A herniated disc also referred to as a slipped disc or bulging disc is most common in younger and middle-aged populations. In most cases, this painful condition can be managed successfully with chiropractic and/or physiotherapy care.
What is a Herniated Disc?
The intervertebral discs are found in between the vertebral bones (aka back bones). The discs function to assist in spinal flexibility, shock absorption and offer a pathway for nutrients into the bones. They play a significant role in absorption of forces and movements that are transmitted through the spine. The space that is formed by the intervertebral disc creates a space between the back bones so that the spinal nerve can exit the spinal cord to travel into the body and into the limbs.
Movement such as forward bending, causes the disc to be compressed along the front end which can cause the weaker more vulnerable outer and back portion (of the annulus) to be stretched out allowing the internal jelly part of the disc (the nucleus) to protrude outwards. To understand this better, just imagine a jelly doughnut. When the disc is pinched at the front, similar to a jelly doughnut being pressed in the front, the jelly gets squeezed out the back.
If you irritate the disc enough and cause pressure that pushes the disc contents backwards then the inner part of the disc called the nucleus gets squeezed further and further backwards. The pressure from the nucleus breaks the many protective layers of the annulus and weakens the integrity of the disc.
Portions of the disc have limited or poor innervation and this means that you can sometimes not feel any pain as this process is developing but then all of a sudden, your back can spasm and you can be left in severe, unrelenting pain. Also, if the nerves are compressed by the protruding disc, you may experience discomfort radiating down your leg.
What Causes a Herniated Disc?
It is common and natural that the discs will suffer from normal wear and tear with aging during daily movements and activities that we participate in. Bending forward, such as putting on your socks or shoes, reaching down, lifting heavy objects and twisting to place them on a shelf can contribute to the stress on the discs and wear them down.
If your back is strong enough, you will not even notice these changes and it should not contribute to any pain or disability. However, if your core is deconditioned and/or you do not have smooth movement through the joints above and below your back or you participate in tasks that require repetitive bending, lifting and twisting (including sit-ups) then you can be putting your discs at increased risk of herniation/injury.
What Should You Avoid with a Herniated Disc?
- Sit-ups- Avoid these at all costs when your disc is injured. It is a common misconception that doing sit ups is what our core needs to get stronger. There are many other core exercises that will help your back when your discs are flared up. Unfortunately, sit ups increase the pressure on the discs and lead to further disc protrusion.
- Forward bending and prolonged sitting will also cause increased pressure on the posterior part of the disc and worsen a pre-existing disc injury.
- Lifting heavy objects combined with a twist is one of the most demanding stresses you can place on a disc.
What Exercises Can You Do for a Herniated Disc?
Baby Cobra-McKenzie Based Exercises
Lying on your stomach, keeping your arms close to your body and elbows tucked in. Push through your hands and allow your upper body to lift off the floor while lengthening the front of your body. Hold for a 5 seconds and repeat 10 times every hour.
One of the things you can do for a sore back is to strengthen your trunk and all layers of your core muscles so that they are able to support your low back and prevent excessive strain through the discs. So how do you strengthen your core without sit-ups?
There are many different options and of course the best exercise for you can be determined by a health professional such as a chiropractor or physiotherapist who will conduct a thorough assessment of your muscle balance. However, you can try these three simple exercises to keep your back strong and healthy:
- Bird Dog
- Forward Plank – Facing the ground with your hands directly under your shoulders, step back to stretch your legs out long behind you. Create a strong line (plank) with your body from your ankle to the top of your head while keeping the natural curves of your spine. You will need to engage your core (tighten your stomach muscles) to keep your buttocks below shoulder height without over-arching your back. Hold 30 seconds and repeat 3x
- Side Plank – During this exercise you will try to form a strong line from head to toe with your body while on facing the side. One hand/arm will stabilize from under your shoulder while you balance on the outside edge of your feet. Hold 30 seconds and repeat 3x
Be sure you are doing these exercises correctly and your spine is staying in a neutral position as you hold and move through this exercise. You should not experience any pain, strain or discomfort while you are doing these exercises.
Chiropractic and or Physiotherapy Care for a Herniated disc.
It is always best to get assessed by a health professional so that they can guide you through an individualized exercise sequence. Your trusted health professional will be able to point out your compensation strategies and can guide you on how to preform each exercise correctly so that you get the most out of it. Your physiotherapist or chiropractor will also provide you with hands on treatment to release stiff muscles and joints. They will also offer therapeutic modalities, acupuncture and provide education so that you understand your condition and how to best care for yourself while you recover.
You may also need soft tissue release and mobilization from a Registered Massage Therapist to compliment your treatment and relieve pain and tension.
How Long Does it Take to Recover from a Herniated Disc?
Recovering from an acute injury may take 6-8 weeks, with the right balance of rest and activity as well as rehabilitation exercises. You will most likely see quicker results with professionally guided treatment.
In re-occurring or long-term back conditions, it can take much longer to respond to treatment. These cases can take a few months to resolve and you may need to put long term self-management strategies in place to prevent recurrences.