What causes a herniated disc?
A herniated disc occurs when the discs between our vertebrae, which serve to reduce friction and absorb shock between the bones, shift and press on the large sciatic nerve. This can cause back pain and radiating pain down the legs.
Causes of a herniated disc
The causes can be attributed to aging, leading to degeneration and drying out of the discs, which reduces their ability to absorb shock. Additionally, a sedentary lifestyle with prolonged sitting or lying down can weaken the muscles, reducing the stability of the spine and increasing the risk of disc displacement.
Poor posture, such as slouching, forward head posture, and rounded back, can alter weight distribution along the spine, increasing pressure on certain joints. In some cases, uneven posture, like leaning to one side due to muscle imbalances, can result in one side being tight and contracted while the other is stretched, affecting the spine’s pressure distribution and potentially causing disc displacement. Without restoring balanced posture, pain will occur again.
Treatment for a herniated disc
The necessary treatment for a herniated disc involves repositioning the disc to relieve pressure on the nerve. Physical therapy treatments include strengthening core muscles (Core muscle strengthening exercises) and specific exercises like McKenzie exercises to realign the herniated disc and reduce back pain. Maintaining proper posture to prevent recurrence is crucial, which involves strengthening and stretching muscles and deep tissue massage to balance the muscles on both sides of the spine for proper posture.
Additionally, physical therapy treatments such as electrical stimulation and ultrasound therapy can help reduce pain.
Physical therapy machine that can help herniated disc
Electrical stimulation
Ultrasound
How to do Core Muscle Strengthening Exercises
1. Start by lying on your back: Bend both knees and squeeze a ball between them. Press your lower back against the floor and lift your legs to form a 90-degree angle with the floor. Breathe normally and hold for 10 seconds. Repeat 10 times per set, 3 sets per day.
2. Start on all fours: Lift your left arm, rotating your thumb upwards, and extend your right leg parallel to the floor with a straight knee. Alternate sides. Breathe normally and repeat 10 times per set, 3 sets per day.
3. Start by lying on your side: Keep both legs straight. Prop yourself up on your elbow at a 90-degree angle and lift your hips so your body is in a straight line. Hold for 3-5 seconds each time. Repeat 10 times per set, 3 sets per day.
How to do the McKenzie Exercise
1. Start by lying face down: Lift your upper body and prop yourself up on your elbows. Hold for 30 seconds.
2. From the initial position: Lift your upper body further, supporting your weight on your palms with your elbows straight. Hold for 30 seconds.
3. If you feel back pain: Stand and arch your back, holding for 10 seconds. This helps to push the herniated disc back into place.
Q&A
Q: Is it dangerous if lower back pain radiates down the leg?
A: If you experience chronic lower back pain that comes and goes for more than 2 weeks, it’s advisable to consult a doctor to determine the cause. If the pain is due to a herniated disc compressing a nerve, an MRI may be needed to assess the severity. Herniated discs can be classified into four stages:
1. Disc Bulging : Initial displacement of the disc without rupture of the outer tissue.
2. Disc Protrusion : Further displacement of the disc without outer tissue rupture.
3. Disc Extrusion : Rupture of the outer tissue with displacement of the disc material into the spinal canal.
4. Disc Sequestration : Complete rupture of the outer tissue with disc material separated from the disc itself.
If the herniated disc compresses a nerve, it may cause pain and numbness radiating down the leg. Untreated, this can worsen, potentially leading to muscle weakness and the need for surgery. Prompt medical consultation is important for diagnosis and treatment.
Q: If I have lower back pain radiating down the leg and want to avoid surgery, will physical therapy help?
A: The effectiveness of physical therapy depends on the severity of the condition. For cases classified as level 1 or 2, where there is no outer tissue rupture, physical therapy can be effective. Proper posture adjustments are crucial to reduce pressure on the spine and prevent recurring pain. However, if physical therapy or medication does not improve the condition, or if it’s at level 4, surgery may be necessary. Surgical options include open surgery, microdiscectomy, or endoscopic surgery, with the latter offering minimal invasiveness, less muscle damage, less blood loss, and faster recovery.
Q: How can I distinguish between lower back pain from muscle strain versus nerve compression due to a herniated disc?
A: You can observe the following signs:
– Herniated Disc : Typically causes lower back pain with radiation and numbness down one leg. Pain may be acute and worsen with bending, coughing, sneezing, or straining during bowel movements.
– Muscle Strain : Usually results in lower back stiffness and discomfort without leg numbness. It may affect one or both sides of the back, with pain that generally doesn’t radiate down the leg.
Treatment for Herniated disc with Traditional Chinese Medicine
What is a herniated disc?
It is a condition when the jelly-like disc between your vertebrae protrudes from normal placement in the spine and pressures nearby nerves or even spinal cord. It can be caused by aging disc degeneration in which the disc will be less flexible and more ruptured and torn in older people. Moreover, in some cases, lifting heavy objects in the wrong position by using lower back muscles instead of leg and thigh muscles or rashly turning and twisting can cause a herniated disc.
Herniated discs mostly occur at the lower back (L4-L5) which can cause pain on one side of the body. The symptoms included :
- Sharp or deep pain on one side of your arm or leg. If the herniated disc appears at the neck (C4-C5/ C5-C6/ C6-C7/ C7-T1), patients will commonly feel pain at shoulder blade, shoulder, elbow, forearm or fingers depending on which cervical nerve root that has been pressed. If it happens at the lower back, people can feel pain or sharp pain at lower back, buttocks, thigh, calf or sole of the foot.
In addition, people can feel sharp pain shooting through their body when sneezing or coughing. - Numbness or tingling radiating through one side of the affected part of the body.
- Weakness of the muscles that are associated with affected nerves, it can cause inability to lift and hold things, or even standing or walking.
Can Herniated discs be treated by Traditional Chinese Medicine?
Traditional Chinese Medicine has been widely used for treating pain-related symptoms for millennia. Since ancient times, many scriptures mentioned that using acupuncture and Chinese herbal medicines can help those who have lower back pain and further related symptoms.
As for herniated disc’s treatment, Traditional Chinese Medicine can be used to stimulate blood circulation and healing process, relieve pain and spasm, nourish internal organs. All of these processes are mainly to increase resorption of herniated discs.
Treatment
Acupuncture : The acupuncture focuses on pain reduction, stimulating the function of internal organs, and improving blood circulation to accelerate the body’s repair process.
Main Acupuncture point – AhShiXue or Pain point ( 啊是穴 ), DaChangShu ( 大肠俞-BL25 ), WeiZhong ( 委中-BL40 ), YaoYangGuan ( 腰阳关-GV3 ), GeShu ( 隔俞-BL17 ), ShenShu ( 肾俞-BL23 ), HouXi ( 后溪-SI3 ), KunLun ( 昆仑-BL60 )
Chinese herbal medicine : In traditional Chinese medicine, herniated disc’s symptoms are classified based on the causes of diseases, divided into two main factors: external factors such as heat, humidity, and wind. And internal factors such as blood stasis and deficiency of kidney’s Yin or Yang. Patients often present with symptoms like cold pain and heaviness in the back, difficulty twisting or stretching, no improvement even when lying flat, increased pain on cold or rainy days, or, in some cases, stabbing pain with clear pain points that worsen with pressure. They may also experience lower body aches, such as in the knees, calves, or feet.
Chinese herbal medicines – ShenTongSuiYu decoction (身痛遂瘀汤) or YouGui decoction (右归丸)
Properties – Nourishes kidney, Yang and blood, relieve pain, stimulate blood circulation
Q&A
Q : How long and how frequently should the treatment be continued?
A : It depends on the severity of the patient’s condition, but it is usually about 2 – 3 months, with follow-up appointments every 1 – 2 weeks.
Q : How long-lasting are the effects of these treatments?
A : Traditional Chinese Medicine focuses on nourishing the body from the fundamental level of the patient’s internal organs. As a result, the effects of the treatment can generally last for more than a year if the recommendations of the traditional Chinese medicine doctor are followed consistently and regularly. But, we would recommend co-treatment of Physiotherapy and TCM for best results and effects.
Q : What kind of procedure will be taken?
A : It depends on the severity of the patient’s condition, but it fundamentally starts with using Acupuncture to stimulate blood circulation and nervous system with taking Chinese herbal medicines for nourishing internal organs. Tui Na may be suggested after the patient’s condition has progressed well.
