Here is an article to debunk the myths around disc hernias. The term hernia simply means the release of a substance or body cavity, and through the term that follows the word, the area affected is designated; for example, inguinal hernia, umbilical hernia, and so forth.
A herniated disc is not a disaster. It is usually treated well if you follow recommendations. It is a protrusion of intervertebral disc nucleus, usually backwards. To illustrate this, compare it to a donut with cream in the center. If you press the front of the donut, the cream will ooze out towards the rear; this is what happens with the core of the disc. As the nucleus remains inside the disc, people do not feel pain because the disc is not innervated.
But by way of being compressed (by gravity, poor posture, or excess weight), the nucleus gradually seeps into the annulus of the disc (protrusion) and a crack forms in the disc. When the kernel is propelled backwards, there is no pain until it comes into contact with the posterior spinal ligaments, which themselves are richly innervated.
It is often the first warning that something is wrong when the person begins to experience lower back pain. This pain becomes worse on waking and in the afternoon. It is increased by a half-flexed position and cough. Sometimes the person may get a “catch” because the back muscles undergo spinal lumbar spasms to prevent the further protrusion of the nucleus. If this situation is not corrected (if the person does not consult a doctor, or does not pay attention to posture or recommendations made), the core can continue its course through the ligaments and end up a herniated disc without neurological signs.
If one or more nerve roots are compressed, we experience neurological signs such as reduced reflexes, loss of skin sensation and loss of strength in one or both legs. A herniated disc is treated the same way as other disc problems, but recovery takes longer when there are neurological signs.
Sometimes an epidural is required. If the hernia is very severe and compresses the nerve roots or spinal cord, traction will be immediately considered. A herniated disc is not produced by trauma, but by an accumulation of injuries. It has been proven that direct trauma with a compressive force in excess of that which we experience on a healthy disc cannot itself produce a herniated disc.
To treat it, we must focus on exercises that promote the expansion of the core shifting back inward. It’s like pressing the back of the donut to return the cream to the center. For the lumbar region, lie on your stomach, and using your hands, arch your back backwards until your belly is off the ground. Do 3 sets of 15 repetitions. These are excellent exercises that you should do 3 times a week to prevent a recurrence.
I have simplified the explanation somewhat in order for you to understand the phenomenon and how to deal with it; in reality it is much more complex than that. The condition, in fact, even produces a local inflammatory reaction with the release of chemicals that cause pain. When the inflammation has subsided, the pain often disappears even if the hernia continues to be present.
The majority of herniated discs occur at L4-L5 vertebral-S1 and C4-C5-C6; because these are areas of frequent adjustments and hypermobility, this is where the disc wears down the most. Herniated discs are very present in areas of stiffness. When inflammation irritates the nerve roots L4-L5-S1, which are the origin of the sciatic nerve, you feel pain in the posterior leg.
It is for this reason that people suffering from pain in the posterior leg say right away that the sciatic nerve is involved. It is not always the case.
When the sciatic nerve is the real issue, we must find where it is agitated, and it isn’t always in the lumbar spine. If the pain does not move below the knee, it is unlikely that the sciatic nerve is involved. It’s the same principle with the upper limb and the nerve roots C5-C6-C7. On a positive note, the core of the disc consists of a liquid that dries up over the years.
So beyond 60 years, it is rare to meet someone who suffers from a herniated disc. In addition, several studies show that long-term outcomes between a person treated for a herniated disc and one not operated on are similar. Finally, if leg pain persists despite surgery, as is sometimes the case, it is no longer the hernia that is at stake. Following the operation, as with any traction in fact, adhesions may form in some depth that limit the mobility of the nerve root.
In these cases, treatments of neural mobilization are very effective and the majority of stakeholders in physiotherapy and osteopathy know these techniques. Sometimes, the cause lies within the pelvis. If the pelvic floor muscles remain tense, it can irritate the nerve roots that pass this place and perpetuate sciatica.
Finally, the most important thing to me is – and will always be – prevention. If you maintain good posture and keep to recommendations concerning posture, you will minimize your chances of developing a herniated disc. Remember, when you’re sitting, align yourself straight and keep your the curves of your spine natural.
For people who sit for long hours at work or in their car, get a good lumbar cushion. Never make efforts to lift an object by bending using your lumbar region; keep your back straight, and bend your knees instead, using the force of your legs. Never use your arms themselves to lift objects around you.
Avoid strenuous activity involving twisting motions. If you have lean forward for a period of time, press your foot down on a low stool; it will relieve some of the load on the lumbar region.
For example, if you shave or do the dishes, open the door of the counter below and press down on the bottom shelf. If need to lift an object, tighten your abdominals before you lift the load, this will remove about 30% of the load on the disc.
In addition, if you have ever suffered from back pain, you have every interest in strengthening the transversus abdominis muscle, because this muscle is the primary stabilizer of the lumbar region and inhibits its pain. If you do not strengthen it, it will not turn on automatically and you will tend to injure yourself repeatedly.