Flexible cushions called “discs” live between each set of vertebrae. The term lumbar disc lesion means that your disc has been damaged.
Disc lesions start when the outer fibers of the disc become weak and may “bulge” or “protrude” out. 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 lower extremity. This condition is called sciatica, which can also be accompanied by loss of reflexes and muscle weakness.
The condition is more common in men and between the ages of 40 and 60. Certain occupations may place you at greater risk, especially if you spend extended periods of time sitting or driving.
Researchers have shown that disc bulges and sciatica may be successfully managed with conservative care like the type we will provide.
Your provider will apply a gentle force with their hands in order to restore motion to any “restricted” joints to improve flexibility, relieve pain, and help maintain healthy joints.
We may apply electrotherapy modalities or therapeutic ultrasound to comfortably decrease your pain, limit inflammation and ease muscle spasms.
Your provider will apply pressure with their hands, or with specialized tools, in order to release muscle tightness which will help improve your circulation, relieve pain and restore flexibility.
Your chiropractor will target tight or weak muscles with specific therapeutic stretching and strengthening. Healthy, strong, and flexible muscles may help prevent re-injury.
Your condition is aggravated by the 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.
Your everyday activities, habits, and postures can have a dramatic impact on your body. The following advice will help you minimize stress while improving your comfort and health:
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.
– 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.
– Keep your neck and back covered while sleeping to avoid drafts that could cause potential muscle spasms.
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 a lying position or roll onto your back.
– 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.
Ergonomics is the science of adjusting your workstation to minimize strain in the following ways:
– Monitors should be visible without leaning or straining and the top line of type should be 15 degrees below eye level.
– Use audio equipment that keeps you from bending your neck (i.e., Bluetooth, speakerphones, headsets).
– Keep your shoulders relaxed and elbows bent to 90 degrees.
– Wrists should not be bent while at the keyboard. Forearms and wrists should not be leaning on a hard edge.
– Keep frequently used objects, like your telephone, close to your body to prevent excessive reaching.
– Take a 10-second break every 20 minutes: Micro activities include: walking, stretching, or moving your head in a “plus sign” fashion.
– Periodically, perform the “Brugger relief position” – Position your body at a 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.
– Hips and knees bent 90 degrees, feet flat on floor or footrest.
– Use a lumbar roll for lower back support.
– Avoid sitting on anything that would create an imbalance or uneven pressure (like your wallet).
– Keep your head, neck, torso, and legs vertically aligned.
– Wear shoes that provide proper arch support.
– Use a footrest to shift your weight from foot to foot.
– Adjust the footrest to approximately 10% of your total body height.
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).
– To lift, stand close directly facing the 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 power zone, 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 golfer’s 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
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.
– 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 and exiting your vehicle is a potentially 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.
Supine Piriformis Stretch
Perform 1 set of 3 contract/relax
Lie flat on your back with your affected knee bent and your ankle touching the outside of your opposite leg. Grasp your knee and pull your thigh across your chest toward your opposite shoulder. If you are unable to comfortably reach your knee, grasp a thin towel wrapped around your knee. Against the resistance of your hand, try to push your knee outward for seven seconds. Relax and pull your knee further across your body towards your shoulder to increase the stretch.
Seated Groin Stretch
Perform 1 set of 3 contract/relax cycles, 2 times per day.
Sit with your knees bent and the soles of your feet together. Slowly allow your knees to drop away from each other, toward the floor. Grasp your ankles with your hands, allowing your elbows to rest on your knees. Lean forward until you feel a stretch in your groin. Against the resistance of your arms and elbows, push your knees upwards for seven seconds. Relax and slowly stretch your knees further into a butterfly position toward the floor.
Semi-Stiff Dead Lift
Perform 1 set of 15 reps, 2 times per day on each leg.
Begin standing with your thumbs on your rib cage and your fingers on the crests of your hip. Stand on one leg with your knee bent only slightly. Slowly flex forward from the hips, moving your chest toward the floor, keeping the back straight. Slowly return to an upright position.
Perform 3 sets of 10 reps, 1 time per day.
Begin standing on one leg and slowly bend your knee to lower your hips toward the floor as though you are going to sit in a chair. Keep your knee positioned directly above your ankle and do not allow it to shift. Consciously contract your gluteal muscle on the planted leg side to return to the start position.