Sleeping with lower back pain and sciatica can be difficult and frustrating. What are ways to get more comfortable sleep?
Sleeping With Lower Back Pain and Sciatica
Various factors can affect sleeping with lower back pain and sciatica, including age, injury and medical history, the mattress (e.g., soft vs. firm mattress), and sleep positions. Unfortunately, there’s no one-cure-all solution for this problem, and depending on the underlying cause/s, they can worsen the pain and cause sleep problems. For example, if a herniated disc places added pressure on the nerves in the lower back, twisting the spine can worsen the lower back pain, and sleeping in a fetal position can exacerbate the nerve pain. (UCF Health, N.D.)
Lower-Back Pain
Low-back pain can be activity-related, intermittent, or constant. (American Association of Neurological Surgeons, 2024) For some, it only occurs occasionally, such as when performing specific movements. For others, it can be excruciating, chronic, and disabling. Low-back pain is unique for everybody and can differ depending on the cause. Some low-back pain symptom descriptions include (Förster M. et al., 2013)
Aching pain deep in the back
Shooting pain flare-ups
Pain caused by slight pressure
Burning
Tingling
Sciatica Not Present
For some, low-back pain may be confined to a specific area known as axial back pain. (Förster M. et al., 2013) The pain may be felt in a band along the lower back and does not radiate down the legs or anywhere else.
Sensory changes radiating down the leg – numbness, burning, and or tingling
Sleep Tools
Consider changing the mattress to improve sleeping with lower back pain and sciatica. For the best spinal support, choose a medium to firm mattress. Pillows, wedges, and other tools can also help improve sleep. (UCF Health, N.D.) It is recommended that individuals who sleep on their backs place a small pillow under their knees to reduce pressure on their lower backs. For those who sleep on their side, placing a pillow between the knees can keep the spine in a neutral/straight position. To relieve lower back pain, consider sleeping in a reclined, angled position with the head and shoulders higher than the hips. This can be accomplished with an adjustable bed or a wedge to prop the body in a regular bed.
Back Sleeping
Easing back pain while sleeping involves maintaining the body in a neutral or straight position. Extending the muscles, tendons, and ligaments too far in any one direction while sleeping with lower back pain and sciatica can cause stiffness, muscle spasms, and pain. Sleeping on the back puts the spine in neutral alignment with the least stress on the neck and back. It evenly distributes body weight to avoid exerting pressure on the joints and prevent backaches. In addition, a supine position allows outstretched ligaments to shrink and recover to their normal positions. (Keck Medicine of USC, 2019)
Chiropractic Assessment
Chiropractic care aims to help individuals improve movement with less pain due to condition, after injury, or surgery. A chiropractic physical therapy team may be best for individuals with acute back, neck, and musculoskeletal pain and discomfort symptoms. A chiropractor can quickly assess your condition and develop a customized treatment plan to expedite pain relief and improve mobility. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.
Förster, M., Mahn, F., Gockel, U., Brosz, M., Freynhagen, R., Tölle, T. R., & Baron, R. (2013). Axial low back pain: one painful area–many perceptions and mechanisms. PloS one, 8(7), e68273. doi.org/10.1371/journal.pone.0068273
Is applying ice the best option for individuals who experience an acute back strain injury?
Temperature Treatment
Ice temperature treatment, also known as cryotherapy or cold therapy, is a treatment that uses freezing temperatures to reduce pain and swelling. It can be applied in a variety of ways, including:
Ice packs:
Ice massage
Coolant sprays
Whirlpools
Ice baths
Ice is usually recommended for acute injuries and is a common and simple way to treat pain and swelling. Individuals can buy freezable gel packs or make their own with ice cubes in a plastic bag or towel. Heat therapy tends to be used more with chronic issues involving muscle spasms to increase blood circulation.
How Ice Relieves Pain and Reduces Inflammation
Ice temperature treatment works by:
Narrowing blood vessels slows blood circulation to the injured area and soft tissues and reduces swelling.
Reduced blood flow also helps control excessive swelling.
Ice has a short-term analgesic-numbing effect. The coldness numbs nerve endings, relieving pain symptoms.
Relieving the pain allows the muscles to relax.
Controlling blood circulation helps control pain by reducing the flow of irritating chemicals that can inundate the injury site. These chemicals are a natural and the correct response to inflammation, but the ice keeps them in check to help control pain.
After a Back Injury
For a back strain injury, ice and anti-inflammatory medication like NSAIDs are the first line of treatment during the inflammatory phase, which usually lasts 24 to 72 hours. Because heat can increase inflammation by increasing blood circulation, it is not recommended as an initial treatment. After the first few days, most doctors and pain specialists recommend using ice or heat, depending on the individual’s preference. While researchers continue to investigate the best ways to treat acute injuries, most doctors still recommend ice as the first line of defense for back injuries.
A review of studies evaluated 20 different treatment categories to learn about their safety and effectiveness. (McIntosh G. & Hall H. 2011) Treatments included over-the-counter pain medications, acupuncture, McKenzie exercises, other back exercises, and temperature treatments. Regarding temperature treatment, the review found moderate evidence that using a heat wrap 5 days after the injury could help relieve pain. However, there was not enough evidence to support the effectiveness of any of the temperature treatments, necessitating more research. (McIntosh G. & Hall H. 2011)
Physical Therapy and Activity
The review found that prolonged rest should be avoided, and gentle exercise and a progressive return to physical activity should be encouraged to achieve the best outcomes for pain relief and restoring function. Staying active significantly reduces time off from work and chronic disability for up to 1 year compared to traditional medical treatment. (McIntosh G. & Hall H. 2011) Research also found that introducing physical therapy early on could expedite recovery. Mobility work, targeted exercises, and strengthening exercises have been shown to relieve pain, reduce injury recurrence, and improve overall function. More research supports physical activity and exercise as effective treatment options for acute lower back strains. However, further research regarding temperature treatments is required. (French S. D. et al., 2006) (See Q. Y. et al., 2021)
Injury Medical Chiropractic and Functional Medicine Clinic
It is important to talk with a healthcare provider to determine the cause and extent of the injury to provide individualized patient education regarding treatment. This can include physical therapy, rest, health coaching, medication, and surgery, which may be recommended in certain cases. Overcoming these limitations is possible. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
Beyond the Surface: Understanding the Effects of Personal Injury
References
McIntosh, G., & Hall, H. (2011). Low back pain (acute). BMJ clinical evidence, 2011, 1102.
French, S. D., Cameron, M., Walker, B. F., Reggars, J. W., & Esterman, A. J. (2006). A Cochrane review of superficial heat or cold for low back pain. Spine, 31(9), 998–1006. doi.org/10.1097/01.brs.0000214881.10814.64
See, Q. Y., Tan, J. B., & Kumar, D. S. (2021). Acute low back pain: diagnosis and management. Singapore Medical Journal, 62(6), 271–275. doi.org/10.11622/smedj.2021086
While some disc herniations don’t cause symptoms, individuals who are overweight with a herniated disc may experience obesity pressure symptoms such as pain, weakness, numbness, or tingling. Can implementing a physical therapy and weight loss treatment program help individuals find relief?
Obesity Pressure
Obesity is one major factor that can contribute to a herniated disc and chronic back pain. When the body has to carry added weight, it can lead to obesity pressure on the intervertebral discs and affect posture and spine position. Researchers have found that other factors, such as inflammation or metabolic changes associated with obesity, can also be involved. (Sheng B. et al., 2017) For individuals who are overweight, weight loss can help resolve a herniated disc combined with physical therapy and can significantly increase herniated disc prevention. (Tokmak M. et al., 2015)
Spine Problems
According to Dr. Alexander Jimenez, owner and head chiropractor at Injury Medical Chiropractic and Functional Medicine Clinic, “When the position of the pelvis and lumbar spine shift out of alignment and become altered, it can profoundly contribute to advanced wearing away of outer fibers in the back region of the discs. These outer fibers house and protect the soft material that cushions and absorbs shock in the spine. Over time, the obesity pressure wear and tear on the fibers can cause chronic pain and microscopic radial tears, leading to a complete rupture.” A rupture causes the soft material to leak, irritate, and inflame surrounding nerve roots. Most herniated discs occur between the sides and back of the vertebra.
Movement Problems
Obesity makes movement difficult, often causing symptoms like shortness of breath and/or early fatigue and exhaustion even with minimal physical activity.
Physical therapy and exercise help relieve obesity and disc herniation.
However, the obesity pressure and herniation pain can make it hard to participate in cardiovascular exercises on a regular basis.
Diagnosis Complications
Obesity can interfere with the diagnosis and treatment of spinal diseases.
This is because weight restrictions and certain imaging tests, like a spinal MRI, can be difficult or impossible to obtain.
A physical examination might not be able to identify signs of nerve compression if an individual is obese. These factors can delay diagnosis.
Disc Position and Posture
Obesity is not the only thing that places pressure on the discs. An individual’s body position significantly influences the health of the shock-absorbing cushions. Sitting generates the most pressure, followed by standing, while lying on your back places the least strain on the discs and, depending on the injury, may help relieve symptoms.
Symptoms depend on the location of the herniation.
The two most common locations are the cervical spine/neck area and the lumbar spine/lower back.
Disc herniations in the neck can affect the arms.
Disc herniations in the lower back affect the buttocks and legs.
Injury Medical Chiropractic and Functional Medicine Clinic
See a healthcare provider if you’re experiencing any of these symptoms. If it is a herniated disc causing symptoms, you might be started on 6 weeks of conservative treatment. This can include physical therapy, rest, health coaching, medication, and surgery, which may be recommended in certain cases. Overcoming these limitations is possible. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
Weight Loss Techniques
References
Sheng, B., Feng, C., Zhang, D., Spitler, H., & Shi, L. (2017). Associations between Obesity and Spinal Diseases: A Medical Expenditure Panel Study Analysis. International journal of environmental research and public health, 14(2), 183. doi.org/10.3390/ijerph14020183
Tokmak, M., Altiok, I. B., Guven, M., Aras, A. B., & Cosar, M. (2015). Spontaneous Regression of Lumbar Disc Herniation After Weight Loss: Case Report. Turkish neurosurgery, 25(4), 657–661. doi.org/10.5137/1019-5149.JTN.9183-13.1
Can individuals relieve back pain by incorporating core strength training to reduce pain and discomfort in their lower backs?
Introduction
Many individuals worldwide have dealt with back issues that make it difficult to complete any task that they are doing. Many often feel pain and discomfort radiating from the three sections of the back and can radiate from the neck, shoulders, and hips. When these areas of the musculoskeletal system are being affected, it can lead to a life of pain and chronic conditions that cause overlapping risk profiles. At the same time, some causes of back pain often correlate with environmental factors and weak core muscles. When a person is dealing with weak core muscles, they will experience instability and pain when they are mobile, leading to back pain. In today’s article, we look at what the core muscles are, how they are connected to back pain, and how strengthening them can reduce the effects of back pain. We discuss with certified medical providers who inform our patients how strengthening the core muscles can reduce back pain. While asking informed questions to our associated medical providers, we advise patients to incorporate various core strengthening exercises to prevent overlapping risk profiles correlated with back pain. Dr. Alex Jimenez, D.C., encompasses this information as an academic service. Disclaimer.
What Are The Core Muscles?
Do you feel a constant ache or pain in your back after lifting or carrying objects in a hunched position? Do you experience muscle weakness in your torso that you can’t stay in a plank position for a few seconds? Or do you experience radiating pain from your lower back to your leg? The core muscles are a group of muscles wrapped around the torso like a support belt that helps with stability, balance, and protecting the lumbar from injuries. The core muscles are found in the lower body’s front, back, and sides. At the same time, the core muscles can help generate intrabdominal pressure while moving the vertebral column. (Flynn & Vickerton, 2024) In the core muscles, the transverse abdominis muscle or the seatbelt muscle. This muscle works with the inspiratory muscles through elastic loading to evoke transversus expiratory activity when breathing and functioning in motion. (De Troyer et al., 1990)
Core Muscles & Back Pain
The core muscles, especially the transverse abdominis muscles, are often overlooked as many individuals frequently deal with numerous factors that cause low back pain. Common core muscles are associated with back pain because environmental factors can neglect the transverse abdominis muscles. Fatigue in the core muscles can cause repetitive asymmetric loading on the spine, which enhances susceptibility to back pain and other injuries. (Zemkova & Zapletalova, 2021) Since back pain is a multifactorial condition that is one of the leading causes of hospital visits and socio-economic issues, many individuals start to neglect the core muscles over time, causing them to be weak. Some symptoms correlated with weak core muscles include:
When this happens, many people start looking for treatment to reduce their back pain and help strengthen their core muscles.
Discover The Benefits Of Chiropractic Care- Video
Strengthening Core Muscles
Before people reduce their back pain and return to their daily routine, they would have to be assessed by a pain specialist like a chiropractor to assess fully what environmental factors are causing the back pain. After the assessment, a chiropractor can work with a physical therapist to reduce back pain and strengthen the core muscles to prevent back pain from returning. When it comes to core strengthening exercises, they focus on either the deep or superficial muscles of the torso, which might produce different effects on lumbar motion. (Puntumetakul et al., 2021) Additionally, core stability exercises can reduce pain in the back and disability reduction and improve a person’s quality of life. (Kanwal et al., 2021) Engaging the muscles through core strengthening exercises can help achieve optimal strength with twisting and side-bending movements to reduce back pain.
Pay Attention To Engaged Core Muscles
However, individuals need to pay attention to engaging their core muscles while maintaining a neutral spine position for stability and preventing back pain. (Cigdem Karacay et al., 2022) This allows individuals to be consistent with strengthening their core and to commit to short workouts incorporated as part of not only their routine but also as part of their customized treatment plan. When it comes to reducing back pain, it is important to ensure that the core muscles are engaged to help build strength and stability, decrease back pain, and improve functionality. When people start strengthening their core muscles, they will be able to be more mindful about how to present themselves and live healthier lives.
References
Cigdem Karacay, B., Sahbaz, T., Gurtekin, B., Yildiz, S., & Ozcan, E. (2022). Effectiveness of whole-body vibration exercise and core stabilization exercise in chronic non-specific low back pain: A randomized-controlled study. Turk J Phys Med Rehabil, 68(2), 184-194. doi.org/10.5606/tftrd.2022.7060
De Troyer, A., Estenne, M., Ninane, V., Van Gansbeke, D., & Gorini, M. (1990). Transversus abdominis muscle function in humans. J Appl Physiol (1985), 68(3), 1010-1016. doi.org/10.1152/jappl.1990.68.3.1010
Kanwal, S., Yaqoob, I., Shakil-Ur-Rehman, S., Ghous, M., Ghazal, J., & Namroz, N. (2021). Effects of core muscle stability on low back pain and quality of life in post-menopausal women: A comparative study. J Pak Med Assoc, 71(1(A)), 37-40. doi.org/10.47391/JPMA.151
Puntumetakul, R., Saiklang, P., Tapanya, W., Chatprem, T., Kanpittaya, J., Arayawichanon, P., & Boucaut, R. (2021). The Effects of Core Stabilization Exercise with the Abdominal Drawing-in Maneuver Technique versus General Strengthening Exercise on Lumbar Segmental Motion in Patients with Clinical Lumbar Instability: A Randomized Controlled Trial with 12-Month Follow-Up. Int J Environ Res Public Health, 18(15). doi.org/10.3390/ijerph18157811
Wattananon, P., Sinsurin, K., & Somprasong, S. (2020). Association between lumbopelvic motion and muscle activation in patients with non-specific low back pain during forward bending task: A cross-sectional study. Hong Kong Physiother J, 40(1), 29-37. doi.org/10.1142/S1013702520500043
Zemkova, E., & Zapletalova, L. (2021). Back Problems: Pros and Cons of Core Strengthening Exercises as a Part of Athlete Training. Int J Environ Res Public Health, 18(10). doi.org/10.3390/ijerph18105400
For individuals trying to retrain their body movements for back health improvement, what is the spinal area that helps the body twist, bend, and stand upright?
Lumbosacral Joint L5-S1
The L5-S1, also called the lumbosacral joint, is a term used to describe a part of the spine. It is where the lumbar spine ends and the sacral spine begins, and it connects these bones. The lumbosacral joint is also susceptible to misalignment and injury, such as disc herniation or a spinal disorder called spondylolisthesis.
The spinal column is the structure that allows the body to stand upright and helps you twist, bend, and alter trunk and neck position. Typically, 24 movable bones in the spine connect to the sacrum and the coccyx, or the tailbone. The sacrum and the coccyx each have multiple bones that fuse over time. L5-S1 consists of the last bone in the lumbar spine, called L5, and the triangle-shaped bone under it, known as the sacrum. S1 is at the top of the sacrum and comprises five fused bones.
Risk of Injury
Each area of the spine has a curve that goes in opposite directions. The places where the spinal curve directions change are junctional levels. The risk of injuries may be higher at junctional levels because the body weight shifts direction as the curves shift. The L5-S1 junction is located between the lumbar curve and the sacral curve. The lumbar curve sweeps forward, and the sacral curve goes backward.
The lumbosacral joint L5-S1 junction is highly vulnerable to misalignment, wear and tear, and injury. This is because the top of the sacrum is positioned at an angle for most individuals. Aging and injury increase the vulnerability of the L5-S1 junction even more. Pain coming from L5-S1 is usually treated with:
Heat and/or ice
Over-the-counter anti-inflammatory medications
Prescription pain medications
Muscle relaxers
Physical therapy
Chiropractic adjustments
Epidural steroid injections
If these therapies do not help, surgery may be recommended. L5-S1 is one of the two most common sites for back surgery.
Conditions
Disc herniation at L5-S1 is a common injury and cause of sciatica, which can cause pain and other issues (MedlinePlus, 2024). The L5-S1 junction is often the site of a condition known as spondylolisthesis.
Disc Herniation
Discs separate the vertebrae, cushioning the spinal column and allowing movement between vertebrae. A disc herniation means the disc slips out of place. (MedlinePlus, 2022) A disc herniation at L5-S1 is a common cause of sciatica. Symptoms of sciatica include:
Burning
Numbness
Pain or tingling that radiates from the buttock down the leg to the knee or foot.
Disc herniation can also cause chronic back pain and stiffness and trigger painful muscle spasms. Bowel problems are also possible with disc issues at L5-S1. Research links irritable bowel syndrome to herniated discs in the lower back. (Bertilson BC, Heidermakr A, Stockhaus M. 2015) Additional studies found disc problems at L5-S1 can lead to difficulty with sphincter control. (Akca N. et al., 2014) Initial treatments for disc herniation include rest and pain relievers to reduce inflammation and swelling, then physical therapy. Most recover with conservative interventions, and those who don’t may require a steroid injection or surgery. (MedlinePlus, 2022)
Spondylolisthesis
Spondylolisthesis occurs when a vertebra slips forward relative to the bone below it. The most common form of this condition is degenerative spondylolisthesis, which generally begins when the spine wears down with age. Isthmic spondylolisthesis is another common variation and starts as a tiny fracture in the pars interarticularis, a bone that connects the adjoining parts of the facet joint. (American Academy of Orthopaedic Surgeons, 2020) These fractures often occur before age 15, but symptoms do not develop until adulthood. Degeneration of the spine in later adulthood can further worsen the condition.
The angle of the sacrum can also contribute to spondylolisthesis. This is because the S1 tips down in the front and up in the back rather than being horizontal. Individuals with a greater tilt are usually at a higher risk of spondylolisthesis. (Gong S. et al., 2019) However, individuals with spondylolisthesis may not have any symptoms. Those who do may experience: (American Academy of Orthopaedic Surgeons, 2020)
Back stiffness
Standing difficulties
Walking difficulties
Lower back pain
Hamstring tightness
Spondylolisthesis is typically treated with non-surgical interventions that can include:
Pain medications
Heat and/or ice application
Physical therapy
Epidural steroid injections
Usually, non-surgical care is tried for at least six months. If pain and symptoms persist, surgery may be an option. Spinal fusion surgery can be effective but requires a long recovery time and can have additional risks.
Injury Medical Chiropractic and Functional Medicine Clinic
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
Bertilson, B. C., Heidermark, A., & Stockhaus, M. (2015). Irritable Bowel Syndrome–a Neurological Spine Problem. Journal of Advances in Medicine and Medical Research, 4(24), 4154–4168. doi.org/10.9734/BJMMR/2014/9746
Akca, N., Ozdemir, B., Kanat, A., Batcik, O. E., Yazar, U., & Zorba, O. U. (2014). Describing a new syndrome in L5-S1 disc herniation: Sexual and sphincter dysfunction without pain and muscle weakness. Journal of craniovertebral junction & spine, 5(4), 146–150. doi.org/10.4103/0974-8237.147076
Gong, S., Hou, Q., Chu, Y., Huang, X., Yang, W., & Wang, Z. (2019). Anatomical factors and pathological parts of isthmic fissure and degenerative lumbar spondylolisthesis.
Can individuals with body pain incorporate Pilates to reduce general aches and pains while strengthening muscles in the body?
Introduction
Environmental factors like poor posture, improper steps, mechanical overload, physical inactivity, and poor dieting can affect a person’s health and wellness, leading to body pains in the neck, shoulders, and back. When this happens, the surrounding muscles become weak and overstretched over time, causing pain and discomfort in different body areas. However, many individuals thinking about their health and wellness can seek various treatment options to reduce the pain and discomfort in their bodies and help improve their muscle strength. Today’s article looks at how body pain can affect posture, what Pilates is, how this exercise regime can be incorporated for body pain, and its benefits. We talk with certified associated medical providers who inform our patients about how incorporating Pilates can reduce body pain. While asking associated medical providers intricate questions, we advise patients to incorporate Pilates as part of their routine and how it can improve their muscle strength. Dr. Alex Jimenez, D.C., includes this information as an academic service. Disclaimer.
How Body Pain Can Affect Posture
Do you experience stiffness or general aches and pains in different muscle areas? Do you often feel constantly tired throughout the entire day? Or do you notice your posture worsening after looking at a computer or phone screen? Many of these environmental factors can lead to pain and discomfort in the body, which then can cause issues that many individuals will tend to ignore until it becomes too much. For instance, environmental factors like obesity are commonly associated with musculoskeletal problems and incorrect body posture, which can be represented as a causal factor for impairment to the body. (Calcaterra et al., 2022) This is because many individuals don’t realize that improper posture can be associated with body pain and, if not corrected, can lead to overlapping risk factors in the musculoskeletal system. Hence, many individuals start seeking treatments to improve postural alignment, but it can also be used to prevent and treat musculoskeletal pain. (Matsutani et al., 2023)
The Non-Surgical Approach To Wellness- Video
What Is Pilates?
While many people seek treatment for their body pain and improve muscle strength, many have started exercising to reduce the stress and discomfort caused by body pains associated with the musculoskeletal system. Since everyone knows that exercising is excellent for health and wellness, it can also help make the body healthier. Many individuals looking for an exercise routine have various options, including Pilates.
Developed in the early 20th century, Joseph Pilates created a system of exercises primarily focused on controlled muscle movement, stretching, and breathing known as Pilates. It has become popular later in the years not only as a physical fitness routine but also as a rehabilitation program. (Byrnes et al., 2018) Pilates uses a combination of repetitive exercises to create muscular exertion and is designed to increase muscle strength and endurance, enhance flexibility, and improve posture and balance. (Kloubec, 2011)
How Is It Incorporated For Body Pain?
While many people are dealing with body pain, some may wonder how Pilates is incorporated into a health and wellness treatment plan. Well, when environmental factors like poor posture and body pain associated with the musculoskeletal system start to cause pain and discomfort to the body. At the same time, that pain and discomfort, if not treated, will also affect the spine’s alignment, causing more musculoskeletal problems. (Shadi et al., 2024) Additionally, Pilates can be combined with non-surgical treatments like chiropractic care to help improve musculoskeletal pain and restore a person’s strength, flexibility, and mobility. This, in turn, promotes mindfulness and a faster recovery. Many individuals will begin to notice that combining a therapeutic exercise method like Pilates and non-surgical treatments can allow the individual to be pain-free and experience additional benefits. This will enable people to understand the impact of stretching exercises caused by Pilates on the components of musculoskeletal fitness aimed at rehabilitation or physical conditioning. (Dos Reis et al., 2024)
The Benefits Of Pilates
Many people will notice how Pilates can help their bodies through these benefits. This includes:
Adapting Pilates to your fitness level and needs: Anyone can start Pilates at any fitness level and go at their own pace.
Core strength increases: Pilates can help strengthen the core muscles, which correlates to improved posture and a strong body.
Strengthening muscles: Pilates can help strengthen and elongate muscles to help individuals look toned.
Natural energy booster: Like many exercise routines, Pilates can give people an energy boost through focus breathing. This increases circulation, stimulating the muscles and spine.
Utilizing Pilates for rehabilitation combined with non-surgical treatment can allow individuals to be more mindful of their bodies and to make tiny changes in their routines. This allows the chances of pain and discomfort from returning, allowing individuals to have a healthier lifestyle.
References
Byrnes, K., Wu, P. J., & Whillier, S. (2018). Is Pilates an effective rehabilitation tool? A systematic review. J Bodyw Mov Ther, 22(1), 192-202. doi.org/10.1016/j.jbmt.2017.04.008
Calcaterra, V., Marin, L., Vandoni, M., Rossi, V., Pirazzi, A., Grazi, R., Patane, P., Silvestro, G. S., Carnevale Pellino, V., Albanese, I., Fabiano, V., Febbi, M., Silvestri, D., & Zuccotti, G. (2022). Childhood Obesity and Incorrect Body Posture: Impact on Physical Activity and the Therapeutic Role of Exercise. Int J Environ Res Public Health, 19(24). doi.org/10.3390/ijerph192416728
Dos Reis, A. L., de Oliveira, L. C., & de Oliveira, R. G. (2024). Effects of stretching in a pilates program on musculoskeletal fitness: a randomized clinical trial. BMC Sports Sci Med Rehabil, 16(1), 11. doi.org/10.1186/s13102-024-00808-6
Matsutani, L. A., Sousa do Espirito Santo, A., Ciscato, M., Yuan, S. L. K., & Marques, A. P. (2023). Global posture reeducation compared with segmental muscle stretching exercises in the treatment of fibromyalgia: a randomized controlled trial. Trials, 24(1), 384. doi.org/10.1186/s13063-023-07422-w
Shadi, N., Khalaghi, K., & Seyedahmadi, M. (2024). Comparing the effects of Pilates, corrective exercises, and Alexander’s technique on upper cross syndrome among adolescent girls student (ages 13-16): a six-week study. BMC Sports Sci Med Rehabil, 16(1), 143. doi.org/10.1186/s13102-024-00933-2
How are MRIs used to help diagnose bulging and herniated discs and help healthcare providers develop effective treatment programs for individuals experiencing back pain symptoms?
Herniated Bulging Disc MRI
A herniated bulging disc is often identified during magnetic resonance imaging (MRI); however, it’s usually an incidental finding that was done for other reasons where spinal problems and/or injuries are found. A bulging disc is relatively common, even in individuals who experience no symptoms. A herniated or bulging disc in the back can be identified with an MRI test, typically recommended when someone experiences back pain symptoms for at least six weeks. (American Academy of Neurological Surgeons, 2024) Normal wear and tear and age cause changes in the spinal disc/s cushion to bulge and become misaligned with the spine. (Brinjikji W. et al., 2015) And with a herniated disc, it can press against the spinal cord and nerves. Repeated heavy lifting, practicing unhealthy postures, a history of back injuries, or underlying health conditions are common causes.
Bulging Disc
Bulging discs are common even in healthy individuals but can be difficult to interpret independently on an MRI, so other symptoms and findings are as important in diagnosis.
Causes
A bulging disc is usually considered age-related degenerative changes that cause the disc to bulge downward with gravity. (Penn Medicine, 2018)
A significant bulge is expected to cause leg pain due to irritation to the nerves going down the legs. (Amin R. M., Andrade N. S., & Neuman B. J. 2017) As the condition progresses, more than one disc can be affected, leading to other spinal conditions, including spinal stenosis.
A Bulging Disc On MRI
A disc bulge will measure over 25% of the total disc circumference. Its displacement is usually 3 millimeters or less from the normal shape and position of the disc. (Radiopaedia, 2024)
Herniated Disc
A herniated disc shifts out of its correct position and compresses nearby spinal nerves, causing pain and mobility issues.
Herniated discs will measure less than 25% of the total disc circumference. However, herniation is based on the type and can include: (Wei B., & Wu H. 2023)
Disc Protrusion – the displacement is limited, and the ligaments are intact.
Disc Extrusion – part of the disc remains connected but has slipped through the annulus or outer covering of the disc.
Disc Sequestration – a free fragment has separated and broken off from the main disc.
Candidates For Spinal MRI
The MRI is generally safe for most, including those with implanted cardiac devices like newer-model pacemakers. (Bhuva A. N. et al., 2020) However, it’s important to ensure that the healthcare team is aware of cochlear implants or other devices so that necessary precautions can be taken. It is recommended for all individuals that symptoms be present for six weeks before an MRI. A specialist may want to see MRI results sooner, especially if symptoms include: (American Academy of Neurological Surgeons, 2024)
A specific injury, like a fall that caused the pain
Recent or current infection or fever with spinal symptoms
Significant weakness in arms or legs
Loss of pelvic sensation.
A history of metastatic cancer.
Loss of bladder or bowel control
An MRI may be needed if symptoms are rapidly worsening. However, many with a disc bulge don’t have symptoms at all. In most cases, an MRI is an outpatient procedure that can be completed in an hour or less but can take longer if contrast dye is used. The healthcare provider will provide specific instructions about MRI preparation.
Treatment
Treatment for a herniated or bulging disc depends on the cause and severity of symptoms.
Over-the-counter pain relief, including nonsteroidal anti-inflammatory drugs (NSAIDs).
Physical therapy
In rare cases that have not resolved with conservative treatment, surgery may be recommended.
Remember that the MRI findings may not identify or rule out all conditions, including muscle strains or ligament injuries, which may require different treatments, such as targeted stretches and exercises. (Brinjikji W. et al., 2015) (Fujii K. et al., 2019)
Herniated Disc
Treatment depends on the cause and severity of symptoms, if any. It can include stand-alone or a combination of physical therapy, medication, and steroid injections. Cases usually resolve in six to 12 weeks (Penn Medicine, 2018). Electrical nerve stimulation may be performed through specialized devices and/or acupuncture to help with nerve compression. (National Institute of Neurological Disorders and Stroke, 2020) Surgery may be recommended if conservative treatments fail to achieve significant pain relief and healing. (Wang S. et al., 2023)
Injury Medical Chiropractic and Functional Medicine Clinic
A healthcare provider can discuss treatment options such as pain medication, physical therapy, and surgery. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
Brinjikji, W., Diehn, F. E., Jarvik, J. G., Carr, C. M., Kallmes, D. F., Murad, M. H., & Luetmer, P. H. (2015). MRI Findings of Disc Degeneration are More Prevalent in Adults with Low Back Pain than in Asymptomatic Controls: A Systematic Review and Meta-Analysis. AJNR. American journal of neuroradiology, 36(12), 2394–2399. doi.org/10.3174/ajnr.A4498
Wu, P. H., Kim, H. S., & Jang, I. T. (2020). Intervertebral Disc Diseases PART 2: A Review of the Current Diagnostic and Treatment Strategies for Intervertebral Disc Disease. International journal of molecular sciences, 21(6), 2135. doi.org/10.3390/ijms21062135
Amin, R. M., Andrade, N. S., & Neuman, B. J. (2017). Lumbar Disc Herniation. Current reviews in musculoskeletal medicine, 10(4), 507–516. doi.org/10.1007/s12178-017-9441-4
Wei, B., & Wu, H. (2023). Study of the Distribution of Lumbar Modic Changes in Patients with Low Back Pain and Correlation with Lumbar Degeneration Diseases. Journal of pain research, 16, 3725–3733. doi.org/10.2147/JPR.S430792
Bhuva, A. N., Moralee, R., Moon, J. C., & Manisty, C. H. (2020). Making MRI available for patients with cardiac implantable electronic devices: growing need and barriers to change. European radiology, 30(3), 1378–1384. doi.org/10.1007/s00330-019-06449-5
Brinjikji, W., Luetmer, P. H., Comstock, B., Bresnahan, B. W., Chen, L. E., Deyo, R. A., Halabi, S., Turner, J. A., Avins, A. L., James, K., Wald, J. T., Kallmes, D. F., & Jarvik, J. G. (2015). Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR. American journal of neuroradiology, 36(4), 811–816. doi.org/10.3174/ajnr.A4173
Fujii, K., Yamazaki, M., Kang, J. D., Risbud, M. V., Cho, S. K., Qureshi, S. A., Hecht, A. C., & Iatridis, J. C. (2019). Discogenic Back Pain: Literature Review of Definition, Diagnosis, and Treatment. JBMR plus, 3(5), e10180. doi.org/10.1002/jbm4.10180
Wang, S., Zhao, T., Han, D., Zhou, X., Wang, Y., Zhao, F., Shi, J., & Shi, G. (2023). Classification of cervical disc herniation myelopathy or radiculopathy: a magnetic resonance imaging-based analysis. Quantitative imaging in medicine and surgery, 13(8), 4984–4994. doi.org/10.21037/qims-22-1387
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