back to BACK basics

Sprains

Typically hurt less bending forward than returning upward

Pain worsens with movement

Muscles feel tight, cramps/spasm common

Loss of normal range of motion

Sprain Recovery time~ 2 weeks

Spain Management :

  • Initially ice bruised/swollen areas;  heat for spasms.
  • Massages, stretches, gentle exercises. Rest. NSAIDs. Msl relaxers.
  • NO lifting. 
  • Protective measures post recovery to prevent relapse.
    • Strengthening core muscles, back support muscles.
    • Learning healthy lifting techniques; no twist lifts.

Disc Recovery time– 2 months to 2 years

Herniated discs

Increase risk with with aging

Not all ruptures are due to heavy lifting

May have no symptoms at all; occasionally an incidental finding on scans

Typically hurt more bending forward and when returning to upright position

Constant pain at some level or continual back awareness

Pain with spinal movements 

Increasing pain with sitting, bending, sneezing

Depending on location of disc – 

Numb, weakness, or tingling in extremity

Radiation of pain to extremity

e.g. shooting pain down legs/arms burning sensations in hip, pelvis, buttocks, shoulders, arms.

Disc Management:

Primary Goal – STABILIZE the ruptured disc area! 

  • The more you move the injured area, the tighter your back muscles around the herniated disc need to get to protect it and the wider the area that will tighten up. Before you know it your entire back is a mess!
    • Take laying down breaks during the day flat on floor is a great
      way to take the pressure off your back, roll over to belly to get up again.
    • Massage areas outside the affected disc zone, not directly over it.
  • Don’t jiggle the jello. The nucleus pulposus is the inner core of your disc. It is a jelly-like substance with collagen fibers. It acts like a shock absorber. That is what actually herniates out of the space, inflaming the nerve roots next to the disc creating pain. 
    • No jumping, jogging, running, hopping, weight lifting, pilates.
    • No horseback riding, jet ski or snow skiing, jumping from planes or other obvious disc jiggling activities.
  • Avoiding twisting the spine that can further compress the spinal nerves. 
    • No twist bending; first turn the body, then bend.
    • No dancing the twist or equivalent. Only mild yoga. Back swim stroke best.
  • Protect back while you are sleeping from inadvertent prolonged twisted positions. 
    • Use supports such as pillows front/back/side; lumbar supports and/or back braces. 
  • Monitor and maintain good posture when sitting, standing, and laying.
  • Avoid prolonged sitting.
    • Walk. Then walk some more. Then walk again. Hills are helpful.

Surgery may be indicateddepending on the degree of rupture and risk of permanent nerve damage by entrapment. Incontinence, weakness, radiating pains, or loss of sensation – should all be evaluated by a professional promptly to provide guidance to determine when or if surgical intervention is warranted. Most discs heal on their own.

                                                                                    K.Smith DNP 2021