From Back Pain to a Healthy Back

Your spine is composed of stacks of discs like structures which eliminate sudden jerks or absorbs shock. Inside the disc, there is a gelatinous jelly-like substance called the nucleus pulposus with tough layer on the periphery which is the annulus fibrosis. Weakness of muscles around these discs or an injury can lead to what we call a herniated disc or more commonly known as slipped disc.

It is not always painful or debilitating, as it might not be involving your nerves. But when the nerves get affected it leads to an excruciating pain in the back. As you grow older, your discs lose their water content and make it prone to easy slippage. Although they can occur at any age but research suggests that most commonly people between 20-50 years are affected. Certain predisposing factors like sedentary lifestyle, smoking, weight, genetics increase the likelihood of occurrence of symptoms. In 95% of the population undergoing disc herniation, the problem exists in the L4-L5 or L5-S1 vertebrae region which constitutes the lower back.

If you are feeling numbness and tingling in some part of your leg or both legs and weakness which causes you to limp when walking along with pain radiating to the arms and legs from the back, then you might be having a herniated disc.

The doctor will check your reflexes, muscle strength, range of motion, palpation of the tenderness in the back region or he might opt for an MRI or X ray.

• Bulging: Here the gelatinous part of the disc called as nucleus pulposus bulges towards the annulus fibrosis.
• Protrusion: The nucleus pulposus finally starts impinging the annulus fibrosis leading to pain and discomfort.
• Extrusion: The gelatinous part of the disc starts emerging out of the annulus fibrosis causing further symptoms.
• Sequestration: This is the phase where the spinal material gets detached and drops into the spinal canal leading to excruciating pain and noticeable symptoms.

Now, the main cause of disc herniation is the weakness of the adjacent spinal muscles. The extensor muscles of the back play a vital role in stabilizing the spine and maintaining the proper posture. These include the erector spinae and the gluteal muscles. However, when you adopt a faulty posture by sitting slouched in front of your computer or any where else, it causes these muscles to weaken and lengthen. Such muscles are then unable to maintain a normal function and the support system of the vertebral discs gets compromised. Additionally, disc herniation presents itself with sciatica like symptoms. Such type of pain is worsened with bending forward or flexion as this increases the pressure on the intra-spinal structures. If you are experiencing unilateral herniation it would most probably be indicated as lateral herniation.

• Most commonly used exercise is bridge with a 5 seconds hold. Bridge helps strengthen the back extensors which normally undergo weakness if not used properly.
• The gluteal muscles and hamstrings play a role also in proper back alignment. Strengthening of the gluteal muscles can be achieved by going upstairs while attaching some weight on the legs. Hamstring muscles which are hip extensors tend to tighten more than other muscles therefore there is a need to stretch them to allow a proper alignment of the hip joint with the rest of the body.
• Let’s not forget the abdominals which include transversus abdominis and obliques. When the abdominals are in balance with the back extensors, a perfect and healthy spine is the outcome.