- Diseases, Disorders & Conditions
Bulging Disc Surgery - Tips To Avoid It
First lets analyze the source of the pain
Where does pain come from? Pain can only arise from the irritation of an innervated structure or from a nerve.
The nucleous pulposus of the disc is not innervated, so it cannot be the source of pain.
However, it can precipitate pain if it irritates an innervated element or a nerve root. This occurs when the nucleous bulges and imparts tension to the annular fibers (these ones are innervated) or the nerve root.
People feel it in the leg when the bulging disc irritates the sciatic nerve. This nerve goes down your leg to your toes.
If you were having symptoms in your arms, that could indicate a neck herniated/bulged disc.
Take a look at the graphic showing the pressure to the disc.
This is to schematize the following:
- When a 70 kg person lay supine, the load on the third lumbar disc is 30 kg.
- When 30 kg of traction is applied, the load on the third lumbar disc reduces to 10 kg.
Note: "...In conclusion, lumbar traction is both effective in improving symptoms
and clinical findings in patients with lumbar disc herniation and also
in decreasing the size of the herniated disc material as measured by
CT". in: Effect of continuous lumbar traction on the size of herniated disc material in lumbar disc herniation,
Bulent Ozturk et al.
- When this person is standing up, the pressure is 70 kg.
- When it is sitting down, the pressure is 100 kg
- Bilateral full straight-leg rising increases the pressure to 120 kg (exercise to avoid)
- Trunk extension when lying prone increases the pressure to 150 kg (exercise to avoid)
- Lifting a 20 kg weight with the back bent and legs straight increases the pressure to an impressive number of 340 kg
Think of these facts together with your daily routine: You probably do the following:
Wake up and seat for coffee;
Seat in your car and drive to work;
when at work you are working seated at a computer or doing manual labor that involves assuming bad postures or lifting weights;
After work you seat in your car;
When you get home you seat in a couch and the routine repeats the next day.
Bulging Disc Surgery - You can avoid it!
Given the facts above, there are many reasons for a disc to protrude, but it's much related with the compression and tensile strain the disc has suffered, lifting excess weights, bad posture, week abdominal and back muscles together with disc degeneration.
Disc degeneration occurs naturally with aging but can also be caused by chemical abnormalities in the disc. This can be derived by nutrition or hereditary factors.
In the long term, degenerative changes in the disc can cause spinal stenosis (narrowing of the spinal canal)
Disc bulging and degeneration at early ages can arise from a deficiency in production of Mucopolysaccharide. This deficiency will cause chemical abnormalities within the disc.
If you have a bulged disc the treatment will largely depend on you. If you have the will-power to learn and follow the recommendations you can avoid a bulging disc surgery.
Most of bulging discs can be treated without surgery.
How to reduce the inflammation, pain and start the healing process?
First of all, you have to reduce the pain so you can start practicing exercise and return to your routine. A little pain can be good to help analyze your posture problems.
I do not advise taking any drugs. They all have secondary effects at the stomach, liver or other levels. Also they are not very effective.
- Apply cold to your back to reduce the inflammation.
- Start doing physical therapy involving Ultrasounds; Transcutaneous electrical nerve stimulation; Massage; Hydrotherapy and Traction or Inversion Tables. Each session should last for about 2 hours.
- Rest: lay down on your back with 2 or 3 pillows underneath your knees. This will reduce the compression within the disc.
You should also use this tip to sleep. If you sleep sideways put a pillow between your legs;
- Use an inversion table if you have one. Otherwise I recommend you to buy one;
- Do not lift any weights; And learn on the proper ways lo lift them.
- Drink plenty of water. This will improve the hydration of the body, including the discs. Discs are made of 79% water in young children, and have hydrophylic properties. As time goes by, this percentage decreases. When the nucleus pulposus of the disc begins to dehydrate, it limits its ability to absorb shock. Also, the annulus fibrosus gets weaker and begins to tear which can cause chronic pain in some persons. As an indicator, try that your urine is always white. This will also prevent you to be in the same position for too long - you will have the urge to go to the bathroom;
- Take the recommended daily intake of vitamin C and minerals like magnesium. It is always better to get the necessary vitamins and mineral from food - they are better absorbed. However I recommend you to take mineral supplements. The lack of some mineral can be helping the condition.
Question: I heard about shark cartilage? My Answer: FORGET IT
- Practice swimming: This sport won't have impact to the spine and will improve your muscles. Also, in a water environment the compression to the discs will be reduced. It is important to have good core muscles - the intra-abdominal pressure absorbs part of the load, 30 % according to Morris, et al.
- Practice sports and exercises with low impact to the spin.
- Avoid those exercises that cause impact, put extra-pressure to the spine or require a lot of torque and torsion. For example, you should walk, but when you run the pressure within the discs increases. So, I don't recommend you to run in an early stage. Always use comfortable shoes, with an outer and inner sole with good impact absorption. Lifting weights while you are standing puts more pressure to discs. Golf swings involves a great torsion to the spine.
- If you have excess weight try to loose it - The excess weight is putting more pressure into the discs.
These are just some exercises that you can do - There are plenty more. Look also for: Side plank, hip bridge, bird dog (preferably with an exercise ball).
You can find more exercises following this link: Video Exercises
Remember: It is also important to know what exercises not to do. The ones mentioned at the beginning are an example.
- Don't be in the same position for long.
- Avoid being seated, and don't be seated for more than 30 minutes.
- Avoid seating at couches, and avoid using your car.
- Always try to keep the lordosis of your spine - everywhere we are told to seat straight - but is this the best way to seat? Does this type of seating maintains the lumbar lordosis? Do the poll on my other article: Spinal disc Surgery
Remember, bulging disc surgery should only be used as a last option, when everything else has failed over a period of 6 months.
Always look for minimal invasive treatments like Nucleoplasty (or Percutaneous Discectomy). This procedure just uses a sort of needle that penetrates the disk and emits radio waves that break up the material in the nucleus: This will decrease the amount of nucleus material putting pressure on the bulging disc wall and sciatic nerve.The success rate of the procedure is 75%-80%. The risks (infection) are negligent. Any open surgery is more prone to infection than this one. You go home the same or the next day.