How To Tell If Your Lower Back Pain Is Muscle
by Dr. Don DuffAug 20, 2019
The low back is a fairly complicated structure, so its no wonder the majority of peopleexperts estimate up to 80% of usexperience pain in this area of our bodies at some point in our lives. In fact, back pain is one of the most common reasons for visits to the doctors office.
The key to relieving back pain is understanding the cause. But diagnosing the of a patients pain isnt always a straightforward exercise. It could be muscle, joint, or disc-related in some cases, it may even arise from issues unrelated to the back. So how can you tell if your back pain is muscle- or disc-related, or attributable to something else entirely? Well cover all the possibilities in this post.
Treatment For Disc Problems
- heat treatment
- gradually increasing activity levels within pain limits
- an exercise program designed to improve strength, flexibility and fitness
- a short-term trial of massage, spinal mobilisation or manual therapy
- non-steroidal anti-inflammatory drugs or steroids
- pain-relieving medications, such as paracetamol.
Sciatica pain may be treated with an injection of anti-inflammatory steroids into the area of the affected spinal nerve. In severe cases of sciatica caused by a large disc protrusion, pain may be relieved by surgery to trim the protruding disc. This may be done to relieve pressure on the affected spinal nerve.
In severe cases of degenerative disc disease, surgery may be considered to remove the disc and fuse together the two vertebrae on either side.
However, severe cases of both sciatica and degenerative disc disease are uncommon.
Remember, most disc problems resolve without specific treatment.
Can This Injury Or Condition Be Prevented
To prevent experiencing a herniated disc, individuals should:
- Use proper body mechanics when lifting, pushing, pulling, or performing any action that puts extra stress on your spine.
- Maintain a healthy weight. This will reduce the stress on your spine.
- Stop smoking.
- Discuss your occupation with a physical therapist, who can provide an analysis of your job tasks and offer suggestions for reducing your risk of injury.
- Keep your muscles strong and flexible. Participate in a consistent program of physical activity to maintain a healthy fitness level.
Many physical therapy clinics offer “back schools,” which teach people how to take care of their backs and necks and prevent injury. Ask your physical therapist about programs in your area. If you don’t have a physical therapist, click on Find a PT to find a certified professional in your immediate area.
To prevent recurrence of a herniated disc, follow the above advice, and:
- Continue the new posture and movement habits that you learned from your physical therapist, to keep your back healthy.
- Continue to do the home-exercise program your physical therapist taught you, to help maintain your improvements.
- Continue to be physically active and stay fit.
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Exercise Relaxation And Positioning
In the past, people who had a slipped disc were typically advised to stay in bed for one to two weeks. Nowadays the opposite approach is taken: people are advised to stay active instead. This is because remaining in a lying position for a long time can make muscles and bones weaker, which can end up causing other problems.
Studies have shown that physical activity can improve mobility. However, whether people keep up with exercise or rest instead wasn’t found to influence the back pain itself. So it is a good idea to try to carry out your normal daily activities as much as the pain allows. Exercise has also been proven to effectively prevent back pain from returning.
Relaxation exercises may also be worth a try to help relieve back pain. How you perceive pain and how well you cope with it can be influenced by your mind.
If the pain is very severe, though, there is sometimes simply no other way to deal with it than to lie down and find a position that puts as little strain on your back as possible. Many people find the “psoas” position comfortable: While lying on your back, you put your lower legs on a raised platform high enough so that your knees are bent at a 90-degree angle. But it is important not to stay inactive for too long.
How Does It Feel
A herniated disk can cause pain, tightness, numbness, weakness, or tingling in the neck, back, arms, or legs. If the bulging or leaking disk pushes on a nearby nerve, pain or muscle weakness may result. If the bulging or leaking disk does not push on a nerve, pain or disability may not occur. Although back or neck pain can be caused by a herniated disk, other factors may be involved. Your physical therapist can test for and rule out other possible conditions.
If a herniated disk is severely pressing on a nerve, or is pressing on the spinal cord, surgery may be needed to immediately relieve that pressure. Your physical therapist can help determine whether either of these conditions is occurring, and will work closely with your physician and surgeon to determine the correct treatment.
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So What Is A Bulging Disc
To understand what a bulging disc is, we must first understand the anatomy of the spine.
Put simply, the spine is made up of individual vertebrae stacked on top of each other. Between each vertebrae is an intervertebral disc that provides a cushion so the vertebrae dont rub together. The discs between the vertebrae, have a gel-like material inside .
A great way to think of the discs is like that of a balloon filled with water, and these discs help resist compressive forces on the spine.
When a disc bulges the gel-like material inside of it gets pushed back towards the nerves and structures of the spine. This bulge can sometimes compress spinal structures, ligaments or nerves in your spine and cause pain, tingling/or burning sensation, and/or other symptoms.
* It is important to note that a bulging disc doesnt always touch the nerves, and for many a bulged disc doesnt even produce any pain at all. However, it could progress to become a herniated disc eventually, which can be problematic.
- Sitting for long periods of time, esp in poor posture puts more pressure on the discs.
- Decreased hydration of the disc as one ages .
- Repetitive bending, lifting, and twisting .
- Heavy lifting with poor form due to stress on the front of the spinal column causing the disc to bulge out back.
- Can also result from osteoarthritis or age-related degeneration.
- Trauma such as a car accident.
Secret #: Practice Yoga
Perhaps one of the best-kept secrets about healing a herniated disc and preventing a reoccurrence is to practice yoga.
While every pose is not going to be suitable for you while you are healing, many of the poses can help shift the weight on the spine, allowing the disc to return to its correct position.
Yoga is a great way to practice better posture, reduce stress and muscle tension, improve breathing and circulation, while improving core muscles that support the spine.
Dont attempt yoga poses if you have never done them before. You might injure yourself more. See a yoga teacher and be sure to tell them about your bulging or herniated disc so they can offer you the proper poses for healing and strengthening.
Some of the best yoga poses for those with disc problems are:
- Ardah Uttanasana
- Childs Pose
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What Is A Disc Herniation
The bones in your back, called the vertebrae, are stacked one on top of another and are separated by discs. These discs contain a tough outer layer, known as the annulus, and a jelly-like inner layer, known as the nucleus.
In the case of a herniation, the nucleus of the disc begins to push through the annulus and, in some cases, goes into the spinal canal. When this occurs, it can contact the nerves along your spine and cause numbness, tingling, pain and weakness down the legs.
Movement Posture And Hydration
The reason movement and good posture are so important is because discs help to support the pressure of our body. If we dont move, the constant pressure pushes the nucleus of the disc against the outer wall and over time, weakens it.
The discs absorb water from their surroundings and if they are under constant pressure , they cannot absorb water. Without water, the discs lose some of their hydrostatic pressure and shock-absorbing properties. Additionally, as the discs lose water, the walls of the disc can dry out and weaken, making them less able to keep the nucleus inside, rather like the weakened walls of a dam which holds back water.
We constantly talk about posture with our patients.
Sitting and slouching squashes the life out of our discs. This is because if we slouch over we put a lot of pressure on the discs at the base of the spine.
When we slouch in one position, we squash the front side of the disc and the nucleus of the disc is pushed back hard against the rear of the disc. The front side can slowly dry out and weaken whilst the back side of the disc can weaken because it has the nucleus forced back against it for long periods.
Pressure can also be exerted on the body when the surrounding muscles are weak, meaning there is less support for the discs and they are squashed even more. The muscles in our back and our core muscles provide essential support to keep the spine supported and strong, which takes excess pressure off the discs.
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Medical History And Physical Examination
After discussing your symptoms and medical history, your doctor will perform a physical examination. The exam may include the following tests:
- Neurological examination. A neurological examination will help your doctor determine if you have any muscle weakness or loss of sensation. During the exam, he or she will:
- Check muscle strength in your lower leg by assessing how you walk on both your heels and toes. Muscle strength in other parts of your body may also be tested.
- Detect loss of sensation by checking whether you can feel a light touch on your leg and foot.
- Test your reflexes at the knee and ankle. These may sometimes be absent if there is a compressed nerve root in your spine.
Clinical photo of a doctor performing the straight leg raise test.
Reproduced from JF Sarwak, ed: Essentials of Musculoskeletal Care, ed. 4. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2010.
What Does A Herniated Disc Feel Like In The Lower Back
Answer itherniated lumbar discfeelbackfeellike
How do you treat a herniated disc in the lower back?
Common nonsurgical measures include:
What are the symptoms of a ruptured disc in the lower back?
Symptoms of a ruptured disc can include:
- Muscle spasms.
- Shoulder, arm, or chest pain.
- Tingling or numbness.
- Pain in your lower back, hips, buttocks, legs, and feet.
- Severe deep muscle pain.
- Loss of bladder or bowel control, which indicates a medical emergency requiring immediate medical attention.
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When To Go To The Doctor For L4 L5 Pain
Thats especially true of the L4-L5 disc area, as it can create additional, painful symptoms that can interrupt your life and have you running to the doctor. Not sure if what youre suffering through is an L4-L5 slipped disc problem or something else? Here are three telltale signs to look out for. 1. Lower back pain
What Are The Symptoms Of A Herniated Disc
Disc herniation can happen in any part of the spine, but its most common in the lower back and neck . These are the flexible parts of the spine, unlike the middle of your back , and because they allow for the most movement, they also have the most wear and tear, causing that lost fluid volume.
If the herniation is minimal, or it’s not pressing on a nerve, you might have no symptoms at all. Dr. Anand says many people live with some degree of herniation.
For those who have herniations that do affect nerves, pain can be severe and unrelenting. It’s typically felt on one side of the body and may radiate to an arm or leg .
Other signs and symptoms of a herniated disc include:
- A dull ache on one side of the body
- Pain when you cough, sneeze, or move into certain positions
- Numbness, tingling, or burning sensations, usually from a compressed nerve.
- Pain that’s worse with sitting, but can standing, walking, and bending can worsen the symptoms as well
- Muscle weakness or spasm that may affect your ability to lift or hold items
- Balance issues or limping due to weakness and/or pain
- Slow reflexes
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Idd Therapy Disc Treatment
Disc herniation usually occurs at a specific level. The two discs at the base of the spine, called L5/S1 and L4/L5 are the most common to suffer herniation. The spinal segments are extremely strong and if they become stiff over a long period of time, it can be difficult to take the pressure off the disc and get the segment moving again.
IDD Therapy is a mechanical tool which allows us to decompress and mobilise targeted spinal segments. It was developed to address the failings of earlier traction treatment and the key with IDD Therapy is it works at the specific spinal segment.
Patients are connected to the Accu SPINA machine with ergonomic harnesses. Then using computer-controlled pulling forces, IDD Therapy directs a pulling force to a targeted level to gently open the space between two vertebrae and to relieve pressure on the disc and nerves. At the same time, the system gently oscillates the forces, meaning the soft tissues are both stretched and mobilised.
The combination of decompression and mobilisations helps to take the pressure off the disc and restore mobility. The treatment forces applied are progressively increased as the body adapts.
The good news is IDD Therapy is extremely comfortable and suitable for people of all ages. Some patients even go to sleep! IDD Therapy is combined with manual therapy and exercise and patients have a course of treatments over a six week period. The aim is to relieve pain and create a platform for long term healing.
What Are My Options For Herniated Disc Treatment Without Surgery
There are a lot of options for nonsurgical treatment of low back pain. The first is physical therapy. Good physical therapy will allow for the disc to heal and to provide improvements in biomechanics and strength. Recent studies have shown that directed physical therapy is more successful than more random approaches. Often, this is enough.
When the pain is too much to try physical therapy, however, can also be very helpful. Epidural injections are safe when compared to more invasive procedures. Complications include bleeding, headaches, infections, and very rarely, injury to a nerve. However, pain reduction can be markedly improved. Studies have shown excellent pain reduction and return to function with the use of epidural injections.
The combination of these two techniques can be the most effective treatment of all the epidural provides pain reduction and makes the physical therapy that much more successful.
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Lower Back Disc Herniation
You may have heard the term herniated disc. This can occur anywhere along the spine where a disc is present however most commonly in the lower back and neck. What does that mean you may ask? Technically it means that the nucleus pulposus is not contained within the disc. Still not following? Dont worry Ill explain.
So imagine that your disc is like jelly filled donut. You have the outer breading of the donut which is symbolic to what is called the annulus fibrosus of the disc. Then you have the jelly of the donut which is the nucleus pulposus of the disc. A normal healthy disc is the same as a non-oozingjelly donut with everyday movements of the human body. When the jelly starts to ozze is when the trouble starts.
Herniated disc aka oozing donut comes in different shapes and size hypothetically speaking. Depending on how much is ozzing is presents correlates with the severity of the symptoms.
For more information on the different types of disc herniations and the anatomy of intervertebral disc, click here- coming soon.
Just on more thing before reading on. Depending on the medical professional, they use bulging, herniated, slipped, etc interchangeably so be aware. Not to say one person is correct or incorrect but the terms use in this website pertains to the actual anatomical changes within the disc.
If you are a male over the age of 45 you are at more risk of experiencing this condition, just the nature of the beast.
How Can A Physical Therapist Help
In all but the most extreme cases, conservative care often produces better results in treating a herniated disk than surgery or pain medications, such as opioids.
Your physical therapist will work with you to design a specific treatment program that will speed your recovery, including exercises and treatments that you can do at home. Physical therapy will help you return to your normal lifestyle and activities. The time it takes to heal the condition varies, but results can be achieved in 2 to 8 weeks or less, when a proper posture, pain-reduction, stretching, and strengthening program is implemented.
During the first 24 to 48 hours following your diagnosis of a herniated disk, your physical therapist may advise you to:
- Rest the area by avoiding any activity that causes worsening symptoms in the arms or legs.
- Avoid bed rest.
- Stay active around the house, and go on short walks several times per day. Movement will decrease pain and stiffness, and help you feel better.
- Apply ice packs to the affected area for 15 to 20 minutes every 2 hours.
- Sit in firm chairs. Soft couches and easy chairs may make your problems worse.
- Consult with a physician for further services, such as medications or diagnostic tests.
Some exercises are better for individuals with herniated disks. Your physical therapist will educate you about them. For example:
Your physical therapist will work with you to:
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