[Prophylaxis]

(01-20-2014 09:30 PM)Prophylaxis Wrote:  

(01-20-2014 08:26 PM)Teedub Wrote:  

My reply to your colleague is as follows:

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!

Hey Teedub,

OK, that makes sense now. I won’t ask why you were banned from driving! We can save that for another day!

It sounds like the symptoms have been improving a slight bit which is always good. Especially the fact that you haven’t mentioned the right leg numbness, that means we don’t have to worry as much about the nerve at the moment.

The pain you’re describing can be coming from “nerve sensitivity”, also known as “nerve tension”. All your nerves are connected like a big network that converges on the spinal cord and brain. That’s why, if you have a problem in one area, like your back, you can move a remote area like your head and get back pain. There’s not really any other muscle/ ligament or other connection all the way from your head to back, so we can be pretty sure that movement is “pulling” on your nerve, and making your back pain worse by irritating an already sensitive part of the nerve tissue.

Nerves are like guitar strings- they have a tiny bit of stretch. But NOT much. Nerves get damaged from 2 things:
#1 being compressed (like in the case of a disc putting pressure)
#2 being stretched

You mentioned that you did nerve stretches in the past and they may have made your problem worse- this is makes sense if it was too much stretch on the nerve. You also said that your hamstrings are incredibly tight and when you stretch them, they go back to being tight easily- this can also be the nerve sensitivity that is keeping your hamstrings tight. Like you said, it's like a ‘protective’ reaction so the nerve doesn’t have to stretch. The body is very protective of nerves, the moment there is too much stretch, the body reacts- usually by tightening up muscles to stop further stretch.

This type of nerve sensitivity is likely what is keeping your back pain going. This can happen as a result of disc injury like it says on your MRI.

Treatment:
The point is for you to slowly get that nerve moving, without stretching too much to make your hamstrings react. You don’t get fast results from these exercises, they have to be done very carefully and slowly, and you look for slow changes every couple weeks. If you do them too much or too far, you can expect to make your back pain worse for a few days or more.

We’ll start off with this one, remember, you have to stop the exercise as soon as you feel that uncomfortable stretch in the hamstrings, and definitely if you feel anything I in the back.


Lying on your back, hold on to the back of your knee, then straighten your leg up and down like a pendulum- your leg should not straighten all the way. Don’t hold the stretch… that’s too much pull for the never and it will tighten up your hamstrings after your finished. Just keep it going back and forth 20 times.

In the next few weeks, do everything you can to minimize irritating activities for your nerve (like head down stretches, large strides when you walk…etc..) and do the above exercise to get it moving gently. The more movement you can get out of this nerve without sending your hamstrings to tighten, the more you are letting the nerve heal, getting it back to moving normally, and slowly reducing the back pain.

Never do the exercise in the morning- you’ve said that’s when your back is most sensitive like when putting on socks- so do it at the end of the day.

Careful when doing regular hamstring stretches, in fact, you can stop them for a couple weeks because it sounds like they don’t do any good right now anyway, and they can easily irritate your nerve.

Check back with us in a couple weeks to get progressions. There are a couple others I would like to add- but I want to keep it simple to start... since you've tried a lot of things in physio already, we want to make sure we know what is working before we tell you to do something else.

This is probably one of the more annoying types of exercise to do because you don’t see fast results and you can’t push it… also the results will be slow because you’ve had this problem for a long time and your body is very good at going in to that protective reaction. Stick with it though- it’s the right track, and check in every couple weeks.

Talk to you soon,
Prophylaxis n friends