Your spine consists of 24 individual vertebrae stacked on top of each other. Flexible cushions called “discs” live between each set of vertebrae. A disc is made up of two basic components. The inner disc, called the “nucleus”, is like a ball of jelly about the size of a marble. This jelly is held in place by the outer part of the disc called the “annulus”, which is wrapped around the inner nucleus much like a ribbon wrapping around your finger. The term lumbar disc lesion means that your disc has been damaged.

Disc lesions start when the outer fibers of the disc become strained or frayed. If enough fibers become frayed, this can create a weakness and when the disc is compressed, the outer fibers may “bulge” or “protrude” like a weak spot on an inner tube. If more fibers are damaged, the nucleus of the disc may “herniate” outward. Since the spinal cord and nerve roots live directly behind the disc, bulges that are accompanied by inflammation will likely create lower back pain that radiates into the buttock or the entire lower extremity. This condition is called sciatica. If the disc bulge is significant enough to create a mechanical compression of your nerve, you may also experience loss of your reflexes and weakness. Be sure to let our office know if you notice progressive weakness or numbness, any numbness around your groin, any loss of bowel or bladder control or fever. 


Surprisingly, disc bulges are present without any symptoms in about 1/3 of the adult population. Another one third of adults will experience pain from a lumbar disc at some point in their lifetime. The condition is more common in men. Most lumbar disc problems occur at one of the two lowest discs- L5 or L4. Smokers and people who are generally inactive have a higher risk of lumbar disc problems. Certain occupations may place you at a greater risk, especially if you spend extended periods of time sitting or driving. People who are tall or overweight have increased risk of disc problems. The condition is uncommon in children and is most common between the ages of 40 and 60.



Researches have shown that disc bulges and sciatica may be successfully managed with conservative care like the type we will provide.


Here is a brief description of the treatments we may use to help manage your problem.

Joint Manipulation

Joint Manipulation

Your chiropractor has found joints in your body that are not moving freely. This can cause tightness and discomfort and can accelerate unwanted degeneration i.e. arthritis. Your chiropractor will apply a gentle force with their hands, or with hand held instruments, in order to restore motion to any “restricted” joints. Sometimes a specialized table will be used to assist with these safe and effective “adjustments”. Joint manipulation improves flexibility, relieves pain and helps maintain healthy joints.

 

Therapy Modalities

Therapy Modalities

We may apply electrotherapy modalities that produce light electrical pulses transmitted through electrodes placed over your specific sites of concern. These comfortable modalities work to decrease your pain, limit inflammation and ease muscle spasm. Hot or cold packs are often used in conjunction, to enhance the effect of these modalities. Another available option is therapeutic ultrasound. Ultrasound pushes sound vibrations into tissues. When these vibrations reach your deep tissues, heat develops and unwanted waste products are dispersed.

 

Myofascial Release

Myofascial Release

Overworked muscles often become tight and develop knots or “trigger points”. Chronic tightness produces inflammation and swelling that ultimately leads to the formation of “adhesions” between tissues. Your chiropractor will apply pressure with their hands, or with specialized tools, in order to release muscle tightness and soft-tissue adhesions. This will help to improve your circulation, relieve pain and restore flexibility.

 

Therapeutic Exercise

Therapeutic Exercise

Muscle tightness or weakness causes discomfort and alters normal joint function, leading to additional problems. Your chiropractor will target tight or weak muscles with specific therapeutic stretching and strengthening to help increase tissue flexibility, build strength, and ease pain. Healthy, strong, and flexible muscles may help prevent re-injury.

 

Traction

Your condition is aggravated by compression of your spinal joints and discs. We may perform traction “by hand” or utilize a specialized traction table to “decompress” these tissues. Traction helps to stretch your tight muscles and ligaments, improve nutrition to the discs and increases available space in the openings where your spinal nerves exit.

 

 

 

After this initial course of treatment we will reassess your progress. We will determine the need for any additional care after your reassessment.

Sleep Posture

Sleep Posture

Your mattress and the position you sleep in may affect your condition.


  • Choose a mattress that provides medium or firm support, such as a traditional coil spring or adjustable airbed. Avoid waterbeds, thick pillow tops and soft, sagging mattresses.
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Always sleep on your back with a pillow either underneath your knees or on your side with a pillow between your knees. Avoid sleeping on your stomach.
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Keep your neck and back covered while sleeping to avoid drafts that could cause potential muscle spasms.
 

In & Out of Bed

In & Out of Bed

Here are a couple of tips to help you get in and out of bed more comfortably:

  • To lie down: Sit on the edge of the bed, pull your arms to your sides and tilt your body into the bed, maintaining the bend of your knees at 45 degrees. Finally, bring your feet into in a lying position or roll onto your back.

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To get up: From a side-lying position with your knees bent, push your body upright into a sitting position, swinging your legs over the edge of the bed as you rise.
 

Workstation Ergonomics

Workstation Ergonomics

Ergonomics is the science of adjusting your workstation to minimize strain in the following ways:

  • Wrists should not be bent while at the keyboard. Forearms and wrists should not be leaning on a hard edge.
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Use audio equipment that keeps you from bending your neck (i.e., Bluetooth, speakerphones, headsets).
  • Monitors should be visible without leaning or straining and the top line of type should be 15 degrees below eye level.
  • Use a lumber roll for lower back support.
  • Avoid sitting on anything that would create an imbalance or uneven pressure (like your wallet).
  • Take a 10-second break every 20 minutes: Micro activities include: standing, walking, or moving your head in a “plus sign” fashion.
  • Periodically, perform the “Brugger relief position” -Position your body at the chair’s edge, feet pointed outward. Weight should be on your legs and your abdomen should be relaxed. Tilt your pelvis forward, lift your sternum, arch your back, drop your arms, and roll out your palms while squeezing your shoulders together. Take a few deep cleansing breaths.
 

Lifting Mechanics

Lifting Mechanics

Here are some tips to help you lift safely:

  • Avoid lifting or flexing before you’ve had the chance to warm up your muscles (especially when you first awaken or after sitting or stooping for a period of time).
  • 
Use audio equipment that keeps you from bending your neck (i.e., Bluetooth, speakerphones, headsets).
  • To lift, stand close directly facing object with your feet shoulder width apart.
  • Squat down by bending with your knees, not your back. Imagine a fluorescent light tube strapped to your head and hips when bending. Don’t “break” the tube with improper movements. Tuck your chin to help keep your spine aligned.
  • Slowly lift by thrusting your hips forward while straightening your legs.
  • Keep the object close to your body, within your powerzone” between your hips and chest. Do not twist your body, if you must turn while carrying an object, reposition your feet, not your torso.

An alternative lifting technique for smaller objects is the golfers lift. Swing one leg directly behind you. Keep your back straight while your body leans forward. Placing one hand on your thigh or a sturdy object may help.

 

Lumbar Support Cushion

Lumbar Support Cushion

Sitting without proper support is a common contributor to back pain, so make sure you:

  • Sit all the way back in chairs and car seats to promote proper posture.
  • To lift, stand close directly facing object with your feet shoulder width apart.
  • Squat down by bending with your knees, not your back. Imagine a fluorescent light tube strapped to your head and hips when bending. Don’t “break” the tube with improper movements. Tuck your chin to help keep your spine aligned.
  • Adjust the lumbar support in your car to fit your back.
  • Consider a “lumbar support pillow” to make sitting more comfortable.
 

Entering & Exiting a Vehicle

Entering & Exiting a Vehicle

Entering and exiting your vehicle is a potential risky activity for low back pain sufferers. Follow these tips to limit problems:

  • To enter the vehicle, open the door and stand with your back to the seat, legs close to the side of the vehicle. For larger vehicles, you may wish to begin by standing on the running board. Place your hands on the door and door frame to keep your movements slow and controlled then slowly lower your body into the vehicle.
  • Tuck your head into the vehicle. Keep your knees close to each other, as though they have been taped together, brace your abdomen as though you are about to be punched in the stomach and pivot your body as a whole without twisting or bending at the waist. You may grasp the steering wheel with your right hand to help you pivot.
  • Use a lumbar roll or other support to help maintain good posture. Position the roll slightly above your belt to support the “small of your back”. Adjust your seat so that your knees are slightly lower than your hips. Try to avoid prolonged car rides- take frequent breaks.
  • Before exiting, create adequate space by pushing your vehicle seat back as far as possible and move the steering wheel up and out of the way. To exit, first scoot slightly to the door side edge of your seat, then keep your knees together and pivot with the same cautions that you used to enter the vehicle. When your feet are shoulder width apart and firmly on the ground or running board, grasp the door and door frame, lean forward, but be sure not to bend your back, as you tighten your abdominal muscles. Slowly thrust your hips forward to stand up.
 
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