What is a Prolapsed (Herniated) Disc? - Dr. Jonathan Kuttner
It's possible to have a herniated disk without any symptoms - but when they hurt, they tend to hurt bad!
A herniated disk results when a crack in the strong outer layer of cartilage allows some of the softer inner cartilage to squeeze out of the disk.
These are also know as ruptured or slipped disks.
Most herniated disks occur in the lower back (lumbar spine), although they can also occur in the neck (cervical spine).
It's possible to have a herniated disk without knowing it as these sometimes show up on spinal images of people who have no symptoms of a disk problem at all. However, herniated disks can also be extremely painful.
The most common symptoms include:
Arm and/or leg pain. If the herniated disk is in the lower back, the client will often report with intense pain in the thigh, calf and buttocks. In some cases the pain may also radiate to the foot. If the herniated disk is in the neck, the client will usually report severe pain in the arm and shoulder which may worsen with a cough or when the spine is moved in certain positions.
Tingling and Numbness. Clients will often report a tingling or numbness in the body part served by the affected nerves.
- Weakness. The muscles served by the affected nerves tend to weaken. Often the client may report that they have unexpectedly stumbled (perhaps whilst getting out of a car) or that they have found it difficult to lift moderately heavy items that they are used to lifting (e.g the supermarket shopping).
Trigger Points and Pain Relief
The pain from a herniated disk can often be relieved and controlled with trigger point therapy. The pain map of a herniated disc is most often associated with trigger points in the gluteus maximus, rectus abdominis, and piriformis muscles.
Interestingly, Travell and Simons submitted that trigger points may actually be the root cause of many common spinal conditions, including a herniated disc.
They reasoned that the shortening and tightening of the muscles could be the main source of disc compression and spinal nerve impingement.
Ideally, you'll be able to receive treatment from a trigger point professional. If not, see below for self help information that may be useful.
Self Managed Care
Below are some simple exercises that we often prescribe for clients who we are treating for a herniated disc.
Try using a tennis ball, lacrosse ball, or a pressure tool, as shown. Without using too much force, see if you can apply enough pressure over the area to "feel" the trigger points. The pressure may help dissipate these trigger points and relieve the pain.
It's possible that applying pressure to the trigger points in any of the areas shown will reproduce or magnify your pain symptoms for a short period.
Don't worry. This is a good sign that you're hitting the right spot.
Use your common sense to find the right level of pressure. Always go slowly and don't overdo it.
When NOT to use Pressure Tools
Please note that in the early stages of an acute disc problem the body goes into severe shut down mode. This particularly affects the forward and backward bending muscles (erector spinae) and side bending (quadratus lumborum) muscles.
This is a part of your protective mechanism. For this reason we do NOT advise using pressure tools for the first 6-8 weeks or until the acute stage has ended.
Gluteus Maximus - Use a ball as shown
Piriformis - Use a ball or pressure tool as shown and as described above.
2. Standing Extension
• Stand straight with your hand behind your hips with your fingers facing down
• Push your hands into your pelvis so that your lower back arches
• Don’t use your lower back muscles
This exercise is usually best performed 6-8 times, 2-3 times per day. Always start slowly and progress within your own comfort levels.
3. Chair Sits / Squats
• Sit in a chair, keeping your back straight
• Focus your eyes on a point directly in front of you, and slowly rise to a standing position, taking at least five seconds to do so
• While you rise, do not round your back, but keep it straight, and do not hold onto the chair for support. Be sure to keep your knees pointing forward
• Once you have reached a standing position, slowly lower yourself back to the seated position in the same way, keeping your back straight and taking your time
30 repetitions, 2-3 times daily
4. Figure of Four
• Lying on your back, bend both knees with your feet flat on the ground
• Bend the right knee like a figure four, with the outer left ankle to the right thigh
• Lift the left foot into the air, bringing the left calf parallel to the ground
• Thread your right hand between the opening of the legs and interlace your hands behind your left thigh
• Hold 2-3 minutes and then repeat on the other side
How Often?Twice Daily
5. Laying Prone
• As soon as you get up in the morning you should lay down on the floor, on your stomach
• By getting into this position, your lower back curves/arches
• The increased arch pushes on the disc helping to bring the nucleus forward into the correct position
Hold for 1 min, twice daily
NAT Trigger Point Therapy Courses:
This trigger point therapy blog is intended to be used for information purposes only and is not intended to be used for medical diagnosis or treatment or to substitute for a medical diagnosis and/or treatment rendered or prescribed by a physician or competent healthcare professional. This information is designed as educational material, but should not be taken as a recommendation for treatment of any particular person or patient. Always consult your physician if you think you need treatment or if you feel unwell.
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