Lower back pain: One essential exercise to help heal a disc bulge

 Have you ever thought about how hard your spine has to work? It allows you to stand and bend. It enables you to walk and move around. In fact, it’s integral to almost every movement you do. And if you suffer with any degree of pain in your spine, you’ll know it can be really quite debilitating, impacting on large parts of everyday life.

Unfortunately, as we age, our spine starts to degenerate and weaken, leading to ‘wear and tear’ of its various parts. In today’s tutorial I want to talk about one such issue that can crop up, the bulging or herniated disc, as well as exercises I advise (and don’t advise!) you to do to aid recovery.

What are spinal discs?

Your spine is made up of 33 vertebrae which are split into five different categories, or types, depending on where they sit and how they behave. The lowest nine, around the tailbone or sacrum, are fused together, however the remainder, from the lumbar region upwards are separated by spinal discs. These discs have a hard, fibrous wall, or annulus, encasing the jelly-like nucleus pulposus inside. Ultimately, they’re best described as shock absorbers, or cushions, reducing the impact of movement on the vertebrae themselves.

What is a disc bulge?

The problem comes when there is damage or weakening of the outer wall of a disc that allows the nucleus pulposus to move beyond its normal position. If the outer layers of the annulus are still intact and the nucleus is still contained within the disc, this is termed a bulging disc. While if the annulus is weakened to the point that fluid can escape, this is known as a herniated disc.

And while a bulging disc can lead to discomfort, it’s the further deterioration of this that can cause real pain, as the nucleus is able to break through the wall and touch a nerve.

While bulging and herniated discs often occur due to the aging process, this is not always the cause. Extended periods of exercise can also result in problems.

Can a bulging disc heal on its own?

The good news is that a bulging disc can heal naturally over time, with the majority shrinking over the course of two years leading to a reduction in symptoms. The migrating fluid from the inside of the disc can start to move back to position, taking the pressure off the nerve and relieving the pain.

This can happen thanks to the liquid that has moved out of position being dehydrated or potentially reabsorbed and is aided by our immune response. I share more information about this during the video tutorial above.

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How to speed up healing of a bulging disc?

If you’ve been looking around for exercises to do to relieve a bulging disc, you may have been told to try the McKenzie Approach, or the floppy push up. Essentially this is a case of laying on your stomach on the floor and then using your hands to lift your chest up. It extends the spine and causes the back of the vertebrae to be compressed together, driving material forward and creating a vacuum.

Taking information from Lower Back Pain by Dr Stuart McGill – probably the leading expert in this field – my advice is that this method can often cause more issues than it helps. It has been shown during studies that the McKenzie Approach works in people who have 70% of disc height remaining, which means for those where degeneration has already started to occur, it will not be as effective.

There’s also the potential for facet joint damage – that’s the joint between two vertebrae - due to the movement involved in the exercise. Not to mention the fact that the repetition involved can increase disc deterioration.

So I’m not saying no value to exercise, just an understanding that while it may help move disc material back to centre of the disc, there are drawbacks and potential limitations to it.

So what’s the answer?

There is a more effective approach to this, which I demonstrate in the video.

It still involves laying with hips, knees and feet on the floor, but it reduces the extension of the spine and also removes the dynamic nature of the exercise. Instead we are just allowing gravity to do its thing, encouraging the disc material to move back to the centre.

Place one fist on floor with your chin on and then for a little bit more extension add your second fist on top of the first. You will still be getting a compression on the posterior part of the vertebrae and of the disc but less, so not affecting the facet joint as much.

This is a valuable exercise that uses the same principles and essentially the same exercise but modifies it to reduce the more risky elements that may increase disc deterioration and damage to joints.

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