by Nicolas King

 

Lumbar disc bulge? 3 simple exercises to self-treat:

A disc bulge/protrusion is where the outer layers of the fibrous concentric rings of the lumbar disc have been damaged. A weakness of the fibrous layers can allow the inner gel like material of the disc to push out and distort or deform the shape of the disc, forming a “bulge”. This becomes a problem if the disc bulge pushes on a nerve root as it exits the vertebral column. When this happens inflammation builds up around the nerve. This can cause pain to refer into the leg or foot. In severe cases muscle strength decreases and skin sensation dulls considerably.

The goal for self-treatment of your disc problem is to shift the bulging disc material away from the nerve root. This will help by relieving the pressure on the nerve and hopefully relieve your radiating leg pain. Pain shooting down your leg is called pain peripheralization. If the pain stays close to the spine rather than running down your leg, it is called pain centralization.

The goal is to centralise your peripheral pain.

When you centralise pain, you relieve pressure on the nerve and decrease your pain intensity.

If any of the following exercises cause your pain to worsen and peripheralize down your leg- then the exercises must be discontinued. Do not push beyond the limit of your pain tolerance.

  1. Prone lumbar spine push up:

Laying on your stomach with your face down, bring your elbows under your shoulders with your forearms in front of you. Stay in this position for 10-20sec. Proceed to straighten the arms bringing your lumbar spine into an extended position. Contract your buttocks to stabilise the lower lumbar spine. Make sure you keep your hips on the ground. Gently lower yourself onto your elbows. Repeat this push up 10 times. If this exercise is too much for you, then you can simply lay face down, letting your stomach fall into the floor with each deep breath.               (as shown below)

Prone Push up exercise:

         

  1. Correcting lateral lean:

Below: A common disc presentation, leaning away from the disc bulge:

It is common for persons with disc injury to have a lateral lean away from the sight of the pain. If you have pain down the left leg and are leaning to the right, stand one shoulder width away from a wall with your right shoulder closest to the wall. Lean your right shoulder against the wall. Hold your left side of your pelvis with your left hand and proceed to push your pelvis to the right until it contacts the wall. Gently move your pelvis away from the wall. Repeat 10 times. If any pain starts to shoot down the leg do not push into the pain, discontinue immediately.

  

Above: Side Wall Exercise

  1. Standing back extensions:

This is a great exercise to do if you need a break from computer work. Stand with your feet hip- width apart. Place your fingers and palms of the hands over your sacrum and pelvis (in the small of your back). This is to support the pelvis. Proceed to extend backwards in a fluid, controlled manner. Do not extend to, or past the point that causes leg pain referral. Some pain and discomfort in the lumbar spine is expected and is normal. Perform 5 times.

                

Above: Lumbar extensions:

Movements and positions to avoid:

1. Sitting for long periods. For those of you who do computer work it is important to place a rolled-up tea towel or bolster, placed behind your lumbar spine to support and encourage an extended lumbar curve.hg

  

Above: Very few people can maintain good upright sitting posture all the time. A rolled towel reminds and encourages good posture.

2. Avoid bending forward with flexion of the lumbar spine. If you need to lift an object from a low position you must widen your feet, wide and maintain a straight lumbar spine, while limiting forward flexion. Bend the hips to lift.

3. Change standing and sitting position regularly. Do not maintain a seated or standing position for long periods of time.

4. Move – walking will help to push inflammation away from the nerve and out of muscles, reducing your pain and helping the body to heal.

5. Getting out of bed. If you are laying on your back slide your body close to the edge of your bed. Roll onto your shoulder. Lift your knees into a 90 degree angle. Push yourself up to a seated position while keeping your feet and knees together. As your body comes up your feet should gently see-saw to the floor. Do not flex or twist the Lumbar spine. Sit upright in bed before stepping out of bed.

If you are laying on your stomach, move to the edge of the bed. Let your leg (closest to the edge) down onto the floor. Slightly extend the lumbar spine. Maintain this position as you push up under your shoulders. Simultaneously your right leg slides off the bed. Make sure to maintain the extension in your lumbar spine.

         

Above: Getting out of bed from laying on stomach using the straight leg and back technique.

If you have any questions regarding the exercises or require further assessment (some disc bulges need supervised recommendations) give us a call. Hopefully this helps!