Disc herniations are a common problem among people who spend long hours sitting, heavy lifting, or repetitive bending. Back problems also occur for no particular reason. Herniations are often easy to heal, but people often make mistakes and aggravate the problem. Our physical therapists have outlined 5 mistakes to AVOID with a herniated disc.
Herniations are also referred to as “slipped or ruptured discs” because they occur when the disc between two vertebrae becomes damaged. The damage causes the disc to bulge outwards and press against the nerve roots. Within a few weeks, most painful disc herniations heal by themselves. In many instances, herniations do not cause any pain at all. By the time you are 45 years old, it is not uncommon to have an asymptomatic disc bulge or even a herniation show up on an MRI.
Most herniations cause no symptoms, but some cause severe pain and radiating symptoms into the legs.
The biggest mistakes to AVOID with a Herniated Disc:
Letting fear take over.
Too often, when one hears that they have a herniated disc, they become scared and begin to believe that they will have problems for the rest of their lives. This is NOT true. Many herniations are asymptomatic. Even herniations that cause significant symptoms, 66%, will resolve on their own within six weeks. The other 30% need conservative intervention, consisting of education and exercises. Surgery should be very rare in less than 1% of the cases.
Our bodies have a miraculous way of healing themselves. Unfortunately, poor medicine often slows down and sometimes even stops the healing process by improper treatments. Best outcomes are shown with medical interventions that focus on education and empowerment, understanding the cause of the herniation, and how they can heal—not providing medications and treatments that have no benefit.
Getting an MRI.
MRIs are a highly profound picture of your spine and show a lot of detail. But they are still just a black and white picture. They do not differentiate and show which structures are painful. It is similar to taking a picture of your phone’s circuit board. It may show water damage, but it cannot tell you if your phone is working or not. Only by using your phone can you tell if there are any problems. Similarly, only by moving your spine can we ascertain if you have a loss of motion, which movements are painful, what positions cause radiculopathy, and what movements/postions centralize your symptoms.
Masking the symptoms with medication, rather than addressing the problem.
Instead of covering up the symptoms with medication, proper treatment addresses and CORRECTS the problem.
The initial focus of care is to determine the problem or the root cause of your pain.
Every patient is unique, and herniation treatments differ depending on the tear direction and herniation status. Tear direction is critical because pressure in one direction will open the cut, making it worse. While the opposite direction will close the cut and allow healing. The status indicates whether the herniation is active and causing pressure on the nerve. Or if the herniation is inactive and scar tissue pulls on the nerve, causing sciatica. These are two completely different problems and require opposite treatments. One is to avoid opening the disc cut, and the other is to stretch the scar tissue.
Understanding the cause of your herniation is essential to prevent reoccurrence. If you do not address the causative factor, you will continue to reinjure.
When your back is out, the first thing you do is stop moving – because every movement hurts, and you are fearful of making things worse. If you suffer from the most common posterior lumbar herniation, bed rest, and slouched sitting, put the same stress on your back that initially caused the problem. These positions increase the posterior pressure on the disc and push it to herniate further.
Instead…Get up and MOVE! Walking and moving are the best thing you can do for posterior herniations as walking places a slight anterior force on the herniation pushing it back in the center direction. It is essential to minimize your sitting and maintain activity within your threshold. Research has shown that those that continue to work within their tolerance have faster recovery than those that stay home from work.
Passive patient role.
Research has shown that the more involved you are with your care, the better the outcome. Healing is an active, not a passive process. Most current protocols for treating back pain and herniations are passive, including medication, massage, injections, TENS, surgery…all of these have not shown any benefit. Instead, they create a patient role. The more passive care you receive, the longer you suffer and the higher rate of chronicity and disability. Instead, become empowered. Learn what position/activities caused your herniation and what you can do to avoid them as well as heal.
Remember to Mistakes to AVOID with a Herniated Disc:
- Eliminate FEAR by educating yourself on the cause of your herniation. Learn how a disc can heal, similar to a cut on your knuckle.
- Instead of pushing for an MRI, ensure that you receive a thorough Mechanical Assessment.
- Don’t mask your mechanical problem with medications. Instead, treat the mechanical problem with a mechanical treatment.
- Back pain is worsened by static postures of slouched sitting and lying because these positions place posterior stress on the disc, aggravating a posterior herniation. Instead, stay as active as possible, using pain as your guide.
- Don’t take a passive role. Become empowered and take control of your care.
To learn more, download our eBook: Disc Herniations – Everything You Need to Know & How They Can Heal!