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Oh, my aching back….

Are my bulging discs causing my back pain?

Probably not…..at least not in and of themselves. Studies have shown that 1/3 of people over the age of 35 have some sort of “bulging disc”. Unless the disc is severely flattened or compressing a nerve, chances are, this is not the direct cause of your back pain.

First let me explain what the disc is. Essentially the discs are a cushion that sits between the vertebra that make up your spinal column. They are “donut like” in nature with a donut outside a jelly like substance in the middle. They are made up of a large percentage of water and as we age, these discs start to “dry up”. This flattening of the discs is what is referred to as disc degeneration and this in turn leads to a narrower space between the vertebra and the joints that connect them. This then leads to increased “friction “ at the joints space which causes the arthritic changes we see later in life. These changes can lead to inflammation and/or narrowing of the spinal canal where the nerves exit the spine. In addition, this then stresses the surrounding ligaments and muscle which contributes to back pain.

A bulging disc is a small “popping out” of the disc seen on MRI. It is generally asymptomatic and does not result in nerve or spinal compression that leads to radiculopathy or sciatica. If the disc herniates or ruptures however, this may cause pain from nerve root or spinal compression and inflammation. Generally speaking this type of pain would present more with leg pain, numbness or tingling or motor weakness of the lower extremity. Less commonly back pain itself.

What are some things I can do to prevent back pain?

Muscle weakness, tightness and imbalance are the most common causes of non discogenic back pain. Tight hamstrings and hip flexors from sitting at a desk for example can cause excessive rotation of the pelvis which in turn is attached to the spinal column. By improving flexibility of these muscle groups we can decrease the stress on the joints in the spinal and maintain a more neutral spine position relieving the constant irritation on the joints in the spinal column.

Core strengthening and upper back strengthening exercises also help to stabilize the spinal column. After all, the only thing supporting your bones are the muscles and ligaments that attach to it. Strengthening these muscle groups will help stabilize the vertebra and decrease the stresses on the discs and joints of the spine that may be leading to back pain.

Even people who exercise regularly may exhibit muscle imbalances in strength and flexibility that can contribute to these problems. Designing an individual program that addresses your specific needs will help prevent that chronic aching back.