Bodi Empowerment
Managing Disc Herniation and Alleviating Sciatica: Tips and Tricks 1
Suffering from disc herniation? Experiencing sharp pains shooting through your buttock, thigh, and leg due to sciatica? If your daily routine is disrupted by the discomfort of disc herniation, there’s hope. Many people find relief without needing surgery. This post will guide you through lifestyle changes to support your recovery from disc herniation. Stay tuned for our next piece, where we’ll explore exercises to correct and stabilize your condition.
Ultimate Guide To Exercises For Lumbar Disc Herniation Relief
Mary’s Story: A Wake-Up Call
Imagine starting your day like any other, performing your routine toe touches, when suddenly you’re hit with an excruciating pain radiating from your lower back down to your toes. This was Mary’s reality when she encountered a lumbar disc herniation, commonly referred to as a slipped or ruptured disc. Such incidents can lead to what’s known as sciatica or radiculopathy, terms doctors use to describe the pain that extends down your leg.
Understanding Lumbar Disc Herniation:
A glimpse into the anatomy of a herniated disc reveals two main components: the tough outer annulus and the softer, inner nucleus. Dr. Stuart McGill likens the nucleus to sticky phlegm. When Mary bent forward, it was akin to squeezing the front of a jelly doughnut, pushing the inner material backwards and eventually causing the disc to bulge and press on a nerve.
The Culprit Behind the Pain:
Mary’s disc herniation wasn’t a sudden mishap but the result of years of repetitive motions like toe touching and prolonged slouching at her desk. These habits gradually weakened her disc, leading to the moment when it finally herniated and impacted her nerve. The lack of nerves within the disc itself means significant damage can occur without immediate pain, explaining why the problem might not be felt until it’s severe.
A Lesson Learned:
The story underscores the importance of posture and the dangers of neglecting spinal health. While the advice to “sit up straight” might seem simplistic, maintaining the natural curve of your back is crucial. Mary’s experience serves as a potent reminder of the long-term consequences of poor posture.
Disc herniations don’t have to dictate your life. By understanding the causes and adopting preventive measures, you can manage and alleviate your symptoms.
Understanding Disc Herniation: Pain, Prevention, and Care
The Unseen Progression of Disc Herniation (see picture above)
- Bulging Disc: Early stages where the disc starts to protrude due to wear and tear.
- Prolapsed Disc: The disc bulges more as it degenerates, but the nucleus remains contained.
- Extruded Disc: The protective layers give way, pressing on nerves and causing pain.
- Sequestrated Disc: The most severe stage, where disc fragments break away, potentially compressing nerves or the spinal cord.
See Also: MRI, CT scan and X-rays: Is an MRI, CT Scan or X-ray Best For My Pain?
Why Me? The Role of Movement and Genetics in Disc Herniations
Surprisingly, your daily habits and genetic makeup play pivotal roles in disc health. While we can’t choose our genetics, modifying daily movements can significantly reduce the risk of herniation. Proper lifting techniques and posture adjustments are crucial first steps.
Simple Changes, Major Impacts: Daily Habits and Exercise
To protect your spine:
- Adjust Daily Habits: Learn to perform everyday activities in spine-friendly ways to prevent further disc damage.
- Disc-Specific Exercises: Exercises can help reposition the herniated disc.
- Stabilization Routines: Strengthening your core helps maintain spinal integrity, preventing future herniations.
Lifting Techniques: How Weight Lifters Should Lift
Master the Basic Butt-Lifting Technique for Disc Health
- Practice with a long, straight object to ensure your back remains aligned.
- Ensure it touches your butt, mid-back, and the back of your head during the entire motion.
- Squat down and maintain contact with 3 areas and keep the lower back arched the whole time.
- Aim for 30 repetitions to embed this healthy habit into your daily routine for 10 days
Daily Activity Guide: Protecting Your Discs
Then you integrate this lifting technique into everyday life. Initially, whenever you do any of these activities, use the same basic move and you will stop pushing out your disc.
In the beginning, you will need to be conscious each time you are doing any of these activities. To speed things up you can practice each activity like picking up your socks 30 times using the butt lifting technique and it will become even more automatic. You can deepen muscle memory during all of these activities.
For sitting in a chair and driving I recommend that you roll up a Mckenzie Lumbar support roll and put that in the arch of your lower back
Guide for disc herniation daily activities.
- Remember to do all these movements pain-free. Always stop whenever you run into pain with any movement of the spine.
- Disc herniations are linked with long periods of sitting, especially prolonged driving.
- Disc herniations are caused by repeated flexion.
- Prolonged trunk flexion or twisted or bend sideways cause disc herniations.
- Too much lifting, pushing/pulling causes disc herniations
- Vibration while sitting is linked to disc herniations.
- After prolonged stooping or sitting, you should stand. For example, a gardener lifting bags of peat moss after having a prolonged period of rounded lower back, or a driver getting heavy loads out of the trunk after a long drive is not recommended. You should remember to stand for a few minutes before attempting to lift. Studies have shown that ½ hour is even better.
Here are some more exercises that can cause disc herniation.
Activities That Put Out Lumbar Disc Herniations
Yes, it’s very surprising that toe touches, Yoga and certain Pilates can cause disc pressure leading to disc herniations. I have personally treated dozens of Yoga teachers with varying degrees of experience. The fact is some of the exercises involved in Yoga are great for helping disc herniations while others directly push the disc out.
Many Yoga Exercises Put Out Disc Herniations
I know many Yogis who have had to stop many of their exercises due to the pain it cause them in various parts of the body, including their disc.
Next week’s article will go over the second and third ways to help your disc. Remember, you need to do #1 “Daily Disc Activities Correctly” first so that your disc doesn’t keep getting aggravated. Then you can move on to next week’s article which goes over #2 Disc Exercises to Push the Disc Back In and #3 Stabilization Exercises help by keeping the disc from coming out by normalizing how your spine moves.
Looking Ahead: Comprehensive Care for Disc Health
Next week, we delve deeper into specific exercises for disc realignment and stabilization techniques, in this article called Ultimate Guide To Exercises For Lumbar Disc Herniation Relief. Remember, starting with correct daily activities is essential to prevent aggravating your condition further.
Tell us what you think in the comments below and like us on Facebook. This Toronto Downtown Chiropractor will answer all questions in the comments section.
Dr. Ken, has been recognized as the Best Toronto Chiropractor in 2024, 2023, and 2018, here in downtown Toronto. As a sports chiropractor, he excels in treating a wide range of conditions including concussions, temporomandibular joint disorders (TMJ), sports-related injuries, and spinal issues. Beyond his clinical skills, Dr. Ken is an accomplished athlete, having represented Ontario in the Canadian Judo Championships and completed the Toronto Marathon on two occasions. He employs the innovative C3 Program to provide targeted and effective care to his patients, ensuring a holistic approach to their well-being and athletic performance.
Dear Dr.Ken
Thank you being a guiding force.
My name is Amit and I am from India. I read your article on subject matter on internet.
My Xray shows Spondylolysis and also space reduction on L5 & S1 segment of spine. Other symptoms( Pain on back of right hip & Tingling in right leg) indicate some level of nerve compression. I would like to take your suggestions.
1. I have already taken 2-3 days bed rest. Now do I need to take full bed rest further or should I remain slightly active. Which of these will help in speedy recovery. I am a bit confused.
2. Can I use stairs till level 1 of my house
3. It has been diagnosed with above just 3 -4 days back, do you suggest any exercise. I have not gone through MRI so far.
4. Can you suggest any good Cheiropractor in India.
I will be grateful if you can suggest me something on above.
Thanks & regards
Amit
Author
Thanks for your questions Amit. You shouldn’t have bed rest. Now that you already did you should try to stay active but stay away from sports.
2. You should use the stairs.
3. https://www.bodiempowerment.com/part-2-degenerative-disc-disease-exercises-help-lower-back-pain-spondylosis/
Try these: If the pain gets worse or goes further down the leg than you should stop the exercises
Keep in mind just because your X-rays says you have spondylolysis doesn’t mean that’s what’s causing your pain for sure.
These exercises are stabilization exercises that are helpful for spondylosis and spondylolysis.
4. There aren’t many chiropractors in India. Try a physiotherapist with a good reputation.
Hope that helps your spondylolysis.
Dear Dr Ken,
Thanks for your prompt and point wise suggestions. They are really informative and helpful. There are few other points which if you can suggest.
1. My orthopedist doctor has advised Me to wear Lumbar support belt for all the time I am out of bed. It is for 3 months. But I presume it will weaken my back muscles . Looking at my Spondylolysis is it really necessary to wear this belt ?
2. Doctor told me that my Spondylolysis is not because of new injury. Do old Spondylolysis have possibility to heal. How can I prevent it from converting into listhesis in future. My age is 51 years.
Thank you once again.
Regards
Amit
Author
Thanks for your question Amit. There are a few things I am concerned with. First your orthopedist doesn’t read the research. Otherwise he would not say you should wear a belt. Yes it will weaken the muscles and provides no extra benefit and once you stop wearing it you are in danger of really hurting your back. In other words this is a good way to need surgery or at the least hurt your lower back.
You can’t heal spondylolysis but it may or may not be causing your pain. You can do these exercises to stabilize your lower back.
https://www.bodiempowerment.com/part-2-degenerative-disc-disease-exercises-help-lower-back-pain-spondylosis/
Any exercise can make you worse. These exercises should be supervised by a health professional.
Hope that helps your spondylolysis and possible disc herniation.
Dear Dr. Ken
Thank you for your valuable suggestions.
Request you that whenever you get time in future. pls write a detailed article on your blog exclusively on Spondylolysis. This will help people to clear many of misconceptions they have in their mind.
Rgds
Amit
Author
I will write an article on spondylolysis in the future. I already have a schedule of the articles I am going to write so you will have to wait, but I will get to it.
Good luck with your spondylolysis.
Dear Dr Ken,
Apologize for bothering you again.
Now I am under therapy of a physiotherapist as suggested by you.
Along with some mild isometric excercises he is also treating me with laser for Localised pain in my lower hip and TENS for nerve stimulation along with hot and cold packs .Isometric exercises so far adopted are mild such as ankle movement (Roatation & push pull)Deep Breathing , pushing abdomen down towards my back while lying flat, bridge exercise, pulling knees towards chest while lying down, hot & cold packs and 20 min walk along . There is 60-70 % relief.
I am not taking any NSAID since last 4-5 days except half tablet of Muscle relaxant cum NSAID (half tablet let once in a day or two) when I occasionally get tingling and mild numbness in my right leg and mild pain after standing or sitting for prolonged period.
Is it normal to get this occasional tingling and numbness. Am I on a right track of my treatment. My therapist says that he will gradually increase the intensity & variety of isometric exercises.
This occasional tingling & numbness after prolonged sitting or standing and my popping half tablet NSAID worries me.
Pls suggest.
Regards
Amit
Author
Thanks for your question Amit. Usually the PT will answer all these questions. I am guessing that you are asking me as well. It is normal to get occasional numbness and tingling with prolonged sitting or standing.
If the pain, numbness or tingling is going further down the leg than you are getting worse. If it’s going further up the leg you are getting better.
Hope that helps your disc herniation.
Dear Dr. Ken
With the exercises you have suggested and the physiotherapy sessions I am undergoing , there is a recovery of 80-85%. Still 15 % problem is troubling me as now the recovery rate is very slow and I continue to get tingling sensation occasionally . All exercises are really helpful except one exercise ( Crawling position ). Whenever I try doing this exercise I start getting waves of mild but irritating pain in my neck and left arm.
Recently( Last week) I got MRI done for for my lumbar spine. Following are the observations.
1.Early disc desiccation at L3-L4 to L5-S1 levels
2.L4-L5 : Moderate diffuse disc bulge without overt nerve root compression.
3.L5-S1: Acute annular tear with small central -left paracentral -foraminal disc protrusion without overt nerve root compression.
4. Conus Medullaris Termination: L1 level
Request you to kindly guide me further course of action. My Physiotherapist says that it will take 4-5 month for reaching full recovery stage.
BTW does my neck pain during Crawling pose excercise anywhere related to cervical issue as sometime I also get this type of pain in my neck and shoulder whenever there is some strain on these areas.
Thanks for your kind support & advise.
Rgds
Amit
Hello Sir,
I’m 30 years aged, suffering from low back pain since last 3 months. Pain sometimes in lower back, sometimes in gluteal area, sometimes in left leg. Sometimes I feel numbness over my left leg! Recently I have done MRI, Reported taht- ” L4-L5, AND L5-S1: POSTERIOR BULGING OF THE L4-L5, AND L5-S1 DISCS WITH HYPERTROPHIED LIGAMENTUM FLAVUM-WITHOUT SIGNIFICANT COMPRESSION ON CORRESPONDING EXISTING NERVE ROOTS”.
Last 3 days I’m doing extension exercises- as your blog suggested. My question is-
During exercise procedures I feel some pain but after a while it’s almost severity free, but still pain, sometimes pain in butt…. difficult to sit also!. Do I need to continue ?
Another one; What position will be suitable for me for lying on bed?
And, How long usually takes to be pain free in my condition?
It will be very helpful for me if you answer, please. Moreover; If there any suggestions, please let me know.
Thanks in advance.
N.B. : Here in exact MRI report—L4-L5, AND L5-S1: “There are posterior bulging of the L4-L5, AND L5-S1 discs with hypertrophied ligamentum flavum but without significant narrowing of L4-L5, AND L5-S1 bilateral neural foramina or compression of corresponding existing nerve roots.”
Thank you.
Author
Thanks for your question Mirza.
1. If the pain, numbness or tingling is going further down the leg or buttock than when you started the exercise you need to stop. Also the exercises need to be supervised.
2. You should lie on your back or side. In side position with a pillow between the legs with both legs behind the back or straight.
3. I can’t tell you when you will be painfree. Depends on your age, disc, genetics, how often you do the exercises, how long you had the problem etc……..
Hope that helps your disc herniation.
Dr. Ken, thanks for the wonderful portal “Bodi Empowerment” and this discussion forum.
My wife has disk problem. Her MRI reveals lumbar spondylosis, PIVD with:
1. Grade 1 posteriocentral disc extrusion at L5-S1 level causing compression on bilateral exiting nerve roots.
2. Grade 1 posteriocentral disc protusion at L4-5 level.
3. Straightening of lumbar curve.
4. Mild ligamentum flavum thickening and facet arthropathy at L4-5 and L5-S1 levels adding to compression on nerve roots.
What exercise is recommended for her in the above MRI report.
Author
Thanks for your question Puhspinder. I can’t recommend exercises as all you gave me are your wife’s MRI. MRI are often wrong in that unless correlated with the history they really don’t mean much. There are many people, in fact 60% of 60 year old have disc herniations including disc herniations with no pain at all.
You need to tell me what your spouse’s symptoms are.
Hope that helps your spouse’s disc herniation.
Thanks Dr. Ken for reply. My wife has symptoms like sciatica pain in left leg and pain in lower back as well. When she stand, she feels relieved and sitting is more painful. Bending forward is painful and mild pain in back during bending backward. She also feels fatigue after doing a little bit of typical house work. These symptoms occurred after six month of cesarean delivery 2 years ago.
Author
Thanks for your comments regarding your previous question Pushspinder. She should do these exercises. https://www.bodiempowerment.com/herniated-disc-part-2-the-best-exercises-for-your-herniated-disc/
These exercises should be supervised by a health professional. Also if the pain increases or sends pain or any symptoms further down the leg than you should stop the exercises.
Dr ken i have done standing and sitting toe touches for just one day and my sciatica problem of 3 months has just gone like they were never there…thank you dr ken…and i want to ask if there are side effects of toe touches for me and should i continue them or stop them
Author
You are welcome Salmann. In your case you should do the exercises once a day. There should be no side effects for you.
Great to hear your disc herniation has been helped.
Dr ken 3 months ago i got numbness tingling and pain in my left leg…my mri reveals mild diffuse disc buldge at l4 l5 and l5s1 with mild secondary canal stenosis with no nerve root compression….my doc told me to do extension exercises which i have done for 2 months but still i got pain and burness in my feet…..now my doc says my pain is due to calcium deposition and told me to do both flexion and extension exercises….dr ken i am 22 years old and now after 2 months of exercise i could easily touch my toes…but still i got pain in walking and standing and also i have pain in my spinous process when i touch them….so please enlighten me with your noble advice …and dr ken why i got spinous process pain during touching them..plz help me
Author
Thanks for your question Salmann. First you don’t do both flexion and extension exercises at the same time. It’s one or the other. If it’s a posterior disc bulge than you do extensions, if it’s a anterior, disc bulge you do flexion. Doing both counteracts the other. Also calcium deposition or what I think you and your doctor are referring to is spurs. I doubt your disc has calicified as you are 22 years old. Even spurs are too early for your age.
Try just the flexion exercises and see how you get on.
Hope that helps your diffuse disc bulge at L4L5 and L5S1.
Hi Dr. Nakamura and thank you for this article.
I am 28 and have been in pain for 11 months, but only got my MRI 5 months ago (L4-L5 bulge). My primary pain is when I do any flexion. My lower back feels extremely tight. This tightness is the entire lower back, a very broad area. The pain is worse after any activity. I am trying to play professional basketball, but have not been training due to my injury.
I also have pain if I hyperextend. This is a sharp pain in the lower right back. I don’t feel this often though as we don’t hyperextend in day to day life.
I also sometimes feel a tiny pinch in my right buttocks, but it’s minimal.
I have been seeing a physiotherapist who my sports medicine doctor sent me to. The physiotherapist gave me:
1. The Mckenzie method (hyperextension exercises) (3 times/day)
2. Core strengthening (a lot of glute strengthening)
3. Nerve Flossing (3 times/day)
The nerve flossing works like a miracle, but it’s only short term. I can bend with ease after I nerve floss, not a deep bend, but a semi bend. It hurts to hug my knees if I lay on my back, after nerve flossing it doesn’t.
I’m still in pain though, especially after any activity, even very light activity. I was wondering if you had any advice. I am wondering what may be next. And was wondering your thoughts on prolotherapy.
My MRI…
L4-L5:
Small posterior central disc protrusion/herniation elevating the posterior longitudinal ligament indenting the anterior thecal sac. No central spinal canal stenosis. Patent intervertebral foramina, no intraforaminal neural compression. Trace fluid in the left L4-L5 facet joint, possibly reflecting synovitis. The posterior margin of the disc protrusion lies in close proximity to the right and left L5 nerve roots in the anterolateral aspects of the thecal sac/lateral recesses.
IMPRESSION:
Small posterior central protrusion/herniation of L4-L5 disc, the posterior disc margin lying in close proximity to the right and left L5 nerve roots in the anterolateral aspects of the thecal sac.
Thanks in advance!
Author
Thanks for your question Travis. You need to try a modification of your McKenzie exercises such as this https://www.youtube.com/watch?v=ghprTmMKp6E
If you do the wrong side you will get worse. You need a new physio that will give you all the exercises you need within 5 visits or you need to see a chiropractor. A chiropractor will treat it differently though.
Hope that helps your posterior central protrusion.
Hello sir…My MRI report shows mild T2 hypo intensity in D11-12,D12-L1 and L1-L2 disc with mild posterior bulge .Modik type 2 changes seen at superior end plate D12 vertebra. mild posterior disc bulge in L4-L5 and L5-S1. As I have been feeling pain in my nerves in both arm and pins and needles in my blood vessels of my both arms,palms,fingers . Apart from this there is continuous pain ( 24 hours) and needle like pain in my shoulder blades and there is stiffness and irritation in between my shoulder blades and my neck also. I have been feeling all these pains for around 10 months .For last three months i am also feeling pain in my chest muscles and it cracks with pain when I stretched my arms wide open backside. My earlier MRI shows nothing that’s why my doctors have been treated me for pain in nerves and muscles….they thought it as a nervous system related problem…..but I didn’t get any relief…but my recent MRI report shows these results. Please tell me the best way to treat my problem.
Author
Thanks for your question Neeraj. There’s a big reason I can’t help you. You describe an MRI of your lower back and the lower part of your mid back while you tell me about the pains in your neck, and shoulder blades. The MRI and what you tell me don’t correlate.
I can’t help your disc bulges or your shoulder pain.
Dear Dr Ken,
I set up a bicycle with an attachment on the back wheel so that I could use it in a stationary position to get fitter (I am 65yrs) but I read in your great website that bicycling is bad for the back. Obviously, the leaning forward posture I can see would be bad; with a (possible) minor herniated disc at waist level, would it still be bad for me to cycle if I just sat upright on the seat? Or, is the leg cycling movement also injurious? Your help is very much appreciated.
Author
Thanks for your question Fran. Great question. You need to sit upright but also keep the arch in your lower back. That’s the key to cycling safely if you have the type of disc herniation that most people have. If you have a different type of disc herniation than it’s better to get in the racing position.
If sitting in a regular chair bothers you chances are riding upright with the arch in your back will help. If sitting doesn’t bother you than you should be fine in the racing position or any other forward position riding a bike.
Hope that helps your understanding of disc herniations for your lower back.
I have bulging l5 that I had surgery on in 2000.Part of the disc taken away.I now have bulge at l3/4 as well and thoracic bulge also.Sciatica has returned and sharp jabbs in glute but only upon walking/standing and it subsides overnight or after rest. I ride bikes…mountain bikes but nothing crazy, bike has full suspension….I dont ride as much as I use to anymore…3 times a week for an hour each time, for fitness now.Im working with a physio and exercise physiologist for muscle imbalances and seeing a muscular skeletal specialist soon too.I have heard riding is good and bad…Im confused?
Author
Thanks for your question Kylie. For most types of disc herniations riding is bad. Why? You are in flexion for long periods of time with the bumps that go along with it. The lower you ride (the further you bend forward) ie. racing position the more stress you put on the disc causing it to bulge more.
If you want to ride you need to ride with an arch in your back, vs the hunched over position.
I question whether you three different health practitioners. Your physio or a chiropractor if they are good should be able to take care of your pain muscle imbalances and everything else that comes with your problem.
Hope that helps your disc hernition.
Dr Ken,
Before 7 months diagnosed with loss of lumber lordosis due to muscle spasm and mild disc bulges at all lumber discs.
After doing physio getting better, but before 2 months i was started yoga (cobra and bridge poses). After that i am feeling heavy stiffness in back specifically in one joint/disc around T12/L1 and getting pain when that region has movement. Even though stopped yoga before a month, still stiffness and pain continues.
What might be the cause? Could i take the MRI again to diagnose the cause?
Thanks
Ram
Author
Thanks for your question Ramakrishnan. There are too many people getting MRIs and too many people who profit from doing MRIs. That’s not how you should diagnose a lower back problem. You should get a doctor that will do a thorough history and examination. The doctor should have a diagnosis in mind without an MRI. You only need an MRI in cases where you need surgery, unusual cases, or when your doctor suspects other things like cancer, infection etc…
Since the cause was mechanical chances are your back pain is mechanical. You just need the exercises that will help you.
Sound like you might have an anterior disc herniation. You need to have a health professional that knows how to diagnose that properly.
Hope that helps your disc herniation.
Hi Ken, I have pain on the right side of my spine when I move incorrectly in some way, or when I touch the particular vertebra on the right side. But thankfully it is localised. I tried to pick up my rather muscularly solid little grandson and felt an explosion of pain from above waist level all over my lower trunk 2.5 months ago, and I have self-diagnosed this to be the problem. In order to help put the herniated disc back in place, should I bend to the right rather than bend backwards in the exercises on your website? Thanks
Author
Thanks for your question Fran. Most discs that go backwards or posteriorly will only show symptoms on one side. I recommend you do the exercises first.
Most people’s spine do not improve if you use side techniques but improve when using the techniques outlined in the article that’s why you shouldn’t start from the side.
Hope that helps your possible disc herniation.
Dear Dr. Ken,
Thanks a lot for your advice. Your efforts have alleviated pain for numerous persons.
I was suffering from low back pain (especially while changing posture) for some days.
I had following diagnosis:
Partially Desiccated L4/5 and L5/S1 disc with mild postero central disc bulge leading to thecal sac and attendant and attendant cauda equina nerve roots indentation with bilateral L4/5 and L5/S1 lateral recess compromise which are further narrowed by bilateral L4/5 and L5/S1 facet arthrosis.
Early bony degenerative changes in form of corner osteophytes from L3 to L5 level with multiple levels smal schmorl’s nodes +, visualized vertebrae are however normal in height and alignment.
Any suggestion about exercises and any caution? Can I continue running with this?
Author
Thanks for your question Arpit. If you want to get better faster than you should stop running until you are better. You should try the exercises here in this link. https://www.bodiempowerment.com/herniated-disc-part-2-the-best-exercises-for-your-herniated-disc/
Please not just because your MRI says you have a disc herniation doesn’t mean that is the cause of your pain even with degeneration, schmorl’s nodes and osteophytes.
If the exercises increase the pain or make the pain go further down the leg than you should stop.
Hope that helps your disc herniation.
Thanks a lot Doc.
Hello doctor,
I’m 21 and suffering from lower back pain and left leg pain for the last 1.5 years. Recently I got an MRI. The results are:
FINDINGS:
Straightening of Lumbar lordosis is seen.
Vertebral bodies are normal in height , outline, marrow signal intensity and alignment.
L5/S1 intervertebral disc shows loss of T2 hyperintensity-S/o Disc dessication.
Rest of the lumbar intervertebral discs are normal in height, signal intensity.
L5/S1 intervertebral disc shows diffuse disc bulge with left paracentral annular tear and extrusion with caudal migration causing thecal sac indentation, left lateral recess and left neural foramina compromised. The left traversing nerve roots (S1) is indented by the disc extrusion.
Lower dorsal cord is normal with no evidence of focal or diffuse signal abnormality.Cord-CSF interface is well-marginated.
Both sacroiliac joints are normal.
Pre-vertebral and para-vertebral soft tissues are normal.
OPINION: MRI findings reveal
* Early degenerative disc disease.
* L5/S1 : Diffuse disc bulge with left paracentral annular tear and extrusion with caudal migration causing thecal sac indentation, left lateral recess and left neural foramina compromised. The left traversing nerve roots (S1) is indented by the disc extrusion.
What should I do? I have done hydrotherapy and physiotherapy still no relief.
Author
Thanks for your question Mrinank. Sounds like you have quite a situation on your hands. You can try these exercises https://www.bodiempowerment.com/herniated-disc-part-2-the-best-exercises-for-your-herniated-disc/
Like any exercises they can make you worse. If your pain gets worse or your symptoms go further down the leg you should stop, including numbness and tingling.
Hope that helps your disc herniation.
Continue to the last thread – Ramakrishnan
Dr Ken,
I am feeling heavy stiffness in the center region of back and getting pain due to that.
1) Is it because of doing back stretching exercise twice daily?
2) how to get relief from the pain due to stiffness?
3) can i do spine stabilizing exercise instead of back stretching exercise?
Thanks
Ramakrishnan
Author
Thanks for your question Ramakrishnan.
That’s great that you are getting stiffness or even pain in the lower back if your leg pain is gone. That means you are getting better.
1. You are doing nothing wrong.
2. Be patient.
3. Just stick with the exercises I have given you so far.
Hope that helps your disc herniation.
Thanks Dr for your answers. I have this doubt many days, now i got it. I have tried to bend forward to touch the toes. I can’t do it completely, because of feeling stiffness in the back (not pain).
Author
Thanks for your comment Ramakrishan. Then you should be able to do your everyday things. When you can do the things that you do in your activities or sport like kicking a ball and running if you play soccer etc.. than you are able to partipate in practice. With game situations anything can happen.
Hope that helps your possible disc herniation.
Hey doctor thnks for the reply for my post.
Her bladder condition has improved and is now urinating normally.
We sought a doctor regarding the vibration in her leg, his suggestion was to wait for sometime and the vibrations will also reduce
I hope that his condition is improving gradually…
Is it ok to wait or is it the silence before a storm?
Hi, Before 8 months i had heavy pain in spine and getting more pain while sitting. MRI reveals that, paraspinal muscle spasm in the lumbar region and mild disc bulge on all lumber discs are present. After doing the exercises, now pain is reduced a lot and sometimes suddenly getting more pain.
My Questions are:
1) How to know that, i will recovered from disc buldge or in the right way to getting healed?
2) When can i bend forward and do the activities? Because i am getting right leg joint pain due to over strain while doing my activities on the floor.
Thanks in Advance
Author
Thanks for your question Ramakrishanan.
1. When you can bend forward while standing and touch your toes you know that you have recovered to the point where you can do everyday things.
2. Answered in #1. Do these exercises. https://www.bodiempowerment.com/herniated-disc-part-2-the-best-exercises-for-your-herniated-disc/
Stop if the exercises give you more pain or give you more symptoms further down the leg like numbness, tingling, or pain.
Remember a disc bulge on MRI doesn’t mean that is what is causing your pain. Hopefully your doctor did a thorough history and exam which more important than an MRI.
Hope that helps your possible disc bulge.
My sister 22yrear has been diagnosed with herniated l5 s1 disc just a week ago. She is experiencing vibration n numbness in her left foot
And is unable to walk properly…she drags her feet as she walks
Is it normal?
How should she sleep to improve the herniated disc
Also she is experiencing problem in unating…even though her bladder has a lot of pressure..it doesn’t comes out
Author
Thanks for your question Soumya. She needs to examined right away by the doctor in the emergency department. This is likely an emergency. Good luck.
Dr. Ken,
6 months back I was very active with sports like volley ball, racquet ball and gym workouts and especially i will do touch toe stretches. And all of a sudden i started feeling this pain in my right buttock when I sit for prolonged hours especially work and while driving and I just checked with my doctors and x-rays of my hip and spine was normal and I was told by doctors that could be a muscle strain and it will go away with few stretches and exercises. so I went on with Physiotheraphy and then to chiropractor and he used to make some adjustments and some stretches it brought down the pain level but not completely solved.
3 months back I went to my home country and I consulted a orthopedic surgeon and we took an MRI and found there is a L5S1 Foraminal disc protrusion and they asked me to go with core strengthening exercises and Came back to USA and with the help of physiotherapist started my exercises (mostly whatever you have mentioned) and the pain was always there but the level went down from 4/10 to 1.5/10. Then later I started doing cobra stretch and also started applying heat regularly I realized my pain in buttocks and ankle region but there was no drop down the foot. Level was 2.5/10. So last 2 weeks i stopped my exercise and started doing icing and my pain is not radiating, mostly it is centralized.
Now my questions,
1. Foraminal disc protrusion comes under which category – posterior lateral or lateral?
2. The regular extension prone prop, squats, bird dog din’t worsen the pain so, shall i continue with those excercises? only after doing cobra stretches i realized pain in my buttock and ankle (at the same time) but the pain was not during exercises only when I sit for sometime and usually when I stand I realize the pain and it fades away in few seconds….
Thanks in advance
Dino
To be exact it is – L5S1 right paracentral – foraminal disc protrusion causing mild canal compromise.
Author
Thanks for your question Dino. You are doing exactly what I ask everybody to do, which is to stop if the exercises cause pain to go further down the leg, in your case it went down to the ankle.
1. It’s central, paracentral (parmedian) AKA lateral recess, foraminal (subarticular) and lateral which are the usual categories.
2. You should continue with the all the other exercises except for the Cobra.
Note: Sounds like the radiologist either can’t decide if it’s paracentral or foraminal but if it’s compromising the formina it’s usually formainal.
Also the Cobra likely aggravated the disc as the disc is going more sideways which sometimes happens.
Hope that helps your formainal disc hernaition.
Thanks Dr.Ken.
In lay-man terms, lets assume a clock, so Central more of 6’o clock; Paracentral – 5 to 6 or 6 to 7 clock; Foraminal – 4 to 5 or 7 to 8 o Clock; lateral 3 or 9 o clock. Am I right? Doctor.
Dino
Author
Thanks for your question Dino.
You are essentially correct. Hope that confirms your understanding of disc herniations.
Dear Doc,
Hope you are doing well.First of all thank you for such informative posts, I am 26 year old male a sales and marketing professional and travel around 50km/day by motorcycle.From last few months i was experiencing some pain at my lower back and i was suggested to go for MRI of L.S Spine and Dorsal Spine. The findings are as follows :-
MRI of L.S Spine findings are
1) Disc Degeneration with posterior disc bulge at L4-5level causing mild narrowing of both neural foramina and adjacent nerve roots.
2) Minimal posterior disc bulge at L3-4 level
3) Mild Lumbar spondylosis with degenerative changes and schmorl’s node in D11 & D12 vertebrae.There is a scralisation of L5 vertebra
MRI of Dorsal Spine Findings are
1) Degenerative changes in dorsal spine
2) Degenerative Changes in D7-8 and D11-12 disc
Hence i would like to tell you that after the diagnosis i have been advised to exercise regularly for minimum 20mins and the exercise includes a)pulling my knees towards the chest b)l.s spine extension excercise c)lifiting up the legs to 45-50degree angle and bending the feet towards body. though i am performing the same regularly in a correct manner but still i am getting pain, and hence want to say so times the pain move towards legs (hips thighs also) and as a result i am not able to perform it any more
So my question to you are
1) though i am doing my exercises correctly then still why i am getting pain.? so please suggest me some correct exercise as well
2) in order to reduce my body weight i am walking almost 30-40mins/day, so does walking makes any impact in dis bulging or lumbar spondylosis or disc degeneration?
3) I cannot leave riding motorcycle as i am in sales and my job requires it, so what are the things i should be taking care of while riding bike?
4) I have been advices to use a L.S spine belt and i am wearing it only during riding motorcycle, so do i have to wear it all the time?
5) what will be the correct posture while sitting in office or while hanging out casually as it is not possible to sit at 90degree angle every time and belive me the back really hurts?
6) immediately after waking up i am getting pain, so can it be eliminate?
7) there are so many rumors i heard about bulging disc,degenerative changes and lumbar spondyloisis, are those things really curableor di i have to bear with entire life?
My request to you is that please help me with proper answers so that i can lead a good life as every times i complaints , the physiotherapist and doctors blames me and i am literally fedup with this
thank you
Author
Thanks for your question Patnak.
1. First you seem to be getting advice from a non health professional as you are doing exercises that counter each other. One may be getting you better but you get worse doing the other exercise. Just do these exercises. https://www.bodiempowerment.com/herniated-disc-part-2-the-best-exercises-for-your-herniated-disc/ If the exercises give you more pain or increase symptoms down into the buttock or leg with numbness tingling or pain than you should stop. Anything further down the leg is always a reason to stop the exercises.
2. Usually walking should be helpful.
3. You can always ride a car. First riding a motorcycle puts in you in flexion as in bent forward more so than in a car. If you concentrate on keeping the arch in your lower back that may be enough and you may be able to ride your bike. If you problem is too serious this won’t help.
4. If you wear a belt all the time you will have more problems in the furture and when you do re-injure again it will be that much more severe.
5. Sit with the arch in your lower back. Please read the article for further details.
6. Lie prone or face down then do the exercises in the link.
7. Not sure about rumours but it’s a fact through research contrary to the what many guidlelines for low back indicate. Lower back pain is episodic. This means that it happens from time to time. You don’t actually cure it. You get out of pain for periods of time. Than you do something and re-aggravate it again.
To prevent things do the cobra like exercises.
Hope that helps your disc herniation.
Hi doctor,
I am 26 yr old engineer working in a physically active condition. On year I injured my low back and treated conservatively for three months,but in vain. MRI shows a large disc herniation L5-S1 left compressing thecal sac and nerve root along with disc protrusion at L3-L4 indenting thecal sac without nerve compression. I underwent surgery laminectomy with disectomy L5-S1 and results were asymptomatic for a while. But after 06mnths post surgery I developed symptoms of sciatica in left leg again with back pain . Current mri reveals recurrence of disc herniation again at L5-S1 towards left.
I can’t sit much now and sitting for more than half an hour leaving me with severe pain in down the leg.
What should I do now . The current herniation is small though compressing thecal sac .
should I go for surgery again or do the consecutive therapy.
Swimming give me pain relief for a while.
The exercises that u suggested also show ing momentarily positive results.
Plz guide me as I am n severe mental stress.
Author
Thanks for your question Eby Henry. I would try conservative therapy again with another health practitioner. They may be able to find a treatment that will help you. There are a myriad of treatments. Also you can get a steroid injection near the nerve root or a transformainal injection of steroids which could help the conservative treatment to work.
Surgery is permanent and unreversable and more than 50% fail, as you already know. In fact it is likely a far higher percentage fail. Surprisingly you would likely have been counted as a success by the surgeon.
Hope that helps your disc herniation.