THE SPINE SHRINE

(An Understanding of the Core Stability Concept)

Spine disorders, commonly referred to as ‘Slipped Disc’ are also known by many other names such as Disc Herniation or Intervertebral Disc Prolapse.

1. The Slipped Disc

The vertebral disc in the spine is a unique structure. Its primary purpose is to act as a shock absorber between adjacent vertebrae. Spinal discs also act as ligaments that hold the vertebrae of the spine together and as cartilaginous joints that allow for slight mobility in the spine. There are a total of twenty-three vertebral discs in the spinal column. Specific problems with any of these discs may prompt different symptoms.

Slipped disc most commonly occurs at the C5-6, C6-7 levels in the cervical spine and L4-5, L5-S1 levels in the lumbar spine—the vertebrae that carry most of the body’s weight. Individuals in the age group 30-50 years are especially susceptible because the elasticity and water content of the disc decreases with age.

Evaluation by a clinical therapist is essential to identify and educate patients about the hidden risk factors in their lifestyles and to guide them in terms of the necessary precautions to be taken, in order to stay pain-free.

2. Pain Management

The first thing to remember in the case of slipped disc is that after the initial 2-3 days of rest in cases of severe pain, it is very important to get back on your feet as soon as possible and keep active. Bed rest for a prolonged period is likely cause weakening of muscles, actually leading to worsening of symptoms. Thus, it is important to start moving around as soon as possible. This will help keep the back mobile and speed the process of recovery.

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There are four stages of disc herniation based on the extent of degeneration:

• Disc Bulging or Protrusion• Prolapse• Extrusion• Sequestration

3. The Most Common Cause of Slipped Disc:

A Collapsed “CORE SYSTEM”

A spine with a weak core system A spine with a strong core system

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DID YOU KNOW!!!Prolonged sitting causes mechanical stress on the spine, leading to general

deconditioning of the muscles (Beware of this because this is the most common reason for slipped disc than lifting up 100 pounds of weight)!!!

4. Symptoms:

Symptoms vary depending on the position and the size of the herniation.

• Pain in the Lower Back (may vary from mild to moderate to severe)• Pain, numbness, tingling sensation which may radiate to the thighs, legs or foot, known commonly by the name Sciatica and may increase on bending forward, straining, sitting, sneezing, coughing. • Weakness in the leg and/or foot.

5. Diagnosis:

• Physical examination, including special tests carried by a trained physical therapist• History of pain• MRI/ X-Rays• EMG and Nerve Conduction Velocity

6. Assessment & Examination:

A thorough assessment of the spine is required to identify the level of prolapse.

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Where is the Pain?

Lumbar Region (Radiating to front and inner thigh) – Suggestive of L4 nerve root involvement

Lumbar, Groin, Sacroiliac Region (Radiating to outer thigh, leg, foot) – Suggestive of L5 nerve involvement

Lumbar, Groin, Sacroiliac Region (Radiating to hips, back of thigh, outer foot) – Suggestive of S1 root involvement

CONVENTIONAL Management:I. Rest/ Movement:a. Intradiscal pressure is the lowest when lying sideways. Hence rest is advised in case of acute back pain.b. Lying down with the hips and knees bent reduces the stress on the back. c. 3 weeks bed rest following slipped disc is now considered old practice as muscles start to weaken and symptoms may worsen and the CORE SYTEM may COLLAPSE.

II. Electrotherapya. Cold pack in the initial daysb. Superficial or Deep Heat may be given later

III. Clinical Evidence: Research based IFT programs

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Key Points on Treating the Pain:

Staying active is better than lying in bed for a long time Having your spine manipulated by a therapist can help treat pain

caused by a slipped disc Taking painkillers may give symptomatic relief

Surgery can repair the damage but it’s worth waiting a while as it can be treated conservatively as well

Did you know???

Physical activity has been scientifically proven to have a preventive effect – and it is probably the most important thing

you can do to help yourself.

IIII. Mobilizationa. Pelvic alignmentb. McKenzie Techniquec. This helps correct the vertebral malalignment.

V. Kinesio taping for relieving Pressure from the discs

7. THE LATEST CONCEPT OF BACKACHE TREATMENT (THE CORE STABILITY): It is the mantra behind a “healthy back and a healthy recovery”.

a. Strengthening Exercisesi. Core Strengthening (the fast track rehabilitation of the spine): The best SPINE-SPECIALISTS will work on the core system of the body.

b. Lower Limb Strengthening

c. Stretching Exercisesi. Lumbar Stabilization Exercises (understand the core concept)

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Functionality is completely dependent upon the support provided by the small guy wires which represent the core muscles. This figure helps explain the importance of the core muscles. As seen above, a good balance between the abdominal and spinal muscles is required to maintain the spine erect.

There is reason why the words ‘back-breaking’ or ‘a broken back’ are synonymous with an extreme sense of helplessness or being crippled with pain. The spine is what props up and supports us—both actually and figuratively. And so, the absolute necessity of taking care of the spine can never be overemphasized. It is rightly said, “Treat your spine like a shrine”.

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Note: - Please consult your physiotherapist before following the aforementioned measures.

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PHYWORLD

Dr. Vandana’s Physical Therapy & Fitness Clinics

Address

4, North Avenue, Punjabi Bagh (West), New Delhi – 110026

C-3, Defence Colony, New Delhi- 110024

Mobile No:

+ (91) - 9910088152, 011- 25225527

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