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disc bulge

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

Health, Spine

Spondylosis and Back Pain: Scan results aren’t the final say

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MRI spondylosisLow back pain is the most common condition I see, but do x-ray, CT and MRI results that show spondylosis and disc protrusion tell us much? Should you take their results as the be all and end all? Find out here.

Low back pain affects about two-thirds of the population at some point in their lives and often means significant time away from what you love doing (and work!), which is not ideal. As well as this, backs are being investigated by advanced imaging much more. Mainly because:

1. As I have said, back pain is so common

2. It means significant time off work and sport, meaning a large cost to the economy

3. And ultimately, imaging is becoming a lot easier to access and cheaper to do

This ultimately means advanced imaging such as MRI and CT scans are being used more and more.

There scans commonly pick up:

  • Disk degeneration
  • Facet joint hypertrophy
  • Bone spurs
  • Disc protrusion and more

spondylosis MRI findings need to be using smartlyWith most of these able to be grouped under the “spondylosis” label, meaning: degeneration of the spine, often also described as osteoarthritis of the spine.

Far too often (really way too much) these results and findings are taken as THE CAUSE of your back pain, often triggering costly and long medical and surgical interventions. Which don’t always leave you int he condition you would hope for.

So really how much faith can you put in the scan results and how can we make the most of this ever-improving and readily accessible technology? Because it really is great that these investigations are becoming much more accessible – although we have a way to go – because ultimately it does mean better outcomes for you.

Now, here is why we can’t just look at your scan result and say “There is your problem, fetch me the scalpal”without taking your entire clinical presentation into account:

Low back pain prevalence form MRI and CT scan

This table shows the results of imaging findings of over 3000 pain-free individuals – Yes they had these findings and are all asymptomatic, meaning showing no symptoms whatsoever.

Find your age bracket on the table to the left and look down the column and see the prevalence of spondylosis in your peers.

For example:

  • 37% of 20-something year olds have disk degeneration
  • 60% of 50 year olds have disk bulges
  • 50% of 60 year olds have facet joint degeneration (1)

Sobering reading huh? The thing to keep in mind is that the people in this study are asymptomatic – SO findings of spondylosis in scans does not automatically mean that they should be causing you pain.

So what does this mean for your scan results, should you throw them out the window?


This is where health professionals need to utilize this great technology and use them as part of their tool belt to our your advantage.

Take away message: Image findings of spondylosis among other things MUST be taken in the context of the patients clinical condition, otherwise you are wasting your time.

MRIThis means that your health professional needs to look at the scan results combined with:

  • Your pain pattern and presentation (night pain, morning stiffness etc)
  • Physical test findings
  • Subjective findings (what you tell us – which is why it is so important that you tell your health pro how it feels and when it hurts etc)
  • Past medical history

And use their clinical reasoning to say “does this scan finding reflect what the patient is presenting with” – That is what a good physio, doctor, specialist etc will do, although all of them should.

2nd take-home message: Unless any red flags are present, low back pain should always have a period of conservative treatment before invasive medical treatment is needed – for most back pain, this will be enough. See this great post to get started on some rehab exercises.

Looking for more? We have compiled all the best info in one, evidence based rehab guide

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Back pain, Core strengthening, Health

Sciatica and low back pain – All you need to know to sort it out

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You may have heard of Sciatica or Low Back Pain, or been told that you have it. BUT do you really know what the sciatic nerve is or how it gets sore?

In this post I we will go over, common causes, misperceptions and finally, self-treatment techniques.

Sciatica is a buzz word used by a huge amount of back pain sufferers and medical professionals but is really an umbrella term and can be caused by a number of things:

– Tension on the sciatic nerve as it passes through the gluts by your Piriformis muscle.

– Compression on nerve roots as the exit the spinal cord by disc herniation.

– Compression or irritation by rough surfaces and extra bone growth (spondylosis or arthritis of the spine).

The symptoms of sciatica range from radiating pain down the buttock and leg to altered sensation in the leg and foot. Back pain may or may not be present.

Physio exercises and information on low back pain

It is very important that you see a good physiotherapist who can diagnose what is causing your low back pain and/or sciatica as this gives a better picture and leads to a more specific treatment approach.

A large proportion of “sciatica” pain is caused by Lumbar disc herniations which is where the disc bulges backwards into a spinal nerve due repetitive flexion (bending forward or slouching), compressing it and restricting movement and sliding of the nerve.

Self-treatment technique #1: Extensions in lying. In order to know whether it is a disc contributing to your pain, lie on your front with your hands under your shoulders like you are going to do a push-up.

In order to know whether it is a disc contributing to your pain, lie on your front with your hands under your shoulders like you are going to do a push-up. (Now remember not to push into too much pain here)
What I want you to do now is push your shoulders up, keeping your hips relaxed a hanging down. Hold this for 10 seconds 10 times and if this either decreases your pain, or decrease your leg pain and causes pain more centrally in the back then, most likely this is a disc problem which is helped greatly by doing this McKenzie exercise twice daily.

Tip: as in the picture above it is best to slowly progress this exercise, so begin only pushing up into the middle position if you have moderate to severe back pain and then progressing up over the next fortnight.

For more information on how this exercise was developed check out Physiopedia.

Self treatment technique #2: The exercises in this great post lay a great foundation to start rehabilitating your back and is an excellent place to start. They are also fantastic for all common causes of back pain!

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Looking for more? We have compiled all the best info in one, evidence based rehab guide

Disclaimer: It is important to stop this exercise if it increases back pain and seek medical attention if symptoms worsen or you lose strength in your legs

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