Disc-oncerting Back Pain

May 7, 2018

There are many causes of back pain. While chronic back pain is often due to many factors (some combination of patho-anatomical, physical, and non-physical factors), acute back pain (less than 6 weeks) can often be traced to simple anatomical causes and the most well-known, and often scariest sounding, is pain from a disc.

Disc problems can be the result of a single, traumatic event but more often are a result of prolonged postures (think slouching) or repeated motions (think shoveling snow or chasing a toddler around/ picking up items off the floor). The injury is a strain to the outer wall of the disc as the inner portion pushes against it. (Though this analogy does not perfectly correspond to the anatomy, the classic way of thinking about a disc is likening it to a jelly donut—the inner jelly pushes against the wall of the pastry.) Though the disc can be injured anywhere along its periphery, because of where the supporting ligaments are particularly strong and weak, and the stresses we most often place on them, disc injuries typically happen backwards or somewhat diagonally out the back.

Though some disc problems are trickier than others, the classic way to determine if you have one is if BOTH of the following are true: With repeated forward bending motions (reaching for your toes), your symptoms worsen and remain worse after you finish AND with repeated bending backward motions your symptoms improve and remain improved.

If you have the classic presentation above, your disc problem is highly treatable and you can likely treat yourself. First off, and most importantly, you need to avoid the positions and activities that keep provoking your symptoms! You need to avoid activities that bring your chest closer to your thighs. So, that means avoiding sitting as much as possible and activities where you reach towards the floor. When you absolutely must do those (and who can avoid them completely?) it is important to keep a slight arch in your low back. Sit with a small pillow behind your low back and use your legs to lower yourself toward the floor.

Second, bend backwards when you have symptoms to make them go away and even when you don’t — prevent the problem from occurring.
If these don’t give you relief, your disc problem may be more complicated or you may have something else so visit us for an evaluation.

By Tom Fontana, MSPT

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