders with your toes ready to prop you into an upward position. Hold this position as long as possible with the goal of eventually hitting 2-minutes. Don’t expect to hold this pose any longer than 30 seconds if you’ve never done them before. Do 5 planks.
- Child’s Pose – In between planks, go into a child’s pose for a minute to stretch the lower back and shoulder muscles.
- Bridges – Lie down on your back with your arms to your side and your knees bent with your feet flat on the floor about shoulder-width apart. Keep your head and feet to the ground as you lift your abdominal area upward. Hold this position for 30 seconds. Two to three bridges per workout should be adequate.
- Side Planks – Lie on one side or the other. Place your legs and feet perpendicular to each other. Prop up your abdominal area by lifting yourself upward, resting your weight on your forearm. If balance is a problem, you can begin this stretch by positioning your legs at a 45-degree angle. Do 20 repetitions. Turn yourself over and repeat.
Is Surgery Necessary?
It is possible that your back pain is so severe that a prescribed pain-killer is the only relief available. With the opioid epidemic that America is going through now, opioid prescriptions are becoming harder and harder to obtain. In most cases, that is a good thing. However, the pain will severely reduce the body's ability to heal itself. Only 5-10% of patients who have a herniated disc will need surgery. A herniated disc is often found to be inflamed and sometimes an anti-inflammatory is prescribed. The pain may be so severe that you will need to see a pain specialist who may prescribe medication along with an epidural to see if that provides relief. If after you and your doctor have reviewed your MRI, and it is agreed that you do in fact need surgery, know that there will be a period of time involved in the healing process. However, whether your spine requires surgery or it does not, at some point you will be referred to physical therapy. Physical therapy is the most important part of the healing process. Whatever you learn from PT will remain with you for the rest of your life. However, it is worth noting that if a ruptured disc is diagnosed early enough, physical therapy may be all that is needed to relieve the burning symptoms of disc herniation. If you are in the early stages of disc degeneration symptoms can usually be managed with some type of physical therapy.