In clinic I treat a major amount of patients who suffer from Discogenic Pain. Natural Treatment such as Osteopathy among other things is very helpful for such cases and can bring about dramatic changes.
So many patients ask me as a result, if and how any exercises can actually be used to help low back pain of discogenic origins, and if yes, then what is the best exercise for doing it.
Many of my patients come to see me suffering from back pain, with low back pain in particular. Pain in the back is an extremely common cause of disability and pain. Since back pain can stem from various different things, finding out what the exact cause is can help us get to the root of the problem and help provide us with a proper treatment protocol for this problem. Many conditions can be the root cause, including strained back muscles, intervetebral disc herniations, stenosis or narrowing of the spine, and other things.
There are times when it is thought that the back pain comes about from the lumbar spine discs that are being worn out and becoming degenerated. Such lower spine disc pain in the lumbar area may also be called discogenic lower back pain.
What exactly may cause discogenic lower back pain may not even be clearly understood. There are certainly visible differences between a healthy lumbar disc and a degenerated one. One issue is that there are those that say that this degeneration process is part of good ol ordinary aging. Most degenerated dics will not cause any symptoms. That being the case, it is even less understood why some people actually do suffer from major pain as a result.
Plus, the pain often does seem to get better as time goes on. So despite the fact that there is degeneration involved and it may be part of aging, people with such discogenic low back pain frequently have improvement with time. Some may be concerned that the appearance of discogenic low back pain may be the start of chronic back pain. This is scary. Most often this does not happen. Most people ailing from such low back pain can see improvement over time with some basic treatment and exercises.
Diagnosing lumbar discogenic back pain may not be that easy. There are specific things to look for in the physical exam, but these same results may also be found in those suffering from other kinds of back pain. Sure, the usual x-rays, CT scans, and MRIs may be done, but because degenerated discs may be found in normal people because of ordinary aging, the scans may show abnormal (supposedly) discs in those without pain or symptoms at all. So how can we prove that it IS disc pain, even if a disc does seem to be not normal in the scans?!
The discogram is a major test used to see if there is a discogenic low back pain diagnoses. A small amount of dye is injected into the suspected problematic disc. The source of apin as well as the disc's structure are both analyzed with the discogram. The test may be called positive, if there is pain from the injection that is the same as the disc pain that the patient feels.
It is often hard to treat discogenic low back pain, but fortunately enough some basic treatments and exercises can solve the actual back pain and I am going to take this even a step further in a moment.
Medicines either by prescription or even over the counter can also work well to get rid of the low back pain. These can be anti inflammatories or NSAIDs which help in the treatment of both the back pain and possible related inflammation. NSAID's side effects can include gastro intestinal bleeding, so people with ulcers in their stomach and GI tract should not be taking them.
As far as exercises and treatment go, there are those that advise strengthening the back muscles as a major step to treat discogenic low back pain. By working on and improving both the flexibility and strength of the muscles of the back, there is a better and more even weight distribution on the spine with less force then being placed on it.
So we all know what I think about back muscle "strenghtening", and you can read a bit more on that in my article Sa+sb=fb: Strong Abs And A Strong Butt Equals A Flexible Back! The flexibility however, is an amazing idea that I definitely agree with.
As I've said there, the weakest link in the back in L5 / S1, the last lumbar vertebrae on the base of the sacrum, and the disc in between them. That's the one most often with discogenic problems as a result and this causes compensations and lesions in the lower lumbar spine and the whole spinal column as a result.
You see, the Sacrum and Occiput or the head and lower back, are like two ends of a snake or whip, and depending on where a problem may occur one acts as a head or handle, and the other as a tail or tip. It's basically like a steering wheel which determines where and how the spine should go and how it should behave.
The key then is to release pressure on the weakest link, while using the mechanism of the spinal column and cord via the Occiput and Sacrum to straighten out the whole spinal complex. This results in the desired flexibility and release of the sacrum and lumbar spine, bringing about the desired balance and even weight distribution which will relieve discogenic low back pain as a result.
Many of you may have seen this on my video for lower back pain which is posted on top of my blog as the first entry or know about it and other exercises from my other articles.
- Lie flat on your back with your legs stretched straight out in front of you.
- Prop yourself up comfortably on your elbows with your forearms on the floor, bed, or mat next to your body.
- You are now propped up and looking straight in front of you.
- In no particular order:
- Split your legs to about twice the width of your hips.
- Internally rotate your hips and legs so that they turn towards each other.
- Dorsiflex the ankles by pulling your toes up and back towards you while pushing your heels down. This pulls on the posterior calf muscles the gastrocs / soleus which you will feel stretching.
- All this opens up and releases the sacro iliac joints.
- Maintain all these parameters that you have set up, for 60 seconds as you lower and roll your chin and your forehead towards your chest and sternum.
- Deep breathing in through the nose and out the mouth as you do all this.
- Keep the shoulders relaxed but supported by your arms.
- You will feel the neck stretching for the first few seconds as it does the work, but by the end of the minute you should feel your lower back being stretched and released as well which is the purpose here. Even if not, the work is most likely being done, so give yourself time to feel and let it work, because it does the job it’s supposed to do anyway.
- Relax and release everything.
- Slowly lower yourself down and lie on your back.
- Do 3 to 5 times per day for just the 1 minute.
In general it is thought that besides for surgery and treatment with the mentioned drugs, there are very few treatment options. In a situation of surgery being done, a lumbar spine fusion is often done, or even the quite new lumbar disc replacement surgery which is being developed, as well as Intradiscal Electrothermal Therapy which was developed in the late 90s.
In my opinion those should be left as a last resort after all other options are exhausted. The body is very resilient and has the ability to heal itself if it is aligned correctly and its balanced structure allows for ideal function.
That's the purpose of the exercise here in helping to treat the discogenic low back pain. With this, the best exercise for the problem as well as others, you can ultimately reach a level of being more mobile, pain free, and totally healthy.
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