Hey guys,

After the success of my other PT thread I have decided to dedicate this particular one to neck and back pain.

Back and neck pain are some of the most common areas of pain we see in our clinic, and there are often many causes to it. My mission is to help treat and manage this often complicated area with individualised exercises prescribed based on your presentation (below).

The format will be similar - if you could fill in the following headings:

Body Chart: (Where exactly does it hurt?)
Age: (DUH)
How long have you had the pain for?: (When did it all start)
Mechanism of injury: Did the pain occur during ONE particular event? Or can you think of nothing that brought it on?
Aggravating factors: What makes the pain worse?
Easing factors: What relieves the pain?
If you have back pain - any leg pain or pins and needles/numbness?
If you have neck pain - any arm pain or pins and needles/numbness?



I will be liaising with my colleague (who specializes in neck and back injuries) and has over 10 years experience. We will work together to help you manage your neck/back pain as best as possible.

There will be a few follow-up questions and tests, as we want to be a thorough as possible before we give you advice.

Disclaimer - this should not substitute for seeing a REAL LIFE health care professional

For any other injuries that aren't the neck or back, please feel free to post in the original thread .

For those who sit in front of a computer monitor for a living, a pair of "bongers" is handy for smoothing out knots in the back or neck.

losing any belly at all helps my lower back pain. Death to carbs. I am a Carb Cult member.

Body Chart: Lower back region, more to the left side
Age: 30
How long have you had the pain for?:

Started a year ago when I started doing squats and deadlifts.

Mechanism of injury: Did the pain occur during ONE particular event? Or can you think of nothing that brought it on?

It comes and goes, but it happens during squats and deadlifts. Sometimes I go without it for weeks, than suddenly at the bottom of my squats it comes back. I'm pretty sure it's those exercices. I'm watching my form to correct them.

Aggravating factors: What makes the pain worse?

Squats and deadlift or sitting in a chair for a long time.

Easing factors: What relieves the pain?

Only time

If you have back pain - any leg pain or pins and needles/numbness?

Yes, the pain and stifness goes down to my left leg.


Seems obvious to just correct my form, but I've heard cases where this was an indicator of a long term problem unrelated to weight lifting, so I'd like to have your opinion.

Quote: (01-16-2014 02:21 PM)Daddy Wrote:  

Seems obvious to just correct my form, but I've heard cases where this was an indicator of a long term problem unrelated to weight lifting, so I'd like to have your opinion.

Hey man,

Just a couple questions:

Do you experience the leg pain when sitting for extended periods?

Does the leg pain go pass the knee?


Just a couple of tests I'd like you to do;

Bending down to toes and back
Sidebending to left and right side
Twisting to left and right side



Do any of these specific movements bring on any of the back or leg pain?

If you do an unloaded squat now, does that bring on your back or leg pain?

^^^ Lumbar Facet Joint Pain.

Have mentioned this a few times on the forum. Don't know if anyone's ever tried it but it works wonders for pain. EGOSCUE.

http://www.egoscue.com/

http://m.youtube.com/watch?v=rqNnmC09eUU

Quote: (01-16-2014 09:21 PM)Prophylaxis Wrote:  

Quote: (01-16-2014 02:21 PM)Daddy Wrote:  

Seems obvious to just correct my form, but I've heard cases where this was an indicator of a long term problem unrelated to weight lifting, so I'd like to have your opinion.

Hey man,

Just a couple questions:

Do you experience the leg pain when sitting for extended periods?

Does the leg pain go pass the knee?


Just a couple of tests I'd like you to do;

Bending down to toes and back
Sidebending to left and right side
Twisting to left and right side



Do any of these specific movements bring on any of the back or leg pain?

If you do an unloaded squat now, does that bring on your back or leg pain?

Hey Prophylaxis, thanks for the reply.

When I sit for a long period of time, I feel the pain in the lower back, but I would say the leg pain is only slight.

The leg pain doesn't go past the knee.

The only test that brings up the pain is the bending down to touch the toes. Brings up the leg and lower back pain on my left side. The unloaded squat also brings up the pain.

It's a diffuse pain that is hard to pinpoint with precision, not the sharp kind of pain. Normally, it gradually goes away after 5 days of my weight training session, but when I do hill sprints or drive for more than an hour, I can feel it.

Quote: (01-16-2014 10:59 PM)Daddy Wrote:  

Hey Prophylaxis, thanks for the reply.

When I sit for a long period of time, I feel the pain in the lower back, but I would say the leg pain is only slight.

The leg pain doesn't go past the knee.

The only test that brings up the pain is the bending down to touch the toes. Brings up the leg and lower back pain on my left side. The unloaded squat also brings up the pain.

It's a diffuse pain that is hard to pinpoint with precision, not the sharp kind of pain. Normally, it gradually goes away after 5 days of my weight training session, but when I do hill sprints or drive for more than an hour, I can feel it.

Almost done!

Does it hurt when you bend backwards all the way?



Do an unloaded squat, then can you do repeated lumbar extensions (15 reps) and redo the unloaded squat - does this reduce the pain at all?

I once had the worst Sciatica pain. I tried everything, I mean everything (except surgery), and then my older cousin gave me this book of his at Thanksgiving, and it changed my life. Cured my completely. Howard Stern, who suffered from back pain, recommended him.

You can buy the book on Amazon or most any bookstore.

http://www.healingbackpain.com

Quote: (01-17-2014 07:53 PM)Prophylaxis Wrote:  

Quote: (01-16-2014 10:59 PM)Daddy Wrote:  

Hey Prophylaxis, thanks for the reply.

When I sit for a long period of time, I feel the pain in the lower back, but I would say the leg pain is only slight.

The leg pain doesn't go past the knee.

The only test that brings up the pain is the bending down to touch the toes. Brings up the leg and lower back pain on my left side. The unloaded squat also brings up the pain.

It's a diffuse pain that is hard to pinpoint with precision, not the sharp kind of pain. Normally, it gradually goes away after 5 days of my weight training session, but when I do hill sprints or drive for more than an hour, I can feel it.

Almost done!

Does it hurt when you bend backwards all the way?



Do an unloaded squat, then can you do repeated lumbar extensions (15 reps) and redo the unloaded squat - does this reduce the pain at all?

Bending backwards all the way hurts a little.

The lumbar extensions reduce the pain but only a little.

What seems to reduce the pain the most is squatting. The first few reps are painful but the more I do them the less pain I feel.

^^That position/lift does wonders for my lower back.

I have/had the same pain as you except mine is on the right side. I'm pretty sure my squats and read lifts, which I haven't done in at least a month, are the cause of the pain. I'm about to start going to the gym again, I don't think I'll be doing those lifts anymore.

McKenzie Method!

Its really the only thing that works for me, Google it. Find a PT that does it. Say no to surgery.



http://www.amazon.com/Steps-Pain-Free-Li...0452282772

Quote: (01-17-2014 08:32 PM)Daddy Wrote:  

Bending backwards all the way hurts a little.

The lumbar extensions reduce the pain but only a little.

What seems to reduce the pain the most is squatting. The first few reps are painful but the more I do them the less pain I feel.

Thanks for the info!

I'd say your back pain is more than likely caused by the lower facet joints on the left side of your lower back being jammed up (the technical term is facet joint arthopathy). These are the joints which connect each vertebrae to one another - when certain segments are jammed up they cause pain (typically to one side).

What's happening when you are squatting some of the segments in the back are not bending as well as they should be.



So what does this mean?

We want to 'open up' these facet joints to allow more room to these joints.

First exercise I want you to do, is gentle lumbar flexion. Begin this by starting on all 4's and slowly lowering your buttocks to your heel (below) Repeat this 20 times every few hours.



Second exercise - if squats make it feel better after a while - keep doing them! - (unloaded of course and avoid deep squats for now). Focus on performing these with a slight posterior pelvic tilt (below)

Third exercise - Pelvic tilts - these are hugely important and really great way to take pressure off the back. You want to focus on posterior pelvic tilts - Here's a video which explains how - do these throughout the day as well, and even as you're squatting, make sure you perform a slight 'posterior pelvic tilt'






Core strengthening will also be beneficial, but for now focus on these exercises. Also chill on any heavy deadlifts etc for now.

Let me know how you go - feel free to PM me, or continue to post in this thread - I'll shoot you a followup message in a week.

Disclaimer - McKenzie is an amazing paradigm for treating back pain, but I think in Daddy's case, he won't get too much relief from repeated extensions. This is why backs can be so challenging to treat - what does miracles for some, might not do anything for others.

Quote:Quote:

I'd say your back pain is more than likely caused by the lower facet joints on the left side of your lower back being jammed up (the technical term is facet joint arthopathy).

The poster said he was only 30 yrs old. From an epidemiological perspective it would not be common for him to have facet arthropathy ... essentially a form of degenerative arthritis at such a young age. Facet arthropathy is a much more common pathology in older adults that manifests typically starting in the 5th or 6th decade of life. If the poster had a history of other forms of degenerative arthritis or something that might make him prone to developing arthritis at such a young age, then perhaps facet arthropathy would creep up higher on the differential.

Additionally, he stated that doing squats, deadlifts, and sitting for prolonged periods of time bring about the pain. This tends to support more of a discogenic etiology of his symptoms as opposed to facet mediated. In addition, from an epidemiological perspective (i.e. common things being common) discogenic pain is much more likely to occur in a 30 yr old as opposed to facetogenic pain.

The poster stated his pain has been around for about a year. Had it been a short amount of time (i.e. few weeks to months) ... given his age, symptoms, history ... myofascial strain/sprain would be much more likely. (and that still may be the cause ... especially, if he hasn't allowed his body to heal from an original insult.)

If there were any sensations of numbness, weakness, paresthesias (pins & needles), and/or dysesthesias (odd sensations) in that left symptomatic leg ... I'd consider getting an MRI to have a look at the lumbar spine, the discs, spinal cord, and spinal nerve roots.

In order to make the definitive diagnosis of lumbar facet arthropathy, he would have to undergo diagnostic medial branch blocks. A procedure by which the nerves that supply sensory/pain information to the facet joint are numbed with local anesthetic placed using live X-ray guidance and a tiny needle. Should the diagnosis be confirmed, a definitive treatment option could include radiofrequency ablation; or simply burning the nerves away so that they are unable to transmit the painful signals from the joints.

All that being said, I think the advice being given above with regards to conservative care, stretching, and exercises is all very salient and excellent. Kudos to the OP for lending a helping hand.

Quote: (01-18-2014 08:18 AM)sthesia Wrote:  

Quote:Quote:

I'd say your back pain is more than likely caused by the lower facet joints on the left side of your lower back being jammed up (the technical term is facet joint arthopathy).

The poster said he was only 30 yrs old. From an epidemiological perspective it would not be common for him to have facet arthropathy ... essentially a form of degenerative arthritis at such a young age. Facet arthropathy is a much more common pathology in older adults that manifests typically starting in the 5th or 6th decade of life. If the poster had a history of other forms of degenerative arthritis or something that might make him prone to developing arthritis at such a young age, then perhaps facet arthropathy would creep up higher on the differential.

Additionally, he stated that doing squats, deadlifts, and sitting for prolonged periods of time bring about the pain. This tends to support more of a discogenic etiology of his symptoms as opposed to facet mediated. In addition, from an epidemiological perspective (i.e. common things being common) discogenic pain is much more likely to occur in a 30 yr old as opposed to facetogenic pain.

The poster stated his pain has been around for about a year. Had it been a short amount of time (i.e. few weeks to months) ... given his age, symptoms, history ... myofascial strain/sprain would be much more likely. (and that still may be the cause ... especially, if he hasn't allowed his body to heal from an original insult.)

If there were any sensations of numbness, weakness, paresthesias (pins & needles), and/or dysesthesias (odd sensations) in that left symptomatic leg ... I'd consider getting an MRI to have a look at the lumbar spine, the discs, spinal cord, and spinal nerve roots.

In order to make the definitive diagnosis of lumbar facet arthropathy, he would have to undergo diagnostic medial branch blocks. A procedure by which the nerves that supply sensory/pain information to the facet joint are numbed with local anesthetic placed using live X-ray guidance and a tiny needle. Should the diagnosis be confirmed, a definitive treatment option could include radiofrequency ablation; or simply burning the nerves away so that they are unable to transmit the painful signals from the joints.

All that being said, I think the advice being given above with regards to conservative care, stretching, and exercises is all very salient and excellent. Kudos to the OP for lending a helping hand.

Hey sthesia,

Thanks for the input. Sounds you come from a medical background - great to know other RooshV members know their anatomy!

You are absolutely right in that it is impossible to subscribe a particular pathoanatomical diagnosis, without scans. Even in clinical practice we can't definitively tell someone they have specifically 'X problem' happening in their back, we can only assess their movement patterns and categorize what tissue is most likely to cause their pain.

I have to disagree with your assumption that just because Daddy is young, means he does not have a facet joint arthopathy. Facet joint problems do not mean arthritis, and certainly younger populations -e.g. gymnasts can be predisposed to them. I have seen countless of young athletes in clinical practice with a clear 'facet joint' problem.

I also have to disagree that Daddy requires MRI's. These are HUGELY over-prescribed, and often do nothing to assist further management of back pain. As you know, someone can have a perfectly normal scan and experience excruciating pain, but another person can have an 'arthritic' back and be in no pain whatsoever. As you mentioned, Daddy has had pain for over a year, which means his nervous system will be playing a role in his pain-state; this will not show up on any scans.

Purely looking at necks and backs from a pathoanatomical model is counter-productive IMO. Assessing gross movement patterns and looking at functional exercises which restore proper movement and relieve pain is far more beneficial.

The exercises I have suggested come from years of clinical practice, and seeing others (similar to Daddy's presentation), which have improved with gentle flexion-based exercises and specific strengthening exercises.

As has been mentioned, back pain is incredibly complicated, but I am determined to help people over the internet, as best as possible, which is why I have enlisted the help of a specialist physiotherapist to help with online assessments.

sthesia's post seems to me like it comes from online study without any clinical experience -- and, especially where back and neck pain is concerned, there is no substitute for clinical experience.

The "epidemiology" of back and neck pain is almost worthless because there is such heterogeneity of clinical presentation. I would trust the OP's intuition here far more than anyone wielding generic stats.

By the way Prophylaxis, great thread.

Hanging from a bar helps open up the spine..



Also, do it upside down:

Quote: (01-17-2014 10:35 PM)puckman Wrote:  

McKenzie Method!

Its really the only thing that works for me, Google it. Find a PT that does it. Say no to surgery.

That depends on what the cause of the back pain is. Back pain can have a myriad of causes. If you have a badly herniated disc causing debilitating sciatica as I had last summer, surgery is likely your only option. I did all the stretches, McKenzies, chiropractor and all and it didn't help me. The herniation had to be removed. So I would say think hard about surgery, but under some situations, surgery may be necessary.

Quote: (01-18-2014 01:37 AM)Prophylaxis Wrote:  

Quote: (01-17-2014 08:32 PM)Daddy Wrote:  

Bending backwards all the way hurts a little.

The lumbar extensions reduce the pain but only a little.

What seems to reduce the pain the most is squatting. The first few reps are painful but the more I do them the less pain I feel.

Thanks for the info!

I'd say your back pain is more than likely caused by the lower facet joints on the left side of your lower back being jammed up (the technical term is facet joint arthopathy). These are the joints which connect each vertebrae to one another - when certain segments are jammed up they cause pain (typically to one side).

What's happening when you are squatting some of the segments in the back are not bending as well as they should be.



So what does this mean?

We want to 'open up' these facet joints to allow more room to these joints.

First exercise I want you to do, is gentle lumbar flexion. Begin this by starting on all 4's and slowly lowering your buttocks to your heel (below) Repeat this 20 times every few hours.



Second exercise - if squats make it feel better after a while - keep doing them! - (unloaded of course and avoid deep squats for now). Focus on performing these with a slight posterior pelvic tilt (below)

Third exercise - Pelvic tilts - these are hugely important and really great way to take pressure off the back. You want to focus on posterior pelvic tilts - Here's a video which explains how - do these throughout the day as well, and even as you're squatting, make sure you perform a slight 'posterior pelvic tilt'

Core strengthening will also be beneficial, but for now focus on these exercises. Also chill on any heavy deadlifts etc for now.

Let me know how you go - feel free to PM me, or continue to post in this thread - I'll shoot you a followup message in a week.

Disclaimer - McKenzie is an amazing paradigm for treating back pain, but I think in Daddy's case, he won't get too much relief from repeated extensions. This is why backs can be so challenging to treat - what does miracles for some, might not do anything for others.

Thanks a lot for the advise. I plan on still going to the gym, deloading my squat and DL by about 20%.

I also bought a foam roller. I will do the exercises you prescribed and get back to you.

I've had some PM's that Prophylaxis thinks would be beneficial for all to read. I'm having some trouble formatting it so it doesn't look like crap to read, as there's no 'quote' function for PMs.

EDIT - No need, he's done it already.

I figured the following would be a great insight for everyone -

Quote:Prophylaxis Wrote:

Quote:Teedub Wrote:

I can give you my MRI report. Well, a thoroughly condensed version! I'm 27 and it is lumbar pain and hamstring/calf tightness. Some of which may just to me being pretty inflexible anyway.

"This 27 year old gentlemen presented in the clinic with history of low back pain, since September last year (2012) He reports no shooting pain and no pins and needles. There are no bowel or bladder symptoms.

On examination his lumbar flexion was mid to shin level with tightening of hamstring. Neurological examination consisting of dermatome, myotome and reflexes was fine. SLR was between 60-70 degrees with severe tightening of hamstring. No spinal tenderness. Pain provocation for S1 joint normal and hip movements were pain-free.

An MRI scan of the lumbar spine was arranged and this reported L4/L5 right-central disc protrusion touching but not compressing the right L5 nerve root. L5/S1 broad-based left-central to left-subarticular disc protrusion mildly displacing and flattening the left S1 nerve root.

Can you properly explain what all that technical speak means. I've seen a physio since this and she didn't properly explain.

I've read it never heals because discs receive no blood flow. So I would guess that surgery is the only option, shaving the disc down.

Some other points:

- Lying in bed for long periods makes it worse. I think walking may make it better. To be honest, I've had it for so long that I just sort of deal with it.

- Swinging my right leg forward makes my back 'twinge'

Sorry for the essay!

Tom

Hi Tom,

I’m Prophylaxis’s colleague, he told me to take a look at the thread and to see what I think.

First off, I’d be happy to explain your MRI results, it sounds like you haven’t had a proper explanation. Really whoever sent you for the MRI should be the one to explain it because they know your history and legally you are under their care. However, we are very happy to give opinions.

There are a few things that are important to know. If a disc bulges it can put pressure on the nerves that come from your spine and go down your legs. Each vertebra is numbered, in the low back they are L1, L2…, then one nerve comes out the right and one out the left of each vertebra, and they are named the same way L1, L2, L3…
Each of these nerves has 3 jobs, in very specific patterns:
1)“Myotome”: supplies certain muscles in your legs- for example, the L4 nerve is responsible for the muscles straighten your knee.
2)“Dermatome” : Give sensation to certain patches of skin on your legs- if this is interrupted, you get specific patches of numbness, or pins and needles.
3)“Reflexes”: For example, S1 nerve is responsible for your ankle reflex (if you hit the Achilles tendon


If the disc bulges and puts pressure on a nerve,1 or more of the 3 functions above can be interrupted. That’s not so good- it’s when we start thinking about surgery if physio is not helping, because ongoing pressure on that nerve can damage the nerve permanently. From everything I’ve read in your report and what you said- you don’t have a problem with any nerves… this is the evidence:
o“No shooting pain and no pins and needles”
o“Neurological examination consisting of dermatome, myotome and reflexes was fine”

So even though you have a disc protrusion at L45, it is “touching, but not compressing the L5 nerve root”. At the level of L5, S1 the bulge seems to be “flattening” the left S1 nerve root, but remember, all your nerve functions were good when they tested them, so it’s not affecting your nerve function, even tough there is a bit of pressure from the disc.

So, that’s why you get a lot of different info from people about your back- it’s not a straightforward problem….there are disc bulges on MRI but unless those bulges are pressuring nerves, we can’t tell for sure if the disc is actually causing your back pain. It’s debatable, so we have to resort to the information you tell us, and if you get you back pain with certain movements and test.

Here’s what we know about you, and here is where I need a bit more info too…
oFrom what Prophylaxis told me, your back pain does not get better or worse bending backwards repeatedly. Correct?
oYou also have tight hamstrings that are limiting your straight leg raise (SLR as described in your report)
oBending forward is stiff for you and tight in the hamstrings… Question #1: Any back pain when you bend forward as if to touch the floor with straight knees?
oYou said you get a “twinge” in the back when you swing the right leg when walking. Question #2: The next time that happens, will you please test it a bit and see if the “twinge” gets stronger or weaker if you put your head down or up?
oQuestion #3: does it hurt your back to sit for a long time? If so what chairs (e.g. low chair? office chair?), and what are you doing when it hurts? (e.g. reading? computer?)


I can see why you’ve been to different practitioners and it hasn’t helped- it's a bit hard to figure out where it's coming from. like I said, it could be coming from different sources and the MRI isn’t necessarily telling us what we need to know in order to help your pain. Let me know about those 2 questions and we’ll take it from there!

Take care,
The Colleague☺...haha, and YOU were sorry about the essay!!

My reply to your colleague is as follows:

Quote:Quote:

Hello 'colleague' haha,

Wow thanks, that was more informative than anyone else I've been to.

I do feel a little discomfort bending backwards a lot. But very minor. Same bending left, to the right I have a little bit of a sensation down my right leg. My right leg, as I mentioned, is also the one that twinges my back.

Q1) No back pain when trying to touch toes, just tight hamstrings like as if I was just very inflexible. However, first thing in the morning there may be a little 'twinge'. Maybe, not sure. Like with the right leg swing thing, all the symptoms seem worse first thing in the morning. Why is that? Does something happen to the disc throughout the day due to movement or something? I just know there's sometimes back pain when I'm sitting on my bed putting my socks, and that's even after a shower so it takes a few hours I suppose for whatever happens during movement to take effect.

Q2) I know about the head up and down thing, something to do with stretching of the nerve...very fascinating! I was given some exercises to do where you sit on the edge of a platform and put your leg out in front while your head is down which makes the stretch 'worse' and then wiggle your foot back and forth...this stretches the nerve apparently. To answer the question yeah the twinge is worse head down, chin tucked in toward my chest. I just did it then to test on my kitchen table and as well as the twinge (which I suspect is the nerve, right?) it tightens my hamstring too when I put the right leg out. With nerve problems due to discs, is it possible to ever get flexible? Or do the hamstrings stay tight as a defense mechanism or something?


Q3) No, sitting at a computer for extended periods doesn't seem to do much. I do try and sit straight and often put a cushion just behind my lumbar for support. The only thing that hurts after typing for ages is the top of my back/neck...which is common in everyone really. Unless you know some cool stretches or something?!

Finally, discs can't really heal themselves can they...as they receive no blood flow, so is surgery the only way to actually get rid of the protrusion? I.E Shave it down? I know strengthening the core is good to prevent further cases of buldges/hernias etc, but can they actually mend existing ones?

Think we should both accept our essay tendency! Thanks again for your help! I'm guessing this is all part of some business plan or other as nobody gives this much of their advice away for free!

Quote: (01-20-2014 08:26 PM)Teedub Wrote:  

My reply to your colleague is as follows:

Quote:Quote:

Hello 'colleague' haha,

Wow thanks, that was more informative than anyone else I've been to.

I do feel a little discomfort bending backwards a lot. But very minor. Same bending left, to the right I have a little bit of a sensation down my right leg. My right leg, as I mentioned, is also the one that twinges my back.

Q1) No back pain when trying to touch toes, just tight hamstrings like as if I was just very inflexible. However, first thing in the morning there may be a little 'twinge'. Maybe, not sure. Like with the right leg swing thing, all the symptoms seem worse first thing in the morning. Why is that? Does something happen to the disc throughout the day due to movement or something? I just know there's sometimes back pain when I'm sitting on my bed putting my socks, and that's even after a shower so it takes a few hours I suppose for whatever happens during movement to take effect.

Q2) I know about the head up and down thing, something to do with stretching of the nerve...very fascinating! I was given some exercises to do where you sit on the edge of a platform and put your leg out in front while your head is down which makes the stretch 'worse' and then wiggle your foot back and forth...this stretches the nerve apparently. To answer the question yeah the twinge is worse head down, chin tucked in toward my chest. I just did it then to test on my kitchen table and as well as the twinge (which I suspect is the nerve, right?) it tightens my hamstring too when I put the right leg out. With nerve problems due to discs, is it possible to ever get flexible? Or do the hamstrings stay tight as a defense mechanism or something?


Q3) No, sitting at a computer for extended periods doesn't seem to do much. I do try and sit straight and often put a cushion just behind my lumbar for support. The only thing that hurts after typing for ages is the top of my back/neck...which is common in everyone really. Unless you know some cool stretches or something?!

Finally, discs can't really heal themselves can they...as they receive no blood flow, so is surgery the only way to actually get rid of the protrusion? I.E Shave it down? I know strengthening the core is good to prevent further cases of buldges/hernias etc, but can they actually mend existing ones?

Think we should both accept our essay tendency! Thanks again for your help! I'm guessing this is all part of some business plan or other as nobody gives this much of their advice away for free!

Hey Teedub,

Thanks for the info! Can you clarify a couple points for me, I’m still trying to establish if there’s a pattern to your symptoms.
You’ve just said that you have no back pain when bending to touch your toes, and that sitting is OK. You’ve also said that the twinge is on the right side.

In your original post about this problem, before you got the MRI, you listed your aggravating factors as “Driving, sitting in certain positions for too long”. Is that still the case? If so, which sitting positions give you the pain.

You also said that the pain was central and slightly to the left- has it now moved to the right?

At one point in the thread you said you get “Back pain when I bend over, often worse in the morning”. Did there used to be pain when you bent over and not anymore?

When you bend over to test this, make sure you slide your hands down your thighs and try to reach your feet so you’re actually bending your low back. Also see if head up and head down change your pain when you’re in the bent over position.

I know that these things can sometime be a bit variable but there should be some pattern we can pick up that gives us clues. Especially if it’s been going on for a while, it can involve more than one problem, which can make things a bit confusing.

Thanks!

^ I got banned from driving so that's not longer an issue! I think the problem is a bit better than it originally was when you first joined the forum. Sitting doesn't seem to aggravate it anymore. There is mild back discomfort when bending over to (attempt to) touch my toes. No, just tried it again, there's no back pain, sorry - just very tight hams. Possibly it did used to hurt, but right now it seems there's not much pain by this point in the day, as mentioned in my reply last night (my time).

I think the 'twinge' is very slightly to the right yes. I think it probably always was, but I just didn't have scans to back it up. Hence why it's my right leg that causes it to niggle (trying to use more words that just twinge!) rather than my left.

Just tested for you, as I mentioned last reply, when bending to touch my toes in the manner you asked it seems to get tighter when I put my head down and bring my chin into my chest. No pain in back though as of yet. But when I do that stretch thing with head down on the edge of the table with leg extended - there is a pull/twinge/sensation in my back (slightly to the right) when it is my right leg extended in front of table. Think I already went through this though so won't repeat myself.

Thanks again!!