Stop Low Back Pain (Part 2)by Brian Schiff, The Fitness Edge Medical Treatment for Disc Problems Depending on the severity of your problem, you may encounter several different treatment options. I will briefly summarize common solutions suggested by physicians I have worked with in the past. Treatment typically begins with X-rays and a physical examination. The X-ray will reveal any arthritis, joint space narrowing and degenerative disc disease present. An MRI may be indicated in the presence of numbness, tingling, or referred pain indicating a herniated disc. If there is muscle weakness or delayed reflexes, some MD's order an EMG to test nerve pathways (identify compression). Most docs will prescribe some form of an anti-inflammatory medication to reduce pain and inflammation. If there is significant spasm, the doctor may also prescribe a muscle relaxant. In acute cases of sciatica, the physician may prescribe steroids (typically a prednisone dose pack). The next progression also includes physical therapy. Therapy will often consist of modalities (heat, ice, ultrasound, e-stim, etc.) as well as specific exercises to address your problem. Treatment should be based on a thorough evaluation that clearly identifies the stability of the disc (easily recognized by ability to flex and extend with the resultant symptoms on exam). Therapy should address posture, body mechanics, activity modification and appropriate exercise. Treatment may consist of pelvic traction, although it is less successful in the lumbar spine as compared to treating disc problems in the cervical spine. Exercise programs should focus on core exercises and mechanically reducing the disc. Therapy will typically alleviate most symptoms in 4-6 weeks. If not, it is necessary to return to the physician for further testing and evaluation. At this point, you may undergo site specific epidural injections (done in a series of 3) to target the area. Should this fail, it may be necessary to consider operative intervention. Such choices include discectomy, laminectomy, and fusion. Surgery should be the last resort as it can make things worse (I have seen this before). Other alternative treatments may include acupressure or acupuncture, massage therapy and chiropractic care. I have seen favorable results with most of these, but no guaranteed pattern of success. The important thing to remember is that you need to know the problem before you can treat it successfully. Therefore, do not wait until you can not walk to seek medical attention. Nerves can be damaged quickly and heal very slowly, so forget about "no pain no gain."
5 Exercises to Solve Back Pain The following exercises are not intended to serve as medical advice and are not intended to treat a medical problem. If you suffer from back pain, please seek the advice of your doctor prior to trying these exercises. They are general exercises I use with my clients that have worked well, but keep in mind they are applied differently depending on each client's particular case. Prone prop - This is a positional technique used to mechanically reduce lumbar disc bulges. You may or may not need a pillow (s) under the hips while doing this. You lay on your stomach and prop up on the elbows, while keeping the hips/stomach on the floor. Hold in this position for 3-5 minutes. Repeat twice per day. This should not increase symptoms in the leg, and if it does should be stopped immediately. Press-up - Start in the push-up position with the hands beneath the shoulders. Keeping the hips against the floor at all times, you press the upper body off the floor to extend the lumbar spine. The hips should not come off the floor. Perform 10 repetitions. This should follow the prone prop exercise, and again not cause an increase in leg symptoms. Crunches - Whether done on a stability ball or the floor, performing a 45 degree crunch is effective for strengthening the abs. Do not do a full sit-up ever again! This causes forces in the lumbar discs to go through the roof. The abs are most active in the first 45 degrees, so raise up until the bottom of the shoulder blades clear the floor. If on the ball, start in a table top position and rise up about 45 degrees. Perform 2-3 sets of 15-20 quality reps. Standing trunk rotations - Using a cable or tubing, stand with the knees slightly bent and abs tight. You begin by holding the handle so the arms are nearly straight and extending from the center of your body outward. Next, deliberately pull the cable or tubing across the body 90 degrees to the right and then slowly return to midline. Repeat 10-15 times and then repeat on the other side. Perform 2-3 sets. Remember to allow the hips and knees to move as well. This movement is necessary to train the obliques and strengthen the disc in a line of pull that it will encounter on a daily basis. Low back extension - While I prefer a 4 degree back extension machine, today I will describe this maneuver on the floor. Lay face down with a small rolled towel beneath the forehead. With the hands folded in the small of the back, slowly raise the upper torso off the floor. Pause 1-2 seconds and then slowly return to the floor. Perform 2-3 sets of 10-15 reps. To increase the difficulty, keep the arms extended fully in front of the body (superman position). To continue to part three, click HERE Doug's Note: Brian Schiff is both a friend and a professional I trust. Over the last couple years, he's taken a leadership role in helping Americans alleviate pain through his books on injury prevention and rehabilitation which can be found at:
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