Condition Series: How To Heal A Disc Herniation Without Drugs or Surgery

If you have been told that you have a disc injury, disc bulge, disc herniation, or anything to do with a disc within your lower back, this video is for you.

Oftentimes, when we hear disk injuries, disc bulges, and disc herniations, and most of us think that means immediate surgical consultation or immediate surgical needs. Now, in some cases, it is very pertinent and important to be co-managing this with an orthopedic surgeon. But for the majority of cases, that is not the case. So my goal here today is to help reassure you and give you some confidence in your body and in your back, if you have been told that you have a disc injury, a disc bulge or a disc herniation.

I’m Dr. Antonio Gurule with Live Loud Chiropractic and Coaching. My wife and I have owned Live Loud  Chiropractic and Coaching in the Lafayette, Colorado in Boulder County area for seven years. I’ve suffered with this. I have treated many patients with disc bulges and disc herniations. In addition to myself, and what we have done through all of our education and learning and teaching and trial and error of working with people is helped to come up with a system that helps you determine:

1. If it is a disc herniation or disc bulge
2. The severity of that
3. What to do next

You have to have a proper assessment and evaluation to determine what are the triggers and the things that make things worse. Disc injuries usually don’t respond well to rotation and flexion. That being said, if you were to be picking something up where I’m flexing over and bending forward, that is going to be compression of your spine under flexion.

And that is what’s going to be putting the most load on the disc. If a disc is trying to heal from an injury, it’s going to be very hard when you keep pushing on that disc and eliciting more pain and damage. If that’s not being addressed from your PCP, your physical therapist or your orthopedist, then what’s the use? Just putting medications, drugs and, you know, maybe some core stabilization exercises on there is not going to help, you’re going to keep spinning yourself in the loop by recreating more pain. the more pain you create, you’re going to be more sensitive to the pain, which only heightens the amount of pain that you feel. And all of a sudden you’re stuck in this loop.

Today we’re going to walk through a basic example of what a disc examination and assessment might look like. And some of the common cues that we give for movement and some of the common active rehab movements that we give early on and throughout to help you get over the disc injury.

Now again, this is the basic example that helps. This is in no way intended to say that this is for you. Because every disc injury is different in how it happens, the chronicity of the cycle will change and dictate what we need to do. You need a custom plan to help you once and for all get over the disc injury to create more confidence so that you can lead a healthy, active loud life. And if you’re interested in that, please follow along and I think you’ll enjoy this video.

Flexion Intolerant Low Back Pain

So as we already indicated, the more common presentations of lower back pain that we see are what we refer to as flexion intolerant low back pain. Now flexion intolerant, low back pain simply means your back does not tolerate flexion. How is flexion presented out throughout the day? well bending over to pick things up. We have to also consider though when you’re sitting, right and we kind of slump. compression is where things most gets sensitive or irritated when we’re talking about flexion intolerant low back pain.

Now with that, as we already indicated in the intro, these are commonly seen with disc injuries. Now disc injuries does not mean herniations, it does not mean bulges, you can have an annular tear, or some sort of disc sensitivity from an injury, and or from trauma-based and or repetitive based loading patterns that create a essentially desensitized disc. So these are the important things to understand. And what we’re going to try to show today is how we tease out or understand that this is more disrelated, or some sort of compression and flexion irritation.

Now, if you already have been told you have a disc injury, and has been confirmed or an MRI, the good part about that is we can expedite that and just understand the sensitive patterns, as we already indicated, we want to know how sensitive is inflection, whether that’s standing or sitting, load, so on and so forth. But if you’re unsure, and you just have this this back pain that’s been either chronic subacute or whatever that is, we want to determine what is actually the sensitized issue and what are the positions and movements again, that are craving this recurrent pattern of pain that you’re not able to get out of.

Because once you understand that, then we can very temporarily splint this so that we can allow the body to not become so sensitized to that pain cycle, and then reintroduce that later on.

The example that we commonly use is if you had a cut on your knuckle and you kept bending your fingers, that scab or that cut would essentially keep opening up in prolonging the healing process. Whereas sometimes you might need to actually splint or hold that finger straight for a while to allow the healing process to occur. And then after everything’s healed, we regain mobility and function back to that. That’s essentially how we treat disc injuries and these flexion intolerant lower back injuries.

So what we want to look for is, again, what are the positions that are most problematic for you? And then we have a few early intervention tools that I’m going to share with you today that will help you in that early sensitive or painful process.

Now, again, these are great for this early intervention, they’re also very well used and beneficial for just kind of like a daily spinal mobility or scrub, even if you’re not having pain. And if you’re someone who commonly is bending over a lot, labor workers, even those that are more sedentary in a desk position.

Movements for Looking at Range of Motion

1. Bend down and attempt to touch toes. Any pain there?
2. Feet together, arms up overhead, and then lean back. But we do have to keep in mind, if this hurts so much, what your body will commonly do is throw you into an extension where oftentimes you’re kind of walking around like this, because you don’t want to go forward.
3. Heel drop test. Stand up on the toes, and with legs straight, drop hard on the ground.
4. Compression of the spine. Sit at the end of the table, sit up nice and tall, then grab the end of the table and pull yourself down. Any issues?
5. Still seated, kick one leg out in front of her and hold that up. Any tension? Does that go down the leg? Does it create burning symptoms, numbness on and so forth?

When we’re looking at disc mechanics, the disc sits in between the vertebral bodies. So if we flex the spine, round it, and add that compression, we want to see if there’s more sensitivity. More likely than not, if it’s a disc injury, we’re going to see with that compression and flection and these types of movements, increases a pain, potentially symptoms down leg if it is more of a disc herniation or bulge. And that’s what we need to determine for the extent of the injury.

Basic Movement Patterns for Herniated Discs

Now, in knowing all that, what do we do, right? Well, we already know that the disc is injured, and we have a flexion base injury. So this is where we come into the knuckle model, right? We need to temporarily help her “splint” this so that we don’t keep putting more and more pressure to the back of the disk where the injury is.

These are great for two main reasons. They help reduce the pain sensitivity, and help with the healing process.

1. Hip Hinge

The reason why this is important is we’re always bending forward, right, you’re bending forward to pick something up, you’re unloading the dishwasher, you’re washing your face, your hands, we’re typically in a bent over flexed position. If this causes pain, we need to get to a position here where I can load more of my hamstring and my hips to reduce the load on the lower back. The lower back is still being loaded here. But the but the load is reduced.

2. Supported Squat

So in our office, we have a suspension trainer or a TRX. You can also use rings or anything like that. At home, though you might not have that equipment. So what we use is a banister, or a kitchen sink, and you’d essentially just hook your sink, she’s going to be using my hands though to just demonstrate this moment.

Stand with a wide, open stance. Holding on to your support, lean back into your heels a little bit, not just your hips, like your whole body leaning back like you’re waterskiing, right?

So there’s two ways in which I try to coach this. So what I want you to try to do is, don’t let your hips go backwards as much, I want you to try to go straight up and down.

Now the second way we coach this is I want you to waterski more, so I want you to really set your hips back away from me. Really move the hips away from her hands. So in doing this, we’re actually decompressing the lower back.

But hands are anchored this way, what’s in the middle? lower back. So on each rep, that lower back is getting a little bit of traction and a little bit of decompression to help relieve a lot of the tension and aches and pains that we get from that compressive feeling of having these lower back injuries.

3. McKenzie Extension Variation

On the ground, get onto your stomach in an upward-facing dog motion. Shift your weight into your hands and let your hips drop gently. Do multiple reps.

Conclusion

So again, these are the basics. First and foremost, understand pain. Second of all, work on some of the stabilizing muscles that help stabilize the lower back so you feel more comfortable.

These are kind of like your core exercises, but done in a specific way so that we’re not again picking at the scab, then we look at mobility for the mid back and the hips to make sure we have everything we need, then that’s our foundation of getting back to strength, power, agility, or whatever sport or activity that you enjoy doing.

It’s got to go through this progressive plan. We layer in again, soft tissue, dry needling adjustments, all the things that help act as a catalyst. But if I can give her these tools, she’s able to control her pain, so much better at home. And then it doesn’t feel like this end, this end diagnosis, “oh, I have a disc herniation. And all I can do is take medications and sit around.” No, we say this is your medication. These things work oftentimes better than muscle relaxers and ibuprofen and drugs because it maintains your mobility and it gets your body more confident about how to move rather than just sitting and waiting for the pain to return only to come back super stiff and weak.

So if you want to deal with your low back in a very progressive yet conservative way, this is this is how to do it. If you want to just take drugs and wait till it works, that’s totally fine. But most people want to get back to their life. And if you want someone advocating for you to help you through a disc herniation, disc bulge, or disc injury, we’d love to be that advocate and that support team for you. If you found this helpful, please feel free to reach out to us. If you have a family member who is dealing with low back pain, which is extremely common, and they’ve been through the wringer over the years, We would love to have a conversation with them to see how we can support them, whether in the office or even virtually having a consult or conversation over the computer. Thanks for tuning in guys, live loud.