Back pain will affect 80% of the population at some point in their lives. While this pain will be short-lived for some, it will become chronic for others. There are many causes of back pain; disc abnormalities are among the most common.
Spinal discs can become distorted due to age, improper posture, poor bio-mechanics over time, or an injury, such as one caused by improper lifting technique. Discs are composed of a fluid center and tough exterior. Wear and tear occurs to discs naturally as we age, leaving them less capable of cushioning vertebrae and absorbing shock. With age or any of the other factors listed above, the tough exterior of the disc may weaken, while uneven pressure on the spine, usually over a prolonged period of time, will cause the fluid in the center of the disc to be pushed to the weaker side of the disc. This will create a disc bulge. If the exterior develops cracks and the fluid leaks out, a herniated disc is present.
Each of these conditions – degenerated disc, bulging disc and herniated disc – is painful. Each fails to cushion the spine and changes the distance between vertebrae. They also lead to the risk of nerve impingement. The spine has a very important neurological role in the body, supporting nerves that transmit signals from the brain to muscles and organs throughout the body, and return messages to the brain from these parts. If vertebrae and discs change position, they could press on one or more nerves that exit the spine, leading to pain that is felt at the location of impingement and along the nerve’s pathway. The disc fluid, composed of inflammatory materials, can irritate the nerve on its own as well.
A physiotherapist could be a great resource for your path to recovery from disc-related pain like sciatica. They are trained mainly to use exercise as medicine.
Some therapists are trained in a technique that is designed to restore movement and increase disc space in the spine called the McKenzie Program. This program uses back extension stretches to extend the spine. Treatment under the McKenzie model focuses on pinpointing the exact problem through assessments, correcting behavioral patterns that may cause pain in the future (like postural dysfunction), and developing an exercise and stretching routine specified for the individual’s condition.
McKenzie exercises are simple and can be performed at home, but it is best to begin the program with a trained physiotherapist. There are two main reasons for this: 1) your exercises will differ depending on the cause of your pain, and 2) your behavioral patterns should be assessed and corrected if needed before you pursue an exercise regimen, since poor biomechanics combined with exercise can exacerbate your problem.
For an example of a few common McKenzie back extension stretches, see Kick Into Fitness.
Some physiotherapists are also trained in massage techniques designed to loosen tension within connective tissues, such as ligaments, tendons, and the tissue surrounding muscles (myofascia). Tight tissues make it difficult for the spine to stretch and return to its natural alignment. Making connective tissues pliable is a necessary part of restoring health to the back and eliminating pain.
Connective Tissue Manipulation (CMT) is a special type of massage that focuses on increasing blood flow to tense tissues and flushing out toxins built up during their tense state. If your tissues are very tense, the massage may create a sharp sensation like a scratch. The technique creates a reflex that shoots through the tissue, releasing tension. With looser tissues and fresh blood flow, your back will be better able to heal.
Physiotherapists have the skill set to help resolve many types of back pain. If you have a disc-related back problem like sciatica, consider inquiring about the McKenzie program with a physiotherapist, and remember that the tissues around your spine will have an impact on its ability to recover. Don’t hesitate to seek out a safe, conservative solution to your back pain.