Did you know that not all back pain is a result of the same condition? In fact there are many conditions that can cause lower back pain. Proper diagnosis of your low back condition is paramount in order to make sure you choose the correct treatment. A thorough examination can easily identify a bulged or herniated lumbar disc. The most common orthopedic tests that are used to identify lumbar disc injuries are the Seated Straight Leg Raise Test, Slumps Test and the Supine Straight Leg Raise Test. A positive test will cause pain in the patient’s lower back, hip and possibly radiating pain all the way down their leg to their foot (assuming the test is performed correctly).
What is proper treatment for Lumbar Disc Injuries?
Over the last 10 years we have been developing a low back treatment protocol that has proven to work for the vast majority of patients that suffer from lower back pain due to lumbar disc bulges, protrusions and herniation’s. This approach combines many disciplines that when applied alone fail to get superior results. We have incorporated the best from all of these therapeutic disciplines which has allowed us to achieve amazing and quick results with patients that have been suffering from chronic and acute lower back pain. Let’s look at what disciplines and therapies we have found to be the Gold Standard.
Chiropractic/Spinal Manipulation – Chiropractic and Chiropractors are often discounted as “Quacks” because of their professions inability to move forward into the 21st century. Far too many of them try to solve every problem a patient has by cracking their spine. However, in some instances the results can be nothing short of a miracle. Why? When a Chiropractic adjustment is done PROPERLY to the bulged, protruded or herniated disc the positive result can often be felt by the patient immediately. If done INCORRECTLY the patient will either feel no improvement or might even feel worse. We have developed a system of diagnosis that leads to proper Chiropractic adjustments which takes pressure off the disc typically within 24 hours.
Massage Therapy – While massage may feel good it is not appropriate for a lumbar disc bulge. In fact, if too much pressure is applied on the lower back it will often make the patient worse and cause lumbo-pelvic muscle spasms. However, if moderate pressure massage is done over the muscles affected by the lumbar disc bulge (gluteal muscles, hamstring and calf) while the actual lumbar spine is avoided the results can be excellent when combined with the other described therapies.
Physical Therapy – Alll too often become patients leave their clinic feeling worse than when they arrived. This is due to their over simplification of low back conditions. Many therapists tend to group patients into one of two categories. Either they are too tight and need to stretch or are too weak and need to do strengthening exercises. Lumbar discs neither can be stretched nor strengthened so this approach often fails. However, there are exercises that are known to cause the lumbar disc to move back into alignment. These exercises are centered on lumbar extension and can be extremely valuable to have the patient do at home between office visits. We do not feel it is of good value for the patient’s money or time to do them in the clinic with us watching. After we initially instruct the patient on proper form we send them a video link for reference which works nicely.
Lumbar Traction – Traction is an approved therapy in the case of cervical discs but in the lumbar spine it is a bit more controversial. After years of experimenting I now understand why. The muscles of the lumbar spine are too thick and dense to be undergo traction. Due to this the traction never affects the disc. Lumbar inversion tables provide traction but are not used properly. The name is what gets patients and therapists into trouble. Because the name is an “INVERSION table” patients 100% invert themselves. This actually causes tightening of the lower back muscles due to fear on the patients part that they will slide off the machine and head first into the floor. In addition the ankle stabilizers that help hold the patients feet must be secure, so secure that they are often too tight and cause pain. Thirdly, being upside down causes blood to rush to your head and is uncomfortable and if you have blood pressure issues can actually be dangerous. In the case of Inversion Traction Therapy “Less is more” and that by not completely inverting patients we achieve a far superior result.
Think of it like baking a Cake – It is almost as if each discipline has baked a cake on their own and has their favorite ingredient yet discounts others that have a different but excellent recipe. Rather than experimenting with those other recipes (therapies) they discount them instead of trying to incorporate the best of those other recipes into their own. Instead we have identified what works the best from each discipline and what does not and came up with an amazing approach to fixing lumbar disc injuries.
Let me leave you with one last concept regarding therapies. Most therapies can be helpful if applied for the right reason to the right area and with the correct frequency and intensity. Let pain be your guide. In the case of the three most common therapies you can do on your own at home……..
- Stretching – You can over-stretch, you can under-stretch or you can stretch the perfect amount. Do this little test. Pull your finger back like you are stretching it but only pull it back ½ inch. You are technically stretching it but as you can feel it will probably not be enough to cause any positive change. Now pull your finger back until it hurts. It is painful because you are causing damage….which is not your goal. Now pull your finger back until it almost hurts…..then back off slightly. That feels comfortable and is exactly how the proper range of stretching should be established.
- Strengthening – Imagine you have biceps tendonitis and it hurts you to curl weight. Now you perform bicep strengthening exercises in an attempt to fix the tendonitis. The curling of weight will cause more pain and more tendonitis! The exact wrong time to strengthen something is while it is inflamed. Trying to fix non-muscular type injuries by strengthening muscles is usually going to result in failure as well. In fact, most chronic pain conditions are NOT MUSCULAR!!
- Massage – Have you ever had an experience with a massage therapist where you were in pain because they were applying too much pressure. Remember pain is your body’s neurological signal that damage is occurring. A common home massage tool is regularly misused. When patients tell me they are using a foam roller or a lacrosse ball for self-massage I always ask them “Does it hurt when you do it”? The answer is usually less. Again, you can use too much pressure, too little pressure or the perfect amount.
These principles may make sense to you now having read them and I hope they might help you stop hurting yourself in an attempt to correct a painful lumbar disc condition. If you would like to schedule an appointment with Dr. Allen D.C. call:858-268-8525 or email Drallen@sdri.net