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Back pain

Slipped Disc: What is it and how to fix it

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Slipped discs are very common, right? Well, to tell you the truth… they don’t actually happen! Find out what a slipped disc really is and how YOU can sort it out yourself.

Slipped disc, Herniated disc, disc bulge and sciatica are all interchangeable and often used to explain the same thing. Now I need to say first of all that intervertebral discs cannot actually “slip” as they are firmly attached to the vertebrae above and below vertebrae by very strong ligaments – Slipped disc is just a colloquial term which has bred a lot of fear over the years but really there is nothing to fear!

The two common sites for herniated discs are the lumbar spine (low back) and the Cervical spine (neck). Today we are going to cover the low back as this is the most common, but stay tuned for self-treatment of herniated discs in the neck!

Discs cannot actually “slip” as they are firmly attached to the vertebrae above and below vertebrae by very strong ligaments

Basic anatomy:

lumbar anatomy - slipped discs and herniation

The spine is made up of vertebrae stacked on top of each other, held together by ligament and muscle. in between each vertebra is an intervertebral disc. Now in the lumbar spine, there are 5 vertebrae and the most common level for disc herniations are L5/S1 – this is the Disc between your lowest lumbar vertebrae and your Sacrum. roughly 80% occur here with the second most at L4/5 above it.

The Lumbar discs are made up of a harder outer layer, holding in a gooey middle.

How does a Disc herniation occur?

When too much force is repeatedly put through the front of the disc (such as bending forward, slouching and lifting heavy objects) the gooey center of the disc is forced forward and eventually (after thousands of bends)it forces through the outer layer.

A lot of Discs are injured doing very simple things light, changing a light bulb or picking up a baby but it is not that action that does it, it is a build up over time and it can take any little thing to tip it over the edge!

Now there is different levels of disc damage as you can see in the picture below:

disc bulge levels herniation - how to fix slipped disc

Now, sequestrations are serious and often need surgery but the remaining levels can be and should be treated conservatively (non-surgically) first.

Depending on the level of disc herniation, they can cause symptoms in different places down the leg due to the nerve roots that get annoyed. Keep in mind though that Disc herniations often do not have pain or change on sensation into the legs – there is a very wide range of presentations.

Herniated disc symptoms: You can have some or all of these.

  • Pain worse in the morning and cold/bad weather
  • Sciatica – Common back and leg pain caused by irritation to one of the 5 Lumbar spinal nerves. The nerves are irritated by the disc compressing on it or inflammation from the disc herniation. This usually only occurs down one leg.
  • Back spasm – often people are given this as a diagnosis but muscle spasm DOES NOT HAPPEN FOR NO REASON – there is always something behind it. Muscles around your back tighten up and go into spasm to protect your back and try to stabilize it so that no more damage is done.This is called muscle guarding and is a natural mechanism initially but in the following days, it can lead to a lot of discomfort, pain, and limitation.
  • disc bulge, slipped disc, herniation - self treatment physiotherapyAggravated by sitting, prolonged standing, bending and twisting.

Recovery and healing time

Recovery: Up to 80 percent recover within 6 weeks

Healing time: 12-18 months due to poor blood flow into the discs.

When to go to the hospital or see your Doctor

  • Weakness in your legs
  • Change in bladder or bowel (toileting) function.
  • Constant unremitting pain or pain not improving

If in doubt see your local health professional as this information is not meant to replace the assessment and advice of a health professional.

“Slipped disc” Self-treatment

1. keep active: back in the day bed rest was the first port of call, now it is the opposite. keeping relatively active is the best thing for your back and you need to remember that the chances are your back will get better and that over 80% of the population get back pain just like yours!

2. Exercises: to get the right muscles firing again to stabilize your spine and to loosen off the tight muscles (so that you dont feel hunched over and shuffling!) follow this link: Must know exercises for acute low back pain

3. Stiffness in your upper spine puts a huge amount more stress though your low spine and gets worse when in back pain! Here is a great way to mobilise your own spine

4. The greatest exercise for Disc Herniations: this exercise was developed by a top Physiotherapist Robin McKenzie. Repeated Extensions In Lying (REIL) act to centralise the disc and gradually reduce the disc Herniation.

Prone extensions in lying McKenzie exercise for disc low back pain

Position: Lying on your Front with your hands in front of you like you are going to do a push up.

Action: Keeping your hips and back relaxed, push your shoulders up. Do not push into pain, so stop when and if you feel pain and hold it for 10 seconds then relax down and repeat 10 times.

Initially start on you elbows as shown, then progress to straight arms.

Prone extensions in lying McKenzie exercise for disc low back pain physiotherapy

Reps and sets: 10 x 10 second holds 3 x daily


Remember: if pain worsens with this exercise do not push as far or as hard. If pain continues to worsen then consult a health professional.

These easy steps will help you so much, just remember that you WILL have good days and bad days but if you stick to the above 4 things, your Disc pain will get a lot better. Try and persevere with these exercises for 6 weeks at least!

Let me know how you get on and don’t forget to like, share and follow and remember, a slipped disc doesn’t exist!

For a more thorough rehab plan, download our Complete Low Back Self-Rehab Guide

Also see: progressed exercises for keeping back pain away


Back pain, Core strengthening, Health, physical therapy, physiotherapy

Beating Low Back Pain – Must know Physiotherapy Exercises

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Don’t put up with low back pain and Sciatica. Below are the best and safest exercises to treat your low back pain yourself.

With 80% of the population experiencing low back pain in their lifetimes, and 84% of those having a recurrence within the same year, this is a huge problem, but a problem that can be helped… alot! As with most other pain and injury, treatment and exercises combined lead to optimal results, so below are five exercises for you

As with most other pain and injury, treatment and exercises combined lead to optimal results, so below are five of the best exercises for you to rehabilitate your low back pain at home.

1. Bridge, level one:

Start by lying on your back on the floor or bed with your knees bent. Squeeze your buttocks together and lift buttocks off the floor until your body is aligned. Hold for 5 seconds, then lower down. Repeat 10 times twice.

Brideg - up

Bridge level 2:

For the next level up if the above is too easy, keep one leg straight out in the air and perform with one leg. 10 reps each side, 2 sets.

For the next level up if the above is too easy, keep one leg straight out in the air and perform with one leg. 10 reps each side, 2 sets.

SL bridge 1SL bridge 2

2. Glute sling stretch:

Our favorite stretch!

glut and Lat stretch - Hip flexibilityglut and Lat stretch - Hip flexibilityglut and Lat stretch - Hip flexibility

Start on your hands and knees then bring one knee between your hands. stretch the other leg out behind you and across to the other side. Now slowly walk out over your knee with your hands until you feel a good stretch.

Hold for 1 minute each side.

Tip – If that is too much of a stretch then go down onto your elbows first.

3. Bird-dog: 

Instructions: In four point kneeling slowly raise one arm and leg on opposite sides, making sure to keep your back straight (imagine your dinner is sitting on your hips – it is all about control). Lower down in a controlled manner and repeat, 10 times each side twice.

Beginners: Start by raising one leg only.

birddog 2birddog 1

4: Hip flexor stretch: This is important to unload the Low back and pelvis:

hip flex 1hip flex 2

Tip: to get a good stretch “tuck your bum in” or draw the bones at the front of your pelvis up towards the roof. You should feel it in the front of your hip or top of your thigh.

Hold for 1minute.

5: McGill Curlup

Place your hands down on the floor underneath the natural arch in your lower back (Don’t flatten your back.) Only lift your head and shoulders off the ground – unlike crunches, there should be no movement of your lumbar spine. Your hands are there to make sure your back is not curling off your hands or crushing them.

Once you have good spine control then you can take your hands onto your thighs and slide them to the top of your knees to do the curl-up. It doesn’t feel like you are going far but with repetition, it can get your abs firing well.

Begin with 20 at a time, and build up.

mcgill curl up

The key to all of these exercises is to maintain control and don’t rush them.  Do these exercises twice daily for 6weeks and notice the difference (but don’t stop there!)

Also check out our Lower Back Rehab Guide

And if you want more and harder exercises to strengthen up your low back: Get into some QL strengthening!

Please Share, like and comment to let me know how you go.


Back pain, Core strengthening

Acute Low Back Pain – Getting up and moving

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Low back pain is an incredibly common condition and is the single most common thing I see in practice every day. Luckily there are some great exercises to do early on to get you up and moving.

The following facts show just how seriously we should take back pain!

The bad

  • Low back pain affects 84% of the population at some point in their lives (1,2)
  •  38% of people have back pain each year (3)
  • Close links with low back pain and neck pain (15 fold increased the risk of neck pain)

The Good

  • 50-80% recover within 4-6 weeks
  • This is not uncommon

It may feel really sore and at times disabling but as long as you follow my recommendations below you have a good chance of recovering 100%

In most cases, the majority of low back pain is not serious. What a lot of health professionals do not tell their patients is that 85% of low back pain is categorized as “Non-specific low back pain”. This means that the pain and disability do not have a definitive cause or diagnosis. This non-specific low back pain is what we will be talking about today and I will be giving you the information and exercises to get you walking right and up straight again.

Because 50-80% of people recover in 6 weeks the usual advice is to take painkillers and keep active – but the thing is there is more you can do to speed it along!

First I need to say, yes there is the remaining 15% of back pain that is specific and does have a diagnosis so it is important to have these ruled out and see your doctor – especially if the pain is not improving.

Below I am going to outline a guideline for getting your back to the best it can be when you experience acute low back pain.

Phase 1. Initial inflammatory phase:

This is the stage where most likely it is uncomfortable to walk, bend over etc and you just want to curl up in a ball and stay there (that will not help!). In this phase you need to abide by the Tips below:

  • Number one rule is to keep moving, within reason. This prevents the structures around the spine such as the muscles in spasm from stiffening up too much. This is also very important in order to decrease the loss of stabilizing muscle activity. Now you don’t need to continuously keep moving – just don’t stay in one position for a long period (more than 20 minutes).

Bed rest is one of the worst things for back pain

  • Gentle range of motion exercise: knee rocker – Lying on your back with your knees bent up and feet on the ground – slowly let your knees drop to one side, and then the other. This is a gentle exercise and not to be forced or pushed into pain. Little and often throughout the day.
  • Safe sleeping positions: The best position is in side-lying with your knees bent up a little and a pillow between the knees. This position decreases the forces on the spine and allows muscles to relax.
  • If you must sleep on your back then have a pillow under your knees to unload the spine.
  • Stretch to straighten up: when in back pain your hip flexors tighten up and put a shear force through your spine and cause you to have a bent over, shuffling posture.

hip flex 1hip flex 2

Tip: to get a good stretch “tuck your bum in” or draw your front hip bones towards the roof. You should feel it in the front of your thigh or hip.

Hold for 1 minute.

Phase 2. Recovery:

In this phase, the main things causing stiffness and pain are muscles that are tight and in spasm in your hips, glutes and low back.

1. Glute stretch: To get into the below stretch, start in four-point kneeling and bring one knee forward between your hands. then extend you

To get into the below stretch, start in four-point kneeling and bring one knee forward between your hands. Then, extend your other leg out behind you and across to the other side. Lean forward in this until you feel a stretch in your glute region. To add more of a stretch, walk your hands out in front of you. Hold for 1 minute each side

glut and Lat stretch - Hip flexibility glut and Lat stretch - Hip flexibility

2. Hip flexor stretch: as above in phase 1

3. Bird-dog exercise:

In four-point kneeling slowly raise one arm and leg on opposite sides, making sure to keep your back straight (imagine your dinner is sitting on your hips – it is all about control). Lower down in control and repeat, 10 times each side twice.

Beginners: Start by raising one leg only.

birddog 1birddog 2

4. Bridge, level one:

START POSITION: Lying on your back with your knees bent.
Stabilization: Tighten abdominals.
Squeeze your buttocks together and lift buttocks off the floor until your body is aligned. Hold for 5 seconds and then lower down. repeat 10 times twice.

Brideg - up Brideg 1 legges - up

Phase 3: Strengthening and back stability – and maintain!

To do this make it a routine to do my top five Low back pain exercises daily.

Maintaining core stability is important in preventing flare-ups and ensuring you at your best if flare-ups do happen, to speed up recovery.

Thanks for reading and remember looking after your back is ALWAYS important, not just when it is sore.

Looking for a more detailed self-rehab plan? Download our Complete Low Back Self-Rehab Guide


Back pain, Core strengthening, Spine

QL Muscle Strengthening: Beat Low Back Pain

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Your Quadratus Lumborum muscle (better knows as your QL muscle) can cause you all sorts of back pain and refer pain into your hip and glutes. Having weakness in your QL muscle can mean recurring and frustrating back pain that can cause way too much trouble

So following on from our previous article on how to treat the QL yourself through an easy muscle release, here is how to strengthen it up and beat low back pain.

Strengthen QLSo, what does your QL muscle do?

Easy, it comes from the top of your pelvis (the iliac crest) and attaches on to the bottom rib and the side of your spine. From there, it acts to help you extend backwards, bend to the side, bend forwards and can help in breathing.

So the QL does rather a lot. Not only that but because it attaches to all your lumbar vertebrae and your pelvis, when it goes into spasm, it can really pull on your spine and can also lift one side of the pelvis – Making it seem like your “back is out”

Strengthen Quadratus lumborumAnd you know what? The QL can be a real pain in the butt.

Literally. As with a lot of muscles in the body which cause you to feel pain elsewhere and not where the real issue is. The QL refers pain into the buttock and side of the hip, making it quite deceiving as to where the pain is actually coming from.

Symptoms of QL muscle dysfunction:

  • Deep, aching in the low back, often worse in sitting or standing
  • Pain with coughing and sneezing
  • Pain rolling to either side when lying on your back
  • Pain can refer to the groin and mimic sciatica symptoms
  • You may have one side of your pelvis lifted higher than the other

Strengthening exercises for the QL:

  1. Side plank

Level 1: Hold

Side plank QL strengthening

Build up your QL endurance by holding a side plank.

Aim for a one minute hold (this is the goal, you may not be able to do it straight away!)

Tip: don’t stick your bum out, tuck it in

.

.

Level 2: Leg lifts

Side plank leg raises

When you can hold a straight side plank comfortably for a minute, step it up.

Lift your hips up into a side plank but now lift your top leg up and down while holding the side plank.

Aim for 3 sets of 10 reps, but you may need to start with less reps!

Tip: don’t let your top leg come forward or toes point up.

2. One sided farmers carry

one sided farmers carry for QL strengthening

Here, the QL muscle on the opposite side to the weight you are carrying is working hard to keep you upright.

Hold onto a dumbbell or kettlebell in one hand and do some laps (e.g. 10 x 10m laps on each side)

Tip: try to stay upright!

And that’s it. Easy. Combine those few exercises into your workout at least 3 x weekly to improve the strength of your QL muscle and help beat back pain.

Looking for more? Download out Complete Low Back Self-Rehab Guide

Tip: This is a great stretch to help unload the low back!


Spine

QL muscle release – Exercise for low back pain

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Your Quadratus Lumborum (QL) muscle is a very common cause of back pain, so being able to treat this yourself, effectively, can be a huge relief. Here is a great self QL muscle release to loosen off your low back and reduce your low back pain.

First of all, here is a bit of information about the QL:

QL release anatomyAnatomy:

This muscle runs down either side of your low back, from the top of your pelvis, all the way to your bottom rib. This is why it can affect your breathing when it is in spasm and it pulls down on the lower rib of yours. It also attaches along the way to the side of your spine.

Purpose:

  • Side flexion/bending of the spine
  • Fixation/stabilization of the low rib

The problem:

QL release trigger pointsWhen muscle knots form in the Ql or it goes into spasm due to overload or injury, then it can give you real grief! Often this is more one-sided than the other also, giving you a real lopsided feeling and can make it seem like you have one leg shorter than the other or that your “pelvis is out” (which can’t really happen). The QL refers pain elsewhere and isn’t always felt at the muscle. The referred pain is generally felt in the outer hip and in the glutes and is often described as a deep ache but can be a sharp pain when moving. The trouble is that this muscle is very hard to stretch – but, it is quite easy to do a QL muscle release!

QL muscle release: Release your low back

QL muscle release1. Position

Lie on your back and place a firm massage ball (or a specific, purpose made tool like what the QL Claw) under your QL muscle, which you will find in-between the top of your pelvis and your bottom rib, off to each side of your spine.

QL muscle release low back and erector spinae2. Action:

Bring the knee on the same side as the ball up towards your chest, which puts pressure on the ball. Once you feel like you have the right spot (you will feel it!), holding onto your knee you can either:

1. Rock your knee out to the side and then in again and repeat, OR

2. Repeatedly bend your knee up and down towards your chest.

Slowly and gently work into it for 1-2 minutes on each side and feel free to move the ball up or down slightly to get the right spots.

Do this great myofascial release once a day for two weeks for longer-lasting results and check out new Complete Low Back Self-Rehab Guide that you can download that is packed with self-treatment advice and exercises for more.

Tip: Help prevent this recurring and giving you ongoing trouble by strengthening your QL and the surrounding muscle so that they can handle everything that is asked of them!

Note: If you have acute low back pain, pain going down your leg, or any neurological symptoms please see your local health professional first.


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