The low back consist of five lumbar vertebrae and the sacrum or “tail” bone. Between these vertebrae are discs that act as ligaments and allow the spine to be flexible. A disc is a little like a jelly donut, with a softer center encased within a tougher exterior. When the discs become irritate they can begin to migrate posterior or backwards and cause pain. When the disc migrates it can become a bulge or herniation.
Many factors play a role in disc herniation. The most common are flat-back posture (plumber’s crack), prolonged sitting, working in a slumped position, and incorrect lifting/bending posture. All of these factors place increased pressure on the disc and can lead to irritation and possible herniation.
The symptoms of disc irritation or herniation are pain in the low back, buttock or hip (most common) and radiating pain down one leg. Pain is generally worse in the morning and subsides with movement, increases with sitting or driving, and is irritated with changing of position such as sitting to a standing and rolling over in bed.
According to the Mayo Clinic “Conservative treatment… relieves symptoms in nine out of 10 people with a herniated disk. Many people get better in a mo
nth or two with conservative treatment.” Treatments consist of correcting seated posture, adjusting activities of daily living, corrective exercise, and treating dysfunctions with manipulation, Active Release, and anti-inflammatory nutrition.
The classic disc presents with the symptoms: pain in the low back and/or buttocks area that may or may not travel down one leg. The pain is generally in the SI joint or back of the hip. It will increase with sitting or being slumped over.
The disc patient generally has a flat low back and tight posterior muscles. The hamstrings are tight so the patient can not generally bend down and touch their toes easily and the “piriformis” muscles are tight so sitting in a cross legged position is not comfortable. This presentation generally looks as if the back is rounded and the buttocks is clinched while standing.
Most disc presentations state “I just bent over to pick something up and had pain in my back.” Repetitive flexion (bending) or rotation movements set up the low back for injury.
So if you are dealing with disc-like symptoms click here to see rehab exercises.
Yours in health,
Dr. Justin Hildebrand