Sciatica Causes: The sciatic nerve forms by the union of Lumbar4 to Sacral31 nerve roots and exits the pelvis through the greater sciatic foramen, below the piriformis muscle located deep in the buttocks. The nerve runs down the back of the thigh, into the leg, and ends in the foot. The sciatic nerve becomes inflamed, irritated, and/or mechanically compressed. Any type of pain and/or neurological symptom/s from the sciatic nerve is referred to as sciatica. Sciatica is a type of lumbar radiculopathy, which means that the pain originates from the low back and/or sacral nerve roots.
Sciatica Causes
Physical forces on the nerve can cause mechanical compression due to the following conditions:
Herniated Discs
A disc in the lower back can bulge or herniate, causing irritation and/or compression of a sciatic nerve root.
Foraminal Stenosis
Stenosis, the intervertebral opening through which the nerve roots travel, begins to narrow/close in, can compress or irritate the sciatic nerve.
Degeneration
Degenerative changes in the spine like the thickening of facet joint capsules and/or ligaments can compress the sciatic nerve.
Segmental Instability
Instability of a spinal vertebral segment that happens if one vertebra slips over the one beneath it – spondylolisthesis
Complete dislocation of one or more vertebrae can compress the nerve root/s of the nerve.
Other Sciatica Causes
Tumors, cysts, infections, or abscesses in the lower spine or pelvic region can also cause sciatic nerve compression.
Chemical Inflammation
Chemical irritants can include hyaluronic acid and/or fibronectin/protein fragments that leak out of degenerated or herniated discs. These irritants can cause inflammation and/or irritation of the sciatic nerve.
Degenerated discs can cause nerve tissues to grow into the disc, penetrating the outer and inner layers of the disc, causing sciatica. Immune system responses can contribute to pain when exposed to disc fluid.
Substances such as glycosphingolipids/fats and neurofilaments /protein polymers secreted by the immune system are increased in individuals with sciatica. These substances are released from the reaction between nerve roots and exposed disc material, causing inflammation.
Job Occupation
Individuals with specific jobs have an increased risk of developing sciatica. Examples include:
Truck drivers
Desk workers
Teachers
Warehouse workers
Machine workers
Plumbers
Electricians
Carpenters
Fitness trainers
Sitting and standing for long periods, using improper posture, constantly bending, twisting, reaching, and regularly lifting are risk factors for sciatica.
Piriformis Syndrome
Piriformis syndrome is a condition where the piriformis muscle swells and spasms from overuse or inflammation irritating the sciatic nerve that is right underneath. The nerve can get trapped in the muscle causing sciatica-like symptoms that include:
Pain follows the same pattern in the leg as a compressed sciatic nerve root.
Tingling
Numbness
Discomfort from piriformis syndrome feels similar to sciatica, but it is not caused by compressed sciatic nerve root. Piriformis pain comes from compression of the sciatic nerve near the piriformis muscle.
Genetic Sciatica Causes
Sciatica caused by degenerated and/or herniated discs can be genetic. Research has shown that certain genetic factors are more prevalent in individuals with back and spinal problems. These congenital disabilities can cause the discs to become weak and susceptible to external stress. With time the proteins in the disc break down, compromising the integrity and function.
Arthritis and Joint Issues
Arthritis or other inflammatory conditions around the hip joint can cause pain down the leg, similar to sciatica. This is referred pain that spreads out from the source and is not radicular nerve pain that originates in the nerve roots.
Conditions like sacroiliac joint dysfunction or sacroiliitiscan cause sciatica-like pain that runs down the back of the thigh but usually ends before or at the knee.
The pain can be acute and debilitating, like sciatica but is caused by an abnormal motion or malalignment of the sacroiliac joint.
Body Composition
Normal Cholesterol Ranges
High cholesterol can lead to severe consequences when left untreated, but it can be difficult to spot with no noticeable warning signs. This is why it’s essential to monitor cholesterol levels with blood tests, especially if there is an increased risk. Example of normal cholesterol levels for adults 20 years of age or older:
Total cholesterol 125-200 mg/dL
LDL <100 mg/dL
HDL >40 mg/dL men, >50 mg/dL women
Lifestyle
Lack of physical activity contributes to high cholesterol levels.
Diets that mainly consist of processed foods and saturated fats increase the risk of high LDL levels.
Smoking can lower HDL levels.
Aging
Individual risk for developing high cholesterol tends to increase as the body advances in age. This is why it is recommended to have regular physicals and blood tests.
Genetics
Some individuals are more genetically predisposed to developing high cholesterol and heart disease.
Knowing family medical history can help predict whether it may become a problem.
References
Davis D, Maini K, Vasudevan A. Sciatica. [Updated 2021 Sep 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507908/
Giuffre BA, Jeanmonod R. Anatomy, Sciatic Nerve. [Updated 2021 Jul 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482431/
Hicks BL, Lam JC, Varacallo M. Piriformis Syndrome. [Updated 2021 Jul 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448172/
Raj MA, Ampat G, Varacallo M. Sacroiliac Joint Pain. [Updated 2021 Aug 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470299/
Syringomyelia is a disorder in which afluid-filled cyst/syrinx forms within the spinal cord. It is progressive, meaning that the cyst grows with time causing compression and damage to the spinal cord. The cyst usually begins in the neck/cervical spine but can develop in any area along the spinal cord. There are several possible causes; however, most are associated with a condition known as Chiari malformation. This is where the skull and neck come together, and either the skull is too small or shaped in a way that causes brain tissue to come out and settle in the spinal canal.
Syringomyelia Causes
Syringomyelia can be caused by or from complications of:
Chiari type I malformation develops during the fetal developmental stage and causes the lower part of the brain or cerebellum to stick out from its standard location.
Hemorrhage/bleeding
Inflammation of the spinal cord from virus or bacterial infection like meningitis
Spinal cord injury
Spinal cord tumor
Symptoms
A damaged spinal cord disrupts communication between the brain and the body. Symptoms differ for every individual, but common syringomyelia symptoms include:
Pain, stiffness, or weakness in the neck, arms, back, and/or legs
Symptoms usually develop slowly, but exercise, coughing, or some form of strain can cause sudden onset.
Diagnosis
Physical and neurological exams are performed to determine loss of feeling or inability to move around normally, like walking. Diagnostic tests of the spine will include a CT scan with contrast dye and/or an MRI. Early detection can help before it progresses, causing further damage, and delaying treatment can cause irreversible spinal cord injury. It is recommended at the first sign of symptoms to contact a doctor.
Treatment
Some individuals who have syringomyelia may have no symptoms. These individuals can go about their everyday lives but are recommended to be cautious with neck and back strain. For individuals experiencing symptoms, the primary treatment objectives are to:
Stop or control damage to the spinal cord
Preserve function
Prevent disability
Treatment options include:
Draining the cyst
Surgical removal of the cyst
Chiropractic and physical therapy could be included in the treatment plan to help the individual rebuild lost muscle strength and regain flexibility.
All too often, individuals with this disorder experience treatment delay/s because symptoms can be nonspecific or vague. Education is the key, and individuals can be diagnosed sooner by paying attention to the body’s warning signs.
Body Composition
Does too much protein hurt the kidneys?
While protein restriction can be appropriate for treating existing kidney disease, research shows that high protein intake in healthy individuals does not disrupt or cause damage to the kidneys or kidney function. The amino acids in protein are more likely to be excreted through urine when not being used. However, there are certain risks associated with consuming too much protein, and it is recommended to keep track of protein intake. Eating more protein:
Makes the body feel full longer
Can help curb overeating
Is essential for recovery and growth
When achieving daily caloric goals, maintaining a balance of nutrients like carbohydrates and healthy fats is essential for overall health.
References
Batzdorf, Ulrich. “Primary spinal syringomyelia. Invited submission from the joint section meeting on disorders of the spine and peripheral nerves, March 2005.” Journal of neurosurgery. Spine vol. 3,6 (2005): 429-35. doi:10.3171/spi.2005.3.6.0429
Di Lorenzo, N, and F Cacciola. “Adult syringomyelia. Classification, pathogenesis and therapeutic approaches.” Journal of neurosurgical sciences vol. 49,3 (2005): 65-72.
Fernández, Alfredo Avellaneda et al. “Malformations of the craniocervical junction (Chiari type I and syringomyelia: classification, diagnosis, and treatment).” BMC musculoskeletal disorders vol. 10 Suppl 1, Suppl 1 S1. 17 Dec. 2009, doi:10.1186/1471-2474-10-S1-S1
Naftel, Robert P et al. “Worsening or development of syringomyelia following Chiari I decompression: case report.” Journal of neurosurgery. Pediatrics vol. 12,4 (2013): 351-6. doi:10.3171/2013.7.PEDS12522
Roy, Anil K et al. “Idiopathic syringomyelia: retrospective case series, comprehensive review, and update on management.” Neurosurgical focus vol. 31,6 (2011): E15. doi:10.3171/2011.9.FOCUS11198
Herniated discs, although common, can be challenging to treat depending on the size. Over 3mm is considered a large herniated disc. However, it can progressively get more extensive, and this can cause severe side effects. The size can make the disc slip out of place and start compressing on surrounding nerves, leading to muscle weakness and nerve damage.
X-Ray and MRI
X-rays can’t detect herniated discs, and this is because they highlight calcium in the bones. Because the vertebral discs and the nearby nerves lack calcium, they don’t show up. They do help doctors see other problems that could be causing symptoms like a tumor. A herniated disc will show on an MRI and identify the size and position. Then a medical professional can get a closer look into the bone and surrounding nerves.
Degenerative Disc Disease
A herniated disc is not the same as degenerative disc disease. Degenerative disc disease is when the cartilage and tissues around the disc wear out and down, causing the discs to slowly slide out of their normal position. A herniated disc is the disc getting pulled/yanked out of place.
Tests
Specific tests will help a medical professional like a chiropractor understand the severity of a herniated disc. These include a nerve conduction study and electromyography.
Nerve Conduction Study
A nerve conduction study records electrical impulses in the nerves. Electrode patches are placed on various areas with varying electrical intensities to see different readings. Through the study, medical professionals are better able to understand the health of the nerves.
Electromyography
Electromyography is similar to nerve conduction but uses needles. Electrode patches are placed around the body; then, tiny needles are inserted into a surrounding muscle. The patches then record the reaction of the nerves.
Physical Therapy and Chiropractic Treatment
A herniated disc will usually heal without surgery in around six weeks. However, a herniated disc growing in size can take longer because of a treatment plan that has to be updated accordingly as the treatment progresses.
Physical Therapy
Physical therapy is very useful in working out herniated disc symptoms.
The therapy will slowly help the body recover by using equipment and stretching techniques to strengthen and restore flexibility. One technique is water therapy. Water helps relax the body, and the buoyancy prevents pressure build-up on the spine. This allows the body to stay flexible while avoiding strain and pressure on the herniated disc.
Chiropractic
Chiropractors specialize in herniated discs. Chiropractic works on repairing the whole musculoskeletal system. Once imaging tests have been examined and a personalized treatment plan developed, they perform the necessary adjustments. These include:
Flexion-distraction
This technique uses a segmented table that raises and lowers to release pressure on the spine. The movement also keeps the disc from touching the surrounding nerves, significantly reducing pain.
Pelvic block
The pelvic blocking adjustment utilizes cushions placed under the pelvis. As the chiropractor adjusts the spine, the cushions help to pull the disc back into place gradually.
Therapeutic Massage
Many chiropractors utilize massage therapy as it is highly beneficial for relieving pain and expedites recovery time. One recommended massage for herniated discs is deep tissue massage. The benefits include:
Relieving pressure around the nerves.
Reduces muscle spasms.
Improves the spine’s range of motion.
Releases the body’s natural painkillers.
Recommendations
Individuals are recommended not to overextend the spine. Avoid engaging in physical activities that require a lot of bending, twisting, reaching, etc. However, resting for too long can worsen the condition as the body needs movement to recover correctly. Too much rest can lead to the muscles contracting, leading to painful spasms. Safe activities include:
Herniated discs often result from an injury, but they could also be caused by weakened joints and muscles. If the body does not get enough calcium, magnesium, or vitamin C, the discs can slip out of place more easily. Taking supplements will help strengthen the area by assisting in the production of collagen. Collagen attaches itself around the discs, ensuring they stay in place and are protected. Foods rich in calcium, magnesium, and vitamin c will also help. Foods include:
Red peppers
Pumpkin seeds
Lemons
Almonds
Milk
Healthy yogurt
Peas
Brussel sprouts
Hydration
Hydrating the body with plenty of water can reduce pain. Water increases the fluid around a herniated disc. The fluid works as a cushion between the herniated disc and the surrounding nerves, helping to not press on them. Drinking water will also help with movement and sleep.
Body Composition
What Happens To The Body When Eating Fruit
At the basic macronutrient level, fruit is made up of simple sugar called fructose. The natural sugar the body gets from a piece of fruit is not the same as industrial fructose added to processed products like high fructose corn syrup. Processed foods are filled with empty calories and little to no nutrition. When the body takes in fruit, the liver processes fructose before getting absorbed through the small intestine.
Research shows that adding more fiber-rich foods like fruit increases gut ecology to an anti-obese condition. This happens by increasing the lean-type bacteria and reducing obese-type bacteria. Fruit can help boost healthy bacteria that can help prevent weight gain.
Essential nutrients from fruit include Folate, Vitamin C, and Vitamin B1. The USDA recommends 2 cups of fruit a day, depending on age. Making half of each meal fruit and vegetables can be an effective strategy for weight maintenance. Fruit provides the body with a carbohydrate energy source, and fruit sources can also help meet dietary balance needs and promote long-term weight maintenance.
References
Deniz Bayraktar, Arzu Guclu-Gunduz, Johan Lambeck, Gokhan Yazici, Sukru Aykol & Harun Demirci (2016) A comparison of water-based and land-based core stability exercises in patients with lumbar disc herniation: a pilot study, Disability, and Rehabilitation, 38:12, 1163-1171, DOI: 10.3109/09638288.2015.1075608
Gupta, Anmol et al. “Does Size Matter? An Analysis of the Effect of Lumbar Disc Herniation Size on the Success of Nonoperative Treatment.” Global spine journal vol. 10,7 (2020): 881-887. doi:10.1177/2192568219880822
Polkinghorn BS, Colloca CJ. Treatment of symptomatic lumbar disc herniation using activator methods chiropractic technique. Journal of Manipulative and Physiological Therapeutics. 1998 Mar-Apr;21(3):187-196. PMID: 9567239.
Sharma, Satya P et al. “Paradoxical Effects of Fruit on Obesity.” Nutrients vol. 8,10 633. 14 Oct. 2016, doi:10.3390/nu8100633
There are different possible causes of abdominal pain and digestive problems. Sometimes a bulging disc is the cause. A bulging disc that is causing abdominal pain is rare but possible. When this happens, it’s usually a herniated disc in the upper back, known as the thoracic spine. When the disc bulges to the side, it can cause abdominal pain. One study found that half of the patients presenting with herniated discs also suffered from digestive problems, including irritable bowel syndrome.
Thoracic Disc Herniation
The thoracic spine is the region between the base of the neck and the low back. This section is surrounded and stabilized by the ribcage, reducing the risk of disc herniation. Most herniated disc/s occur in the low back or the neck because those areas with a lot of movement are less stable than the thoracic spine. But they do happen and can contribute and/or cause abdominal pain. This is usually accompanied by pain in the mid-back and the chest. Because this is rare, physicians don’t immediately think that a herniation is causing abdominal pain. This can lead to unnecessary and expensive tests to find the problem.
Lateral Disc Herniation
This is not the most common type of disc herniation. The type of herniation that causes pain in the abdomen is known as lateral disc herniation. This is when the disc bulges laterally/sideways. What happens is it can compress and irritate the nerve root. This is what can cause pain in the abdomen. Types of disc herniations include:
Causes
Most thoracic herniations are caused by trauma to the upper back. This can come from a:
Fall
Auto accident
Sports injury
They can also be caused by degenerative disc disease. If this happens, the discs can become calcified, which could require surgery.
Movements like reaching up to get something or twisting motions like putting on a seatbelt can cause the pain to worsen. Most thoracic herniations happen in young individuals brought on by trauma to the area. Women tend to be affected more by thoracic disc herniation that causes abdominal pain.
Herniated Disc and Bloating
Bloating often comes with digestive problems. A herniated discs can also cause bloating along with abdominal and back pain. However, they are not always related because bloating, and other digestive issues can cause back and abdominal pain. Bloating and pain typically go away after a bowel movement. But it is important to see a medical professional if the problem lasts more than a few days.
Gas and a Herniated Disc
In certain cases, a herniated disc can cause gas. This is rare, but evidence suggests that nerve compression in the spine can affect the digestive system. If back pain, abdominal pain, and digestive issues are presenting, seeking out treatment is recommended.
Treatment
Chiropractors specialize in spinal care. The approach is to balance the entire body and heal the underlying issues. The nervous system travels through the spinal column. If injured or damaged, it can cause all kinds of issues. This includes abdominal pain and digestive problems. A chiropractor will:
Bring pain relief
Realign the spine
Balance the body
Recommend exercises and stretches
Offer nutritional recommendations
Recommend sleeping positions to prevent pain at night
They are different techniques to treat disc herniations. These include:
Full-body diagnosis
Detailed medical history
MRI, CT, or X-Rays
Laser therapy
Ultrasound
Ice and heat
Electrical stimulation
Massage
Physical therapy
Body Composition
Binge Eating
A common and powerful trigger of binge eating is restrictive dieting. This type of diet is a common weight-loss method for short-term goals. This is because a highly controlled program of calorie intake makes it easier to prevent overeating. The problem is that this type of restriction is not sustainable. Most individuals can avoid certain foods for only so long. However, this is not the only reason for binge eating. Many individuals use food as an emotional suppressor. They overeat during:
Levels of high stress
Boredom
Bouts of sadness
Exhaustion/excessively tired
The brain and body are conditioned to crave certain and usually addictive foods. When individuals want to get their minds off of something, cravings can activate and become overpowering. Although it is not an addiction to alcohol or drugs, food addiction is still an addiction. Working through addictive behavior toward any substance will improve the quality of life. Overcoming food addiction promotes physical health benefits and improved mental health. Recognizing addictive behaviors when it comes to food is the first step.
References
Al-Khawaja, Darweesh O et al. “Surgical treatment of far lateral lumbar disc herniation: a safe and simple approach.” Journal of spine surgery (Hong Kong) vol. 2,1 (2016): 21-4. doi:10.21037/jss.2016.01.05
Lara, F J Pérez et al. “Thoracic disk herniation, a not infrequent cause of chronic abdominal pain.” International surgery vol. 97,1 (2012): 27-33. doi:10.9738/CC98.1
Papadakos, Nikolaos et al. “Thoracic disc prolapse presenting with abdominal pain: case report and review of the literature.” Annals of the Royal College of Surgeons of England vol. 91,5 (2009): W4-6. doi:10.1308/147870809X401038
Polivy, J et al. “Food restriction and binge eating: a study of former prisoners of war.” Journal of abnormal psychology vol. 103,2 (1994): 409-11. doi:10.1037//0021-843x.103.2.409
Individuals that go through severe low back pain caused by degeneration, herniated discs, vehicle, personal, work, and sports injuries, surgery, or spinal fusion is usually a last resort if non-invasive treatments fail to provide relief or not enough relief. Patients try to avoid spinal fusion because it can be an intense experience and requires a year-long recovery period. Unfortunately, individuals still experience discomfort and pain after surgery. Do individuals want to know what other treatment options are available, including chiropractic care?
Doctors will inform post-op patients of the risks involved with chiropractic therapy. However, chiropractic medicine can bring natural pain relief after surgery. Chiropractic treatment requires that an individual be adequately or fully healed before beginning a personalized treatment plan. At Injury Medical Chiropractic and Functional Medicine Clinic, we consult patients post-surgery about the effectiveness of rehabilitation spinal adjustments and physical therapy massage.
Wait Time After Surgery
Spinal fusion surgery involves removing the discs between two or more vertebrae and fusing the bones with metal screws and plates. The objective is to correct conditions like herniated discs and degenerative diseases by immobilizing the spine in that area. It can take at least three months for the vertebrae to fuse for a fully immobilized graft. Once the graft is complete, a few months of physical therapy are recommended to loosen/stretch and strengthen the muscles around the graft. Initial recovery combined with physical therapy typically takes a full year for a complete recovery.
It is during recovery where it can be difficult and for discomfort and pain to present. The reason is patients are recommended to avoid any twisting, bending, over-reaching motions, or the graft could break. This can make an individual take on awkward poses/postures, flexing and contracting muscles incorrectly, causing strain. The result is added discomfort and/or pain.
How Chiropractic Helps
Spinal fusion is not guaranteed to alleviate an individual’s back pain completely. But many do experience discomfort or pain post-surgery. This could be for a little while or longer, depending on their condition or injuries. Fortunately, chiropractic treatment can help bring pain relief through mobilization, manipulation, and massage techniques. Manipulations’ objective is to adjust and/or realign the bones of the spine and other areas of the body. Because of the intricacy of spinal manipulations, many who have undergone back or spinal fusion surgery are hesitant to seek chiropractic treatment. Discuss possible chiropractic care with your physician to determine if the surgical graft is strong enough to withstand spinal manipulations. If the graft is adequately/fully healed and your physician believes it can endure mild adjustments, reach out to a chiropractor to discuss a customized treatment plan.
Body Composition Testing
Poor Leg Skeletal Muscle Mass
The gluteal muscles or buttock muscles are the largest muscle group in the body. Individuals can start losing bone density by their 30s. This increases the risk of injury and further bone density loss. Bone density loss is a natural process, but the process can be accelerated for individuals with under-developed skeletal muscle mass. The health of muscles and bones are closely linked. Researchers found that individuals with less muscle mass than average for their height tended to have narrower and thinner bones. This resulted in limited lower bending strength.
Decreased muscle mass was shown to be linked to balance problems and increased risk of falls. There is a higher prevalence of sarcopenia or muscle wasting for patients with hip fractures and a reduction of leg muscle mass. The combination of:
Low muscle mass
Low bone density
Hip fractures
It can have lifelong consequences
References
Fernandez, Matthew et al. “Surgery or physical activity in the management of sciatica: a systematic review and meta-analysis.” The European spine journal: official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society vol. 25,11 (2016): 3495-3512. doi:10.1007/s00586-015-4148-y
Keller, Glenda. “The effects of massage therapy after decompression and fusion surgery of the lumbar spine: a case study.” International journal of therapeutic massage & bodywork vol. 5,4 (2012): 3-8. doi:10.3822/ijtmb.v5i4.189
O’Shaughnessy, Julie et al. “Chiropractic management of patients post-disc arthroplasty: eight case reports.” Chiropractic & osteopathy vol. 18 7. 21 Apr. 2010, doi:10.1186/1746-1340-18-7
Perrucci, Rachel M, and Christopher M Coulis. “Chiropractic management of post-spinal cord stimulator spine pain: a case report.” Chiropractic & manual therapies vol. 25 5. 6 Feb. 2017, doi:10.1186/s12998-017-0136-0
Szulc, Pawel et al. “Low skeletal muscle mass is associated with poor structural parameters of bone and impaired balance in elderly men–the MINOS study.” Journal of bone and mineral research: The American Society for Bone and Mineral Research vol. 20,5 (2005): 721-9. doi:10.1359/JBMR.041230
Here are a few recommended stretches and exercises for relieving herniated disc symptoms. The vertebrae are the small bones that make up the spine. They have cushion discs between each one. These are the intervertebral discs and are the body’s shock absorbers. The discs can be thought of as small balloons that are filled with an elastic gel-type material. There are twenty-three of these cushions.
Functioning as the body’s shock absorbers transferring various forces, weight, and stress from vertebra to vertebra, so that no one is overburdened taking on all the impact the body goes through. But like any machine, the discs can wear down over time, and sustain injury. When this happens the cushioning gel can leak out and press on the nerve roots emerging from the spine. This type of injury is a herniated disc.
Herniated Disc Treatment
A herniated disc can lose its height because of fluid and water loss.
This loss affects the bone structures bringing them closer together affecting the ligaments that connect each segment. The ligaments become loose and do not provide the same stability. Ligaments cannot be strengthened with exercise making it more important to strengthen the muscles around the spine to make up for this stability loss. Depending on the severity of the injury, the displaced disc can cause pressure to build upon the nerves, resulting in pain and other discomforts. This comes from the loss of the disc’s cushion causing the vertebrae to rub against each other. Stretches and exercises designed for herniated discs can work in conjunction with conservative treatment to relieve the pain and discomfort.
Stretches and Exercises for Pain Relief
Consult a medical spine specialist/chiropractor before beginning a stretch and exercise regimen. This is because the herniation can become worse or additional injury/s can occur without proper instruction. Once the injury and clinical considerations have been addressed, gentle stretches and exercises can help reduce the pain and other symptoms. Strengthening the back and hamstring muscles reduces pressure on the spinal column helping to prevent pain and promotes healing by:
Increasing blood flow to the spine
Building strength to support the spinal muscles
Decreases stress on the spine
Helps relieve the pain
Improves abnormal postures and awkward body positions
Equipment is not necessary but there are few items that can help the process.
A herniated disc in the neck is usually caused by a forward head posture and a swayback or excessive curvature of the spine.
Isometric hold
Sit straight
Relax the shoulders
Place one hand on the forehead
Push head into the hand without moving the head
Hold for 5 to 15 seconds.
Repeat 15 times
Chin tuck
Lie on your back on a flat surface
Place arms at sides
Tuck the chin in and down toward the chest until a stretch is felt
Hold for 5 to 10 seconds
Repeat 15 to 20 times
Lumbar/Low Back Stretches and Exercises
Back flexion stretch
This stretch extends the back muscles to relieve low back pain.
Lie flat on your back
Pull the knees toward the chest and wrap your arms around the knees
Lift head straight up off the floor until there is a stretch across the mid and low back
Hold for 10 seconds
Repeat 5 to 10 times
Piriformis stretch
This stretches the small muscle in the buttocks helping to relieve low back pain and helps with sciatica.
Lie flat on your back on the floor or yoga mat
Bend the knees
Plant feet on the floor
Pick up one leg and rest the ankle on the other leg’s bent knee
Reach one arm through the leg and use both hands to grasp the bent leg
Pull the leg toward the chest until there is a stretch in the buttock
Hold for 30 seconds
Repeat on the other leg
Prone extension stretch
This stretch helps reposition the disc back to its proper position, expediting the healing process. Start slowly and if pain presents, stop immediately.
Lie face down on the floor or yoga mat
Place the forearms on the floor next to the body
The elbows should be at a 45- degree angle
Slowly prop the body up, being sure to keep the hips on the floor
Keep pressing upward until the elbows are at a 90-degree angle
Hold the position for 10-15 seconds
Return to starting position
Repeat the stretch 10 times
Gradually increase the upward position hold time until it can be maintained for 30 seconds
Performing these stretches and exercises or similar types will help with herniated injury recovery and prevent worsening or creating new injuries.
Body Composition
Benefits of yoga
Yoga benefits mental and physical health. Yoga helps improve individual physical health. Specific poses can help:
Improve balance
Flexibility
Build/Tone muscle
Prevent injury
Improve sense of well-being
Yoga stretches the muscles while relieving physical and emotional stress. Practicing yoga regularly can prevent obesity, and reduce the risk of developing metabolic syndrome. Yoga can help decrease leptin which is a hormone that helps control appetite. This is important for individuals going through chronic stress who are twice as likely to develop metabolic syndrome.
Disclaimer
The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the musculoskeletal system’s injuries or disorders. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.
Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, CTG*
email: [email protected]
phone: 915-850-0900
Licensed in Texas & New Mexico
References
Court C, Mansour E, Bouthors C. Thoracic disc herniation: Surgical treatment, Orthopaedics & Traumatology: Surgery & Research, 104(1)S31-@40, 2018, https://www.sciencedirect.com/science/article/pii/S1877056817303419.
Spinal decompression surgery could be a treatment option discussion with a doctor to relieve nerve pain brought on by a spinal condition or disorder. Everything to know about the procedures straight from the experts.
Spinal Decompression Surgery Types: Laminectomy or Laminotomy
Both procedures involve the vertebrae�s lamina, which is an arch of bone that protects the spinal canal.
In a laminectomy, the lamina is removed almost entirely.
In a laminotomy, it is a partial removal.
Despite the removal, the large muscles of the back provide sustained protection for the nerves below. Therefore, the spinal nerves are still safe and secure following the procedures. Which one is right depends on the situation.
A laminectomy is usually performed to treat an arthritic condition of the spinal canal like spinal stenosis.
Laminotomy is used almost exclusively to remove a herniated disc.
A laminectomy removes more bone and sometimes the inner edge of the facet joint.
Ultimately, a surgeon will determine which of the two procedures is best for the individual’s needs and condition.
Decompression Surgery
Spinal stenosis or the narrowing of the spinal canal is usually caused by arthritis and overgrowth of the discs and joints. Similar compression issues respond well to non-surgical treatment. But sometimes surgery is necessary to treat uncommon but potentially severe cases. These include patients with:
Bowel or bladder problems caused by the pressure on the spinal nerves
Leg weakness that gets worse
Inability to walk or move for long periods and distance
The objective of spinal decompression surgery is to create space around the spinal cord and surrounding nerves by removing the compressing structure/s. When the cord and/or nerve/s are compressed, physical and neurological symptoms are experienced down the nerve�s pathway. This includes:
Tingling
Numbness
Electric shock sensations
Radiating/spreading pain
Weakness
Once the compressed nerves have space to relax and move around symptoms subside.
Laminectomy process
Lumbar laminectomy is the most common procedure to treat spinal stenosis in the low back.
It also helps treat herniated discs by allowing the surgeon to easily access the discs to repair any damage.
The surgeon removes the lamina and ligaments that have thickened and are causing problems to create more space in the canal.
The surgery enlarges the spinal canal so that pressure is relieved.
By removing the source of the pressure, the pain caused by the compressed nerves is alleviated.
An open laminectomy creates an incision of a couple of inches and exposes the spine.
The muscles of the spine and back are cut through to expose the bone.
Another technique that surgeons utilize is operating through a tube.
They’ve adapted these techniques to be able to decompress both the right and the left sides although they are only operating on one side.
Both procedures, minimal and traditional accomplish the same goals.
The difference is the minimally invasive approach involves one or more tiny incisions also known as skin punctures and small instruments designed to separate muscles and soft tissues instead of cutting through them.
The traditional approach requires a larger incision and instruments that retract, separate and cut tissues.
Laminectomy surgery
Laminectomies are performed under general anesthesia using a posterior approach/lying face down during the procedure.
It can be open or minimally invasive sometimes called a microlaminectomy.
In an open laminectomy, the surgeon makes an incision near the affected spinal area.
Once the incision is made, a retractor will move the skin, fat, and muscles to the side so the surgeon can access the spine.
Next, they remove or trim the lamina and thickened ligaments to enlarge the space surrounding the compressed nerves.
Once done, the retractor is removed and the incision is closed with sutures.
Minimally invasive surgery or MIS is performed using special instruments like endoscopes and tubular retractors.
These instruments allow for smaller incisions and less cutting.
They will also use special eyewear to have a detailed view of the surgical field.
Sometimes, the surgeon uses an endoscope or a microscope focused down the tube to perform the surgery.
The portion of the lamina is removed, along with any bone overgrowths/osteophytes and ligament tissue.
The tubular retractors are taken out so the soft tissue moves back into place, and the incision is closed with dissolving sutures.
Other spinal procedures performed alongside
Laminectomies and laminotomies are typically not performed together. However, a surgeon could perform both if the surgery affects multiple levels of the spine. They can also be combined with other spinal surgeries, that include:
Foraminotomy
A foraminotomy is also a decompression procedure. But instead of removing part or all the lamina, the surgeon accesses the nerves through the spine�s foramen or the passageway that nerves pass through on both sides.
Discectomy
This decompression surgery involves the removal of all or part of the damaged intervertebral disc and is utilized for herniated discs.
Spinal fusion
Fusion is often performed after spinal decompression surgery, as the space that was created by removing spinal structure/s can cause instability to the spine.
Candidates for spinal decompression surgery
Both are common procedures performed by neurosurgeons and orthopedic spine surgeons. Laminectomies are considered one of the most effective treatments for spinal stenosis and spinal canal issues like:
Tumors
Certain types of infections and abscesses
Spinal issues involving bowel/bladder dysfunction
The primary reason for laminectomy is spinal stenosis, most common in individuals over the age of 60.
Other considerations and conditions include:
Non-invasive treatments that don’t improve the condition that includes medication, massage, and physical therapy
Ask questions about the procedure to ensure you are comfortable with the operation. Here are some questions:
What are the risks associated?
Will the surgery relieve all symptoms?
Not having the surgery risks?
What is recovery like?
Recovery
Open or micro, recovery does take time. Following the doctor�s instructions carefully are essential to make a full, healthy recovery.
Individuals should be careful for about a month following the surgery. But does not mean laying down or being sedentary. Movement is crucial to recovery.
The patient should not stay in bed or lie on the sofa.
Wait a week or two before beginning physical therapy if necessary.
Most will have a weak core, poor posture, and poor body mechanics, the goal is to help develop and strengthen these areas.
Things to help with recovery include:
Ice/cold packs will help reduce swelling and pain.
Try not to sit for too long, as sitting is the least comfortable position after back surgery.
Body mechanic awareness means avoiding too much bending or lifting and using the right body mechanics when bending or lifting.
Especially before surgery. Quitting entirely or at least for at least six weeks before surgery will make recovery easier and healthier.
Losing weight
Speak with a doctor about weight. Just 5 pounds can make a significant difference during recovery.
Blood sugar
For individuals with diabetes, having an A1C under eight before surgery is ideal.
Every patient�s recovery is different. Recovery time depends on:
The complexity of the surgery
Personal medical history
Health issues
Recovery typically takes about two to four weeks after the surgery. However, it depends on the reason/s for the surgery.
Questions
Post-laminectomy syndrome
Post-laminectomy syndrome PLS also known as failed back surgery syndrome is a condition where an individual continues to have pain after surgery. Individuals still having symptoms after should speak with their doctor to determine the next phase of treatment.
How long before exercise?
Returning to the gym or getting into an exercise routine will take some time. It is important to follow the doctor�s recommendations and complete the full course of physical therapy before regular exercise activity can resume. Discuss workout plans with the doctor to determine the best timeline for the spine.
Full recovery?
Returning to some activity is possible around four weeks after surgery. Full recovery takes longer as each patient�s recovery is unique. Depending on the complexity of the surgery, most return to all activities within 6 to 9 months.
Body Composition Spotlight
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