Frequently Asked Questions

Q. What are common causes of back pain?

For something that seems so simple, your back is quite a complicated structure. The main components are the vertebrae which are the bones, the discs which lie between the bones and act as "shock absorbers", the joints on both the right and left side which connect the bones at the back, and the muscles and ligaments which run from the base of your skull to your buttocks. All of these components have nerve endings which can send pain signals to your brain if something goes wrong. Most people talk about having "a disc problem" or "arthritis of the joints", or a "pulled muscle". In reality, all the components work together, and none can be injured without at least some damage to all the others. It follows that any solution that just deals with one component will not solve the problem, and will likely just be a quick fix.

Q. How do disc injuries cause back pain?

Discs have the least amount of innervation of all the components, but they do have some important nerves that can really act up if the disc is torn. Disc injuries really cause pain because of the pressure they put on the surrounding muscles and ligaments, triggering the body's healing mechanism (called inflammation). This can lead to abnormal muscle firing and bad habits during movement that may remain long after the disc injury has healed. If these bad movement patterns are not treated, years of back pain and further injury are the likely result.

Q. What is the difference between a herniated disc and a bulging disc?

A bulging disc is basically intact, but sticks out more then it should at the side. A herniated disc has an actual tear in the side wall, and some of the softer inside filling has been squeezed out to where it's not supposed to be. This can really irritate the surrounding tissue and cause lots of inflammation.

Q. Is it true that a bulging disc can be normal?

Yes! Most people are walking around with bulging discs all the time! If they were in an MRI machine, their test would come back as "positive". They do not need surgery for this! There is some debate whether bulging discs even cause pain-certainly not in everyone, maybe in some people only. At the worst, you can only say that bulging discs may be a sign of weak or uncoordinated back muscles and poor movement patterns that put a strain on the discs over a long time.

Q. What are the symptoms of a herniated disc?

A herniated disc often causes a severe, sharp pain that may feel like something ripping when the tear in the disc actually occurs. A typical scenario is lifting something moderately heavy out of the trunk of your car. It should feel better when lying down, and may flare up with standing, walking, bending or even sitting. There may be leg pain, or just back pain. An X-ray may not show it, but a CT scan or MRI should.

Q. How did I herniate my disc?

A herniated disc usually comes from years of improper loading from poor lifting habits, poor muscle tone and coordination, and probably poor nutrition with too much body inflammation.

Q. What is the treatment for herniated discs?

Most herniated discs settle down with time. Reducing the local inflammation can help. Gentle exercises and gradually increasing activity is better then extensive bed rest.

Q. What is degenerative disc disease?

Also known by it's short form "DDD", this is a condition secondary to longstanding wear and tear of the back. The discs may not have their original shape or ability to absorb the shocks of day to day life. There may be bone spurs coming from the vertebrae, which combined with small disc herniations over the years, are called "osteocartilaginous bars". These may start to push towards the spinal cord or irritate the nerves exiting the cord and running down your legs, causing sciatica. Unfortunately, by the time most people notice something wrong with their back, this is what we find. Much of this damage is not reversible. However, with a good strengthening and conditioning program, along with some simple lifestyle changes, this condition does not have to progress. More importantly, the pain from DDD can be significantly reduced. Even people with MRI's that show significant damage don't have to live in severe pain, they can live relatively normal lives with some simple treatment and lifestyle advice.